Coronavirus (COVID-19) Research

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jimmylegs
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Re: Coronavirus (COVID-19): What You Need To Know

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The United Kingdom Multiple Sclerosis Register Covid-19 Substudy (UKMSRCV19) (April 21)
https://clinicaltrials.gov/ct2/show/NCT ... w=2&rank=1

Detailed Description:

Study objectives

To identify the incidence of upper respiratory tract symptoms: fever, cough and breathing difficulties, other symptoms suggestive of COVID-19 infection, respiratory tract infections suggestive of COVID-19, and COVID-19 confirmed by laboratory testing among the UK MS population
To establish if some DMDs increase the risk of COVID-19 infection
To determine the incidence and effectiveness of self-isolation in the MS population. To examine the impact self-isolation has on mood, fatigue, and other routinely collected patient reported outcome measures from the MS Register.
To determine the clinical outcome of respiratory tract infections, including confirmed and suspected cases of COVID-19, in terms of symptoms, time to recovery, hospital admission, requirement for ventilation, and death.
To determine the longer-term impact of COVID-19 on MS, using routinely collected MS outcomes in the MS register, including impact on disability, relapses and changes in DMDs as assessed at 3 monthly intervals.
To determine where people are obtaining their health information during the COVID-19 outbreak.
To establish changes in DMDs prior to and as a result of symptoms related and unrelated to COVID-19

Study Design
Study Type : Observational [Patient Registry]
Estimated Enrollment : 3000 participants
Observational Model: Cohort
Time Perspective: Prospective
Target Follow-Up Duration: 1 Year
Official Title: The UK MS Regsiter COVID-19 Substudy
Actual Study Start Date : March 14, 2020
Estimated Primary Completion Date : July 14, 2021
Estimated Study Completion Date : July 14, 2022

Epidemiological Characteristics of Coronavirus Infection (SARS-CoV-2) in Patients With MS or NMO (COVISEP) (April 21)
https://clinicaltrials.gov/ct2/show/NCT ... w=2&rank=2

Detailed Description:
There are currently no data on the consequences of coronavirus infection in patients with Multiple Sclerosis (MS) or NeuroMyelitis Optica (NMO) spectrum disorder. Numerous questions have emerged regarding the management of immunoactive therapy in the case of infection or suspected infection related to the SARS-CoV-2 virus. Currently, the recommendations issued by the French MS Society are to maintain the disease modifying therapies (DMT) for MS and NMO, but a case-by-case discussion with the expert neurologist for suspected or confirmed COVID+ patients remain highly recommended. Besides DMT, neurological disability could also be a risk factor for severe infection, regardless of the age of the patient.

It is therefore essential to have epidemiological data to describe the characteristics of the clinical expression of coronavirus infection (Covid-19) and factors enhancing the occurrence of severe forms in patients with MS or NMO during of the 2020 pandemic.

This study involves all hospital and neurologists ensuring the follow-up of patients with MS and NMO via the 23 CRC-SEP and associated hospital centers. This multicenter study is based on an already functional network organization, grouping together around forty hospital centers, participating either in the French MS registry (OFSEP), or in the French MS Society (SFSEP). It also benefits from the support of the French clinical research network (FCRIN) through the thematic clinical research network on MS and related diseases (FCRIN4MS). Each day, participating centers will enter data from MS or NMO patients newly tested positive for SARS-CoV-2 or strongly suspected to be diagnosed with COVID-19 using a specific computerized record (CRF Redcap).

Study Design
Study Type : Observational
Estimated Enrollment : 2000 participants
Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Cohort Study Evaluating the Epidemiological Characteristics of Coronavirus Infection (SARS-CoV-2) in Patients With MS or NMO
Estimated Study Start Date : April 20, 2020
Estimated Primary Completion Date : April 20, 2022
Estimated Study Completion Date : April 20, 2022
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Re: Coronavirus (COVID-19) News

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NIH Panel Recommends Against Drug Combination Trump Has Promoted For COVID-19

https://www.npr.org/sections/coronaviru ... r-covid-19

A panel of experts convened by the National Institute of Allergy and Infectious Diseases recommends against doctors using a combination of hydroxychloroquine and azithromycin for the treatment of COVID-19 patients because of potential toxicities.

"The combination of hydroxychloroquine and azithromycin was associated with QTc prolongation in patients with COVID-19," the panel said.

QTc prolongation increases the risk of sudden cardiac death.

