Dept of Internal Medicine Thursday, 06 Aug 2020

Pneumomediastinum in COVID-19 patients: a case series of a rare complication Pneumomediastinum is a rare clinical finding, but one which can be the source of significant concern for clinicians. By presenting 3 such cases, we highlight that pneumomediastinum can complicate the course of a severe coronavirus disease 2019 infection but emphasize that conservative management is the first-line method of treatment, with gradual resorption of the air from the tissues. It is important to be alert to the development of pneumothorax, which will require drainage.

Patient 1

A 52-year-old male with a past medical history of diabetes and asthma, was admitted with dyspnoea, fever and cough. Blood gas levels on admission revealed type-1 respiratory failure and he was placed on non-invasive ventilation with continuous positive air- way pressure (CPAP) (PEEP of 5 FiO2 0.5). His chest radiograph (CXR) on admission demonstrated bilateral mid-zone and basal ground glass opacification typical of moderately severe COVID-19 pneumonia. Article here

AFMC 1

More businesses in India re-open even as COVID-19 cases surge

India reported on Wednesday 52,509 new cases over the novel coronavirus, taking its tally of infections to more than 1.91 million, nevertheless authorities eased restrictions aimed at limiting its spread. More here COVID-19: Gyms, yoga institutes re-open today. Is it safe to go during coronavirus pandemic?

Starting today, India has opened the gymnasiums and yoga institutes for enthusiasts after more than four months. More here COVID-19 treatment could impact patients psychologically Scientists, in newer studies, have now discovered that another illness and symptom could ail COVID-19 survivors- psychological delusions and impairment. More here

COVID 19 BULLETIN News | Research | Developments

Dept of Internal Medicine Thursday, 06 Aug 2020

Safety of intravenous Anakinra in COVID-19 with evidence of hyperinflammation, a case series All four patients showed evidence of deterioration with hyperferritinaemia, and increasing oxygen requirements, with supra-added bacterial infections. Upon commencement of intravenous anakinra, there was subsequent improvement in the patients clinically with reducing ventilatory support and inotropic support, and biochemically,

with rapid improvement in inflammatory markers. Article here.

Engineering human ACE2 to optimize binding to the spike protein of SARS coronavirus 2 Combining mutations gives ACE2 variants with affinities that rival monoclonal antibodies. A stable dimeric variant shows potent SARS-CoV-2 and -1 neutralization in vitro. The engineered receptor is catalytically active and its close similarity with the native receptor may limit the potential for viral escape. Article here

AFMC 2

Do You Want to Be a Vaccine Volunteer?

Maybe you are an altruist looking for a way to help fight the coronavirus. Maybe you are hoping to be among the first to try an experimental vaccine. Or maybe you are just bored or could use a few hundred dollars. Whatever your reasons, scientists, bioethicists and current volunteers say participating in a vaccine trial can be meaningful. And without hundreds of thousands of volunteers, there will be no vaccine for anyone. But you may be surprised by the commitment and risks that a trial entails. Here’s what you need to know. How do I find a trial? A number of sites maintain lists of coronavirus vaccine trials. The Covid-19 Prevention Network site, created by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, helps connect volunteers to Phase 3 studies. Right now, for example, Moderna is looking to enroll around 30,000 volunteers. ClinicalTrials.gov also lists Covid-19 vaccine studies at different phases. What do these different phases mean? There are three primary phases of a vaccine trial. A Phase 1 trial is focused on safety. More here