#205 COVID Cakes and Hot Takes with Rahul Ganatra MD

April 10, 2020 | By Matthew Watto, MD

Hydroxychloroquine, COVID-19 Serology, Convalescent Plasma, Telehealth, Economic inequality… and Cats?!

COVID Cakes, a rundown of recent COVID articles and news stories including: Hydroxychloroquine and azithromycin, serologic testing, use of convalescent plasma, economic inequality / health disparities… and COVID in cats?! We’re joined by Curbsider/Internist/Epidemiologist, Rahul Ganatra MD, @rbganatra (VA Boston) who provides critical appraisal of the article that inspired Trump’s infamous hydroxychloroquine and azithromycin comment. Plus, @Paulnwilliamz and @cjchiu give us  some telehealth along with the usual antics. 

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Credits

Written, Produced by: Rahul Ganatra MD, Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP

Cover Art and Show Notes by: Matthew Watto MD, FACP

Hosts: Chris Chiu MD, FACP, FAAP; Matthew Watto MD, FACP; Paul Williams MD, FACP   

Editor: Matthew Watto MD 

Guest: Rahul Ganatra MD

COVID Cakes Time Stamps

• 00:00 Intro, COVID-19 and cats by Shi J Science Apr 2020; Picks of the week: Kimberly Manning thread Frontline-ish; Steak Umm thread; Some Good News YouTube Channel by John Krazinski
• 07:08 Telehealth (Greenhalgh BMJ 2020), Breathlessness (Roth score calculator), ACP COVID-19 resource site
• 11:50 Telehealth best practices (*Linked below): Postpone routine therapy, Choose therapy that doesn’t require monitoring Treat empirically, Only order tests that will change management, Keep people out of the ED ; Doximity dialer for video calls is in Beta testing
• 16:42 Convalescent plasma and Serology (Chenguang JAMA “Trial” of Convalescent Plasma; Nat’l Academy Sciences 10 pt study; COVID-19 Insights Blog by Bill Rodriguez; FDA Press Release re: SARS-CoV-2 Serologic Testing; FDA Emergency Auth for Rapid IgG/IgM 
• 21:45 Chris discusses the decontamination of N95 masks using CCDS (CCDS, Battele news Report)
• 23:45 Inequality during the pandemic VOX and NYTimes articles on inequality
• 25:30 Hydroxychloroquine background; Rahul provides critical appraisal for HCQ + azithromycin article from France (Gautret et al IJAA 2020) and Rahul’s tweetorial 
• 49:18 Pre-print data; Rahul discusses a newer HCQ randomized clinical trial article (Chen medRxiv 2020)
• 43:05 Outro

Links

All links for these brief show notes are included above in the time stamps. 

Goals

Listeners will hone their skills in critical appraisal as they update themselves on all things COVID-19

Learning objectives

After listening to this episode listeners will…

1. Discuss the limitations in the evidence for hydroxychloroquine and azithromycin as treatment for COVID-19
2. Discuss some challenges of telehealth during the COVID-19 pandemic
3. Be aware of racial disparities during the COVID-19 pandemic
4. Explain the rationale for serologic testing and the use of convalescent plasma in COVID-19 disease

Disclosures

Dr Ganatra reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Ganatra R, Williams PN, Chiu CJ, Watto MF. “#205 COVID Cakes and Hotakes with Rahul Ganatra MD”. The Curbsiders Internal Medicine Podcast. http://thecurbsiders.com/episode-list April 10, 2020.