Hydroxychloroquine prescribing information.
https://www.drugs.com/pro/hydroxychloro ... blets.html
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Re: Coronavirus (COVID-19): What You Need To Know

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I thought I should remind anybody out there who's worried about use of soap in the lungs because the lungs need surfactant, that incredible as it may seem, soap is a very effective surfactant, as anyone who has mixed distilled water with a small quantity of Dawn detergent in order to clean 78 RPM records, knows...
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Re: Coronavirus (COVID-19) News

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Young and middle-aged people, barely sick with covid-19, are dying from strokes
Doctors sound alarm about patients in their 30s and 40s left debilitated or dead. Some didn’t even know they were infected.

https://www.washingtonpost.com/health/2 ... -patients/

Thomas Oxley wasn’t even on call the day he received the page to come to Mount Sinai Beth Israel Hospital in Manhattan. There weren’t enough doctors to treat all the emergency stroke patients, and he was needed in the operating room.

The patient’s chart appeared unremarkable at first glance. He took no medications and had no history of chronic conditions. He had been feeling fine, hanging out at home during the lockdown like the rest of the country, when suddenly, he had trouble talking and moving the right side of his body. Imaging showed a large blockage on the left side of his head.

Oxley gasped when he got to the patient’s age and covid-19 status: 44, positive.

The man was among several recent stroke patients in their 30s to 40s who were all infected with the coronavirus. The median age for that type of severe stroke is 74.

As Oxley, an interventional neurologist, began the procedure to remove the clot, he observed something he had never seen before. On the monitors, the brain typically shows up as a tangle of black squiggles — “like a can of spaghetti,” he said — that provide a map of blood vessels. A clot shows up as a blank spot. As he used a needlelike device to pull out the clot, he saw new clots forming in real-time around it.

“This is crazy,” he remembers telling his boss.
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Re: Coronavirus (COVID-19): What You Need To Know

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NHE wrote: Fri Apr 24, 2020 11:20 pm Young and middle-aged people, barely sick with covid-19, are dying from strokes
Doctors sound alarm about patients in their 30s and 40s left debilitated or dead. Some didn’t even know they were infected.

https://www.washingtonpost.com/health/2 ... -patients/

Thomas Oxley wasn’t even on call the day he received the page to come to Mount Sinai Beth Israel Hospital in Manhattan. There weren’t enough doctors to treat all the emergency stroke patients, and he was needed in the operating room.

The patient’s chart appeared unremarkable at first glance. He took no medications and had no history of chronic conditions. He had been feeling fine, hanging out at home during the lockdown like the rest of the country, when suddenly, he had trouble talking and moving the right side of his body. Imaging showed a large blockage on the left side of his head.

Oxley gasped when he got to the patient’s age and covid-19 status: 44, positive.

The man was among several recent stroke patients in their 30s to 40s who were all infected with the coronavirus. The median age for that type of severe stroke is 74.

As Oxley, an interventional neurologist, began the procedure to remove the clot, he observed something he had never seen before. On the monitors, the brain typically shows up as a tangle of black squiggles — “like a can of spaghetti,” he said — that provide a map of blood vessels. A clot shows up as a blank spot. As he used a needlelike device to pull out the clot, he saw new clots forming in real-time around it.

“This is crazy,” he remembers telling his boss.
The lungs of COVID 19 patients are damaged even before symptoms appear. Since symptoms appear only 5 days after infection, use of the pulse oximeter will signal need for early treatment. See following: (Violin sent me this letter.)

'Silent Hypoxia' Is Making Some Coronavirus Patients Critically Ill—Here's Why It's So Dangerous

https://www.health.com/condition/infect ... nt-hypoxia

Some of the coronavirus patients Dr. Levitan saw with pneumonia had blood oxygen saturation levels as low as 50%, proving how “silent” silent hypoxia really is.

The infection that’s silently killing Coronavirus patients I have been practicing emergency medicine for 30 years. In 1994 I invented an imaging system for teaching intubation, the procedure of inserting breathing tubes. This led me to perform research into this procedure, and subsequently teach airway procedure courses to physicians worldwide for the last two decades. So at the end of March, as a crush of Covid-19 patients began overwhelming hospitals in New York City, I volunteered to spend 10 days at Bellevue, helping at the hospital where I trained. Over those days, I realized that we are not detecting the deadly pneumonia the virus causes early enough and that we could be doing more to keep patients off ventilators — and alive. On the long drive to New York from my home in New Hampshire, I called my friend Nick Caputo, an emergency physician in the Bronx, who was already in the thick of it. I wanted to know what I was facing, how to stay safe and about his insights into airway management with this disease. “Rich,” he said, “it’s like nothing I’ve ever seen before.” He was right. Pneumonia caused by the coronavirus has had a stunning impact on the city’s hospital system. Normally an E.R. has a mix of patients with conditions ranging from the serious, such as heart attacks, strokes and traumatic injuries, to the nonlifethreatening, such as minor lacerations, intoxication, orthopedic injuries and migraine headaches. During my recent time at Bellevue, though, almost all the E.R. patients had Covid pneumonia. Within the first hour of my first shift I inserted breathing tubes into two patients. Even patients without respiratory complaints had Covid pneumonia. The patient stabbed in the shoulder, whom we X-rayed because we worried he had a collapsed lung, actually had Covid pneumonia. In patients on whom we did CT scans because they were injured in falls, we coincidentally found Covid pneumonia. Elderly patients who had passed out for unknown reasons and a number of diabetic patients were found to have it. And here is what really surprised us: These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. How could this be? We are just beginning to recognize that Covid pneumonia initially causes a form of oxygen deprivation we call “silent hypoxia” — “silent” because of its insidious, hard-to-detect nature. Pneumonia is an infection of the lungs in which the air sacs fill with fluid or pus. Normally, patients develop chest discomfort, pain with breathing and other breathing problems. But when Covid pneumonia first strikes, patients don’t feel short of breath, even as their oxygen levels fall. And by the time they do, they have alarmingly low oxygen levels and moderate-to-severe pneumonia (as seen on chest X-rays). Normal oxygen saturation for most persons at sea level is 94 percent to 100 percent; Covid pneumonia patients I saw had oxygen saturations as low as 50 percent. To my amazement, most patients I saw said they had been sick for a week or so with fever, cough, upset stomach and fatigue, but they only became short of breath the day they came to the hospital. Their pneumonia had clearly been going on for days, but by the time they felt they had to go to the hospital, they were often already in critical condition. In emergency departments we insert breathing tubes in critically ill patients for a variety of reasons. In my 30 years of practice, however, most patients requiring emergency intubation are in shock, have altered mental status or are grunting to breathe. Patients requiring intubation because of acute hypoxia are often unconscious or using every muscle they can to take a breath. They are in extreme duress. Covid pneumonia cases are very different. A vast majority of Covid pneumonia patients I met had remarkably low oxygen saturations at triage — seemingly incompatible with life — but they were using their cellphones as we put them on monitors. Although breathing fast, they had relatively minimal apparent distress, despite dangerously low oxygen levels and terrible pneumonia on chest X-rays. We are only just beginning to understand why this is so. The coronavirus attacks lung cells that make surfactant. This substance helps the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from Covid pneumonia starts, it causes the air sacs to collapse, and oxygen levels fall. Yet the lungs initially remain “compliant,” not yet stiff or heavy with fluid. This means patients can still expel carbon dioxide — and without a buildup of carbon dioxide, patients do not feel short of breath. Patients compensate for the low oxygen
Patients compensate for the low oxygen in their blood by breathing faster and deeper — and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder. Twenty percent of Covid pneumonia patients then go on to a second and deadlier phase of lung injury. Fluid builds up and the lungs become stiff, carbon dioxide rises, and patients develop acute respiratory failure. By the time patients have noticeable trouble breathing and present to the hospital with dangerously low oxygen levels, many will ultimately require a ventilator. Silent hypoxia progressing rapidly to respiratory failure explains cases of Covid-19 patients dying suddenly after not feeling short of breath. (It appears that most Covid-19 patients experience relatively mild symptoms and get over the illness in a week or two without treatment.) A major reason this pandemic is straining our health system is the alarming severity of lung injury patients have when they arrive in emergency rooms. Covid-19 overwhelmingly kills through the lungs. And because so many patients are not going to the hospital until their pneumonia is already well advanced, many wind up on ventilators, causing shortages of the machines. And once on ventilators, many die. Avoiding the use of a ventilator is a huge win for both patient and the health care system. The resources needed for patients on ventilators are staggering. Vented patients require multiple sedatives so that they don’t buck the vent or accidentally remove their breathing tubes; they need intravenous and arterial lines, IV medicines and IV pumps. In addition to a tube in the trachea, they have tubes in their stomach and bladder. Teams of people are required to move each patient, turning them on their stomach and then their back, twice a day to improve lung function. There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter. Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates. Pulse oximeters helped save the lives of two emergency physicians I know, alerting them early on to the need for treatment. When they noticed their oxygen levels declining, both went to the hospital and recovered (though one waited longer and required more treatment). Detection of hypoxia, early treatment and close monitoring apparently also worked for Boris Johnson, the British prime minister. Widespread pulse oximetry screening for Covid pneumonia — whether people check themselves on home devices or go to clinics or doctors’ offices — could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia. People using the devices at home would want to consult with their doctors to reduce the number of people who come to the E.R. unnecessarily because they misinterpret their device. There also may be some patients who have unrecognized chronic lung problems and have borderline or slightly low oxygen saturations unrelated to Covid-19. All patients who have tested positive for the coronavirus should have pulse oximetry monitoring for two weeks, the period during which Covid pneumonia typically develops. All persons with cough, fatigue and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70 percent accurate. A vast majority of Americans who have been exposed to the virus don’t know it. There are other things we can do as well to avoid immediately resorting to intubation and a ventilator. Patient positioning maneuvers (having patients lie on their stomach and sides) opens up the lower and posterior lungs most affected in Covid pneumonia. Oxygenation and positioning helped patients breathe easier and seemed to prevent progression of the disease in many cases. In a preliminary study by Dr. Caputo, this strategy helped keep three out of four patients with advanced Covid pneumonia from needing a ventilator in the first 24 hours. To date, Covid-19 has killed more than 40,600 people nationwide — more than 10,000 in New York State alone. Oximeters are not 100 percent accurate, and they are not a panacea. There will be deaths and bad outcomes that are not preventable. We don’t fully understand why certain patients get so sick, or why some go on to develop multiorgan failure. Many elderly people, already weak with chronic illness, and those with underlying lung disease do very poorly with Covid pneumonia, despite aggressive treatment. But we can do better. Right now, many emergency rooms are either being crushed by this one disease or waiting for it to hit. We must direct resources to identifying and treating the initial phase of Covid pneumonia earlier by screening for silent hypoxia. It’s time to get ahead of this virus instead of chasing it. Richard Levitan, an emergency physician in Littleton, N.H., is president of Airway Cam Technologies, a company that teaches courses in intubation and airway management.
Dr. Levitan believes pulse oximeters are the way forward when it comes to detecting and treating the coronavirus. “Widespread pulse oximetry screening for COVID pneumonia—whether people check themselves on home devices or go to clinics or doctors’ offices—could provide an early warning system for the kinds of breathing problems associated with COVID pneumonia,” he wrote.
He added that all patients who test positive for the coronavirus should have pulse oximetry monitoring for two weeks, as this is the period during which COVID pneumonia typically develops.
“All persons with cough, fatigue, and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70% accurate,” wrote Dr. Levitan. “A vast majority of Americans who have been exposed to the virus don’t know it.”


