Can touching a barbell in the gym get you sick with the coronavirus?

[ickyrica]

The man, 62, was in hospital in France being treated for coronavirus, when he started experiencing the erection, known as priapism.

While coronavirus is known to cause blood clots in up to a third of Covid-19 patients, this is believed to be the first case in which the clots developed in a patient’s penis.

The man, who is unnamed, had been in intensive care at the Centre Hospitaliser de Versailles in Le Chesnay for two weeks, initially experiencing the typical symptoms of a fever, dry cough and difficulty breathing.

His condition quickly deteriorated, and he was placed on a ventilator.

However, the researchers were shocked to discover ‘previously unidentified priapism.’

While the tip of his penis was flaccid, the two chambers of tissue in his penis were rigid, due to blood clots.

Thankfully, the doctors were able to remove the blood from his penis using a needle.

The doctors are fairly certain that his priapism was triggered by Covid-19.

that's it, never leaving the house!! Jesus man...

It's like you're in an exclusive club... Until tomorrow...

 

[Michael Scally MD]

Wear a mask.

Seriously, just wear one. Almost any mask will do, really. N95, surgical, spandex, homespun cotton. For people who aren’t front-line health care workers, what matters is whatever you can get your hands on that fits over your nose and mouth.

As the nation plunges for a second time into the depths of this brutal pandemic, officials worry we’ll soon have as many as 100,000 new cases every day. Summer won’t save us. Neither will bluster or bleach.

It’s easy to want to give up, but it would be wrong. Wearing a mask is not only simple and cheap, it’s also proved to be effective in slowing the virus’s spread. It will protect the health and even save the lives of your loved ones, your neighbors and people you don’t know.

This isn’t hard. If the lower half of your face is not covered when you go out in public, stop searching for excuses and go mask up.

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[SteroidsBro]

Will you stop telling people what to do you piece of shit?

 

[DrinkFlintWater]

Taking the plunge...heading to the Jersey shore all weekend. Mask on, fingers crossed, hand sanitizer on deck.

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

My first ever tweetorial! In the last 48 hours, there has been a lot of buzz in the lay press (WSJ, CNN) about a new observational study of hydroxychloroquine (HCQ) in COVID-19. … https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

[H]ere are my basic concerns about the paper… (6/x)

(1) Immortal time bias—median time to starting HCQ was 1 day (IQR 1-2), and the KM curves show that by day 2 there was already an 8% absolute mortality benefit with HCQ, which increased to about 11% on day 3. (7/x)

(2) Competing risks-- follow-up was in-hospital only but the authors failed to incorporate discharge to home as a competing risk (same issue as in the single-arm compassionate use Remdesivir trial published earlier this year in NEJM). (8/x)

(3) Throwing away lots of perfectly good data. As best I can tell, the authors adjusted for 18 covariates, all of which were coded in a binary fashion including age, BMI, serum creatinine, and admission oxygen saturation. Why would anyone do this? (9/x)

4. Inclusion of post-admission covariates in risk-adjustment and the propensity score including need for ventilator, ICU admission, and use of steroids and tocilizumb at any time during the admission. They could have easily included these as time-varying covariates. (10/x)

5. Exact matching on the propensity score in the propensity-matched analysis, which seems to have resulted in completely identical patient populations with respect to the covariates of interest. In addition to producing a truly remarkable Table 3/Love Plot. (11/x)

Quite honestly, I can’t figure out a good reason why anyone would have done this at all. At a minimum, it probably results in a serious loss of power. (12/x)

6. Failure to account for date of admission or to report use of HCQ over time. Presumably, increased use of HCQ occurred later in the series—a time at which the health system had learned how to care for these patients much better. (13/x)

The authors argue that these results show that the benefit of HCQ is highly dependent on the timing of administration, because previous studies of severely ill patients (RECOVERY) and of very early administration (post-exposure prophylaxis in the Boulware et al NEJM)... (14/x)

... have both shown no benefit. However, if the benefit seen in the Henry Ford study is real, this would represent the narrowest therapeutic range I’ve ever seen. (15/x)

There probably are others that are more subtle as well, but these were all fairly obvious. Quite frankly, any competent peer reviewer should have picked up on several of these, so a lot of my issue here is with the journal (International Journal of Infectious Diseases). (fin)

Thread by @djc795: My first ever tweetorial! In the last 48 hours, there has been a lot of buzz in the lay press (WSJ, CNN) about a new observational study of…

 

[Michael Scally MD]

#COVID19 It's amazing how many #Hydroxychloroquine fans are taking victory laps based on an over-hyped retrospective analysis with sig imbalance in age and steroid rx %.

https://ijidonline.com/article/S1201-9712(20)30534-8/fulltext


In medicine, randomized controlled trial always >>> any retrospective study.

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Dr JIM]

Retrospectively based upon data out of China, which I'll admit is sketchy, containment was unlikely from the outset but we can and must limit the mortality of those populations at greatest risk.

JIM

 

[Michael Scally MD]

In Houston, the largest medical campus in the world has exceeded its base intensive care capacity. In the Rio Grande Valley, elected officials pleaded this week for military intervention to avoid a “humanitarian crisis.” And in several major cities, testing sites are overrun, with appointments disappearing in minutes and hundreds waiting in line for hours.

Eight weeks ago, the White House lauded Texas as a model for containing the COVID-19 pandemic.

Now, Gov. Greg Abbott’s plan to reopen the economy has unraveled as the state struggles to contain one of the worst outbreaks in the country.

Public health experts say the worst of the crisis was avoidable in Texas, where Abbott stripped local officials of the ability to manage their own outbreaks and until Thursday refused to mandate masks and other basic mitigation practices. The governor reopened before the state could adequately monitor the virus, health experts said, then ignored signs in late May that infections were beginning to run rampant.

If Abbott’s team does not quickly implement a new strategy to stanch the spread of the virus, the state could see a ghastly jump in deaths through the rest of the summer, warned Baylor College of Medicine immunologist Dr. Peter Hotez.

He cited a new Children’s Hospital of Pennsylