Coronavirus Testing Chief Complaint: SOB HPI: 43 year-old male anesthesiologist presents to the ED with increasing shortness of breath, tachycardia and lethargy. Patient reports alternating positive and negative COVID tests since early March, job related exposure, as well as travel to Belize and twice to Summit County (considered a hotspot for COVID) since early March….
Read MoreContributor: Jared Scott, MD Educational Pearls: Cholera has been responsible for 6 previous global pandemics and currently the world is in the seventh pandemic of cholera, ongoing since 1961. Cholera originated in the Ganges Delta of India and spread worldwide but largely is unseen in the US and other developed countries due to water sanitation…
Read MoreHost: Elizabeth Esty, MD. At this point, with so many of the studies we’ve digested exploring correlations, associations, observational studies and anecdotal reports and speculation, we could subtitle the show: what we don’t know about COVID. And so, today, we’ll look at what we don’t know about Vitamin D and COVID. There have been a number of…
Read MoreHost: Elizabeth Esty, MD. Smoking is known to increase both susceptibility and severity of all manner of colds and pneumonias, so you’d think the world’s 1.1 billion smokers would be at risk in this pandemic of what at first seemed to be a just a respiratory virus. What’s more, tobacco smoking increases risk for COPD,…
Read More*(A shorter and more clinically focused follow up piece to our COVID Digest released on 5/1/20) Contributor: Nick Tsipis, MD Educational Pearls: Case series reported 5 cases of generally young and healthy patients with COVID-19 who presented to the ER with acute stroke Now several case series showing cardiovascular involvement or complications related to COVID-19…
Read MoreHost: Elizabeth Esty, MD In the US, few people receive vaccination for tuberculosis (TB), a disease that hasn’t been a major killer here for many decades. But while we in the US mostly experience TB as a relatively rare but real threat in its multidrug resistant form, particularly in patients with HIV–or in Victorian novels–TB…
Read MoreContributor: Don Stader, MD Educational Pearls: COVID-19 commonly appears as a bilateral patchy infiltrate on chest radiograph, but this is a non-specific finding Sensitivities range from 17-70% for COVID-19 Many other viral pneumonias such as RSV and influenza can have similar findings Point-of-care ultrasound (POCUS) demonstrates B-lines, water-fall sign, or hepatization of the lung, but…
Read MoreHost: Elizabeth Esty, MD Last week we looked at neurologic presentations of COVID-19; this week we’ll look more closely at strokes in young people with COVID. A letter published 2 days ago in the NEJM with lead author Thomas Oxley, the Neuro ICU director at Mt Sinai, presents five case studies of relatively young patients…
Read MoreContributor: Don Stader, MD Educational Pearls: COVID-19 is diagnosed with a nasopharyngeal swab (q-tip). This unfortunately can be painful, but if the swab doesn’t go deep into the nasal cavity the sample can be inadequate leading to false negatives (missed infections). The sensitivity of the COVID-19 RT PCR test is low, ranging from 66-80% in…
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Host: Elizabeth Esty, MD Accumulating clinical evidence suggests that many patients with COVID have neurological symptoms and that some may even present with neurologic manifestations of the disease. Most COVID patients have a cough, respiratory distress, and while clinicians often speak about how similar the presentations of patients with respiratory COVID are, it’s worth looking…
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