Best regards, Vesta.
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Re: Coronavirus (COVID-19) News

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Antiviral Drug Remdesivir Shows Promise For Treating Coronavirus In NIH Study

https://www.npr.org/sections/health-sho ... -nih-study

Preliminary results of a major study of the antiviral drug remdesivir show it can help hospitalized patients with COVID-19 recover faster. Dr. Anthony Fauci hailed the findings, released Wednesday, as "quite good news."

"The data shows that remdesivir has a clear-cut, significant, positive effect in diminishing the time to recovery," Fauci said during a meeting with President Trump and Louisiana Gov. John Bel Edwards. "This is highly significant."

The study was sponsored by the National Institute of Allergy and Infectious Diseases, which Fauci leads and is part of the National Institutes of Health.

Fauci said it was the first "truly high powered" randomized placebo-controlled trial of remdesivir, noting that it involved more than 1,000 hospitalized patients at sites in numerous countries. Another randomized controlled trial in China, with results that were also announced Wednesday, was far smaller.

The NIH trial of the antiviral, which is made by Gilead Sciences, began on Feb. 21. The preliminary study results are not yet published in a peer-reviewed trial, but NIH released the results after an analysis by the data safety monitoring board overseeing the trial. Fauci said the results were announced because of the ethical responsibility to allow the placebo group to access remdesivir, since there is now clear evidence that the drug works.

The analysis found that remdesivir shortened the time it took a hospitalized COVID-19 patient to recover, compared with a placebo. The study defined "recovery" as being well enough to be discharged from the hospital or returning to normal activity.

The preliminary results found that patients who received remdesivir recovered 31% faster — the median time to recovery was 11 days rather than 15 days. The results also suggest a slightly lower mortality rate for the group receiving remdesivir, but until the complete data are analyzed, it's not certain if that effect is significant.

