John Laffey
Professor Anaesthesia and ICM Galway.
Update on Covid19 research.
The @AAGBI webinar continues.

Knowledge is rapidly evolving. There was nothing known about #covid19 until a few months ago. We learn as we treat. Are there different phenotypes - is it even ARDS? This paper peer reviewed, but many papers have not been reviewed.

Notes excess commentary on papers which have not been peer reviewed, even when it is clear that they are pre-print. Notes hydroxycloroquine discussion, which became highly politicised. It has gone from miracle pill to poison without even a single proper study.

High flow oxygen research - focussed on controlling aerosol from these devices. Many improvised devices. (note MacGyvering @drlauraduggan @hypoxicchicken ) . Also sharing ventilators ...

No therapies for #covid19, however multiple candidates.

Remdesivir:

Another covid19 treatment candidate is the HIV combination lopinavir/ritonavir. (Notes red = relevance to Ireland).

Favipiravir.

Arbidol.

Hydroxychloroquine. Huge media attention. Large number of RCTs in progress.

Inactivated convalescent plasma.

Immunomodulatory therapies. Hyperimmune response may be in an issue in at least a subset of patients.
Methylprednisone:

Interferons.

Anti-IL-6 Monoclonals

Anti-IL-1 Monoclonal.

Mesenchymal Stem Cells.

Note that this paper is a case series, but may be promising.

REMAP-CAP Trial. Pandemic domain being rolled out.

Solidarity Trial. Doesn't require positive pressure ventilation for enrolment. WHO global study. Multiple treatment arms.

APPROVE-CARE: awake proning for COVID. NUI Galway coordinating in Ireland.