September 25, 2020

On today's episode we discuss: —Management: A 31-year-old female kidney transplant recipient on immunosuppressants tested negative twice 18 days after initial positive test for SARS-CoV-2, yet tested positive again for SARS-CoV-2 via RT-PCR on day 20 with recurrence of symptoms. Despite treatment with lopinavir-ritonavir and resolution of symptoms 6 days after treatment, the patient continued to test positive by rectal swab for an additional 21 days and was monitored by serial cycle threshold of viral RNA. —R&D: Diagnosis & Treatments: An observational study of 242 patients with severe COVID-19 pneumonia and corresponding elevated inflammatory markers (including 61 patients receiving methylprednisolone in week 2 of infection) found 22 patients (9%) died and 31 (12.8%) suffered death or intubation. Hazard ratios for death and death or intubation for the week-2 MP group had lower adjusted risk for both outcomes compared to out-of-week-2 MP (administered Week 1 or Week 3), non-pulse glucocorticoids (<100mg/day), or no glucocorticoids, but these values were only significant in patients with low SpO2/FiO2 (<353).