Fauci said that while 31% may not seem like a huge deal, "it is a very important proof of concept. Because what it has proven is that a drug can block this virus."
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Re: Coronavirus (COVID-19): What You Need To Know

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interesting re the sensory losses mentioned towards the end...

Mom with Multiple Sclerosis Overcomes COVID-19 at Home (Apr 29)
https://my.clevelandclinic.org/patient- ... 19-at-home
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Re: Coronavirus (COVID-19): What You Need To Know

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An Italian programme for COVID-19 infection in multiple sclerosis (April 30)
https://www.thelancet.com/journals/lane ... 2/fulltext

"...The severity of COVID-19 infection in 232 patients was classified as mild ... in 223 (96%), severe ... in four (2%), and critical ... in six (3%).2 Of the six critical patients, one recovered and five died; all had a positive swab (appendix p 2). 21 patients had undergone a 5-day course of methylprednisolone within 3 months before the onset of COVID-19.
These results appear to be slightly reassuring and do not seem to contradict guidelines that we and others had already issued on the management of multiple sclerosis treatments in the time of the COVID-19 pandemic. These data must be considered only preliminary, however, and there is not enough information to speculate about any susceptibility to [or] protection from COVID-19 afforded by disease-modifying therapies. The same is true for the effect of comorbidities, sex, and other medications (beyond just the disease-modifying therapies) that patients with multiple sclerosis might be taking..."
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Re: Coronavirus (COVID-19) News

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Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19
https://www.medrxiv.org/content/10.1101 ... 20065920v2

BACKGROUND: Despite limited and conflicting data on the use of hydroxychloroquine in patients with Covid-19, the U.S. Food and Drug Administration has authorized the emergency use of this drug when clinical trials are unavailable or infeasible. Hydroxychloroquine, alone or in combination with azithromycin, is being widely used in Covid-19 therapy based on anecdotal and limited observational evidence.

METHODS: We performed a retrospective analysis of data from patients hospitalized with confirmed SARS-CoV-2 infection in all United States Veterans Health Administration medical centers until April 11, 2020. Patients were categorized based on their exposure to hydroxychloroquine alone (HC) or with azithromycin (HC+AZ) as treatments in addition to standard supportive management for Covid-19. The two primary outcomes were death and the need for mechanical ventilation. We determined the association between treatment and the primary outcomes using competing risk hazard regression adjusting for clinical characteristics via propensity scores. Discharge and death were taken into account as competing risks and subdistribution hazard ratios are presented.

RESULTS: A total of 368 patients were evaluated (HC, n=97; HC+AZ, n=113; no HC, n=158). Rates of death in the HC, HC+AZ, and no HC groups were 27.8%, 22.1%, 11.4%, respectively. Rates of ventilation in the HC, HC+AZ, and no HC groups were 13.3%, 6.9%, 14.1%, respectively. Compared to the no HC group, the risk of death from any cause was higher in the HC group (adjusted hazard ratio, 2.61; 95% CI, 1.10 to 6.17; P=0.03) but not in the HC+AZ group (adjusted hazard ratio, 1.14; 95% CI, 0.56 to 2.32; P=0.72). The risk of ventilation was similar in the HC group (adjusted hazard ratio, 1.43; 95% CI, 0.53 to 3.79; P=0.48) and in the HC+AZ group (adjusted hazard ratio, 0.43; 95% CI, 0.16 to 1.12; P=0.09), compared to the no HC group.

CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.
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Re: Coronavirus (COVID-19): What You Need To Know

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i havent read this in detail yet. at first glance i don't see specifics on how responses to the listed questions would inform the user's next steps

Digital triage for people with multiple sclerosis in the age of COVID-19 pandemic
https://link.springer.com/content/pdf/1 ... 4391-9.pdf

Q1) How old are you?
a. Less than 18 years
b. 19-50
c. 51-70
d. More than 70

Q2) Have you had any contact with
a. No contact with any of b-d
b. People from high risk or lock-down areas
c. Suspected case of COVID-19 infection
d. Positive case of COVID-19

Q3) Are you on disease modifyng treatment? If yes, please tell us which treatment you are on.
a. Interferon or Glatiramer acetate/glatiramoids
b. Teriflunomide, Fingolimod, Siponimod, Dimetylfumarate, Natalizumab,
c. Ocrelizumab, Cladribine, Mitoxantrone, Cyclophosphamide
d. Alemtuzumab, Hematopioetic Stem Cells Transplantation
• None

Q4) Which was/were your previous treatment(s) multiple choice is possible
a. Interferon or Glatiramer acetate/glatiramoids
b. Teriflunomide, Fingolimod, Dimetylfumarate, Natalizumab,
c. Ocrelizumab, Cladribine, Mitoxantrone, Cyclophosphamide
d. Alemtuzumab, Hematopioetic Stem Cells Transplantation
• None

Q5) Do you have any of the following disease?
a. Hypertension
b. Chronic Kidney disease
c. Diabetes, Heart disease, Respiratory disease
d. Cancer on chemotherapy
e. None

Q6) Do you have a recent blood cell count? (last month)
• Yes
• No

Q7) If yes, your lymphocytes are:
a. More than 1400/mm3
b. 701-1400/ mm3
c. 501-700/mm3
d. 200-500/mm3

Q8) Do you have any of the following symptoms? multiple choice is possible
a. Sore throat, Nasal congestion, Runny nose, Diarrhea
b. Dry cough
c. Fever
d. Breathing difficulties, shortness of breath
e. Lost or reduced sense of smell and taste
f. None

Q9) If you have symptoms are they getting worse?
a. No
b. Yes

Q10) If yes, do you think they are getting worse rapidly?
a. No
b. Yes
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Re: Coronavirus (COVID-19) News

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jimmylegs wrote: Fri May 01, 2020 9:03 am i havent read this in detail yet. at first glance i don't see specifics on how responses to the listed questions would inform the user's next steps

Digital triage for people with multiple sclerosis in the age of COVID-19 pandemic
https://link.springer.com/content/pdf/1 ... 4391-9.pdf

Q3) Are you on disease modifyng treatment? If yes, please tell us which treatment you are on.
a. Interferon or Glatiramer acetate/glatiramoids
b. Teriflunomide, Fingolimod, Siponimod, Dimetylfumarate, Natalizumab,
c. Ocrelizumab, Cladribine, Mitoxantrone, Cyclophosphamide
d. Alemtuzumab, Hematopioetic Stem Cells Transplantation
• None

Q4) Which was/were your previous treatment(s) multiple choice is possible
a. Interferon or Glatiramer acetate/glatiramoids
b. Teriflunomide, Fingolimod, Dimetylfumarate, Natalizumab,
c. Ocrelizumab, Cladribine, Mitoxantrone, Cyclophosphamide
d. Alemtuzumab, Hematopioetic Stem Cells Transplantation
• None
The drugs in these groupings have disparate methods of activity. The groupings seem nonsensical. They also misspelled dimethylfumarate twice.
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Re: Coronavirus (COVID-19): What You Need To Know

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i don't see any text re the grouping logic so far either. might be drawn from the sources cited. re spelling, they're not alone. probably english is not the authors' first language.
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Re: Coronavirus (COVID-19): What You Need To Know

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so far from a first google on one grouping, i found two classifications which appear to cover off everything. it expect it will take at least one more search to break down those groups further and arrive at four categories.
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Re: Coronavirus (COVID-19) News

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jimmylegs wrote: Fri May 01, 2020 10:36 amre spelling, they're not alone. probably english is not the authors' first language.
The naming of molecules in organic chemistry follows a set of standards known as International Union of Pure and Applied Chemistry (IUPAC) Nomenclature. Being international, it doesn't matter what country you're in, a molecule's name remains the same.

For example, 1,2,3,4,5,6-hexamethoxy-7,7-dimethyl-1,3,5-cycloheptatriene will still be the same no matter where you are.
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Re: Coronavirus (COVID-19): What You Need To Know

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re spelling, looks like a few countries didn't get the memo https://tr.intl.chemicalaid.com/info/ch ... und=C6H8O4

may 5 update re questionnaire treatment groupings:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604695/
"The newer immunotherapies for multiple sclerosis (fingolimod, natalizumab, dimethyl fumarate, teriflunomide, alemtuzumab) offer advantages of efficacy or tolerability over the injectable therapies of the 1990s. But they also have greater risks."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002664/
"Mitoxantrone is currently the only chemotherapeutic agent approved for treatment of MS in the United States... Other chemotherapeutics that have been tested in MS to date include cyclophosphamide, methotrexate, cladribine, and the mAbs alemtuzumab and rituximab. While there has been varying evidence of efficacy for these compounds, each appears to be associated with serious risks that require careful consideration and management."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126913/
"Alemtuzumab reduces GvHD and TRM after SCT. Use of alemtuzumab requires awareness and strict management of the risk of opportunistic infections and of an increased risk of disease recurrence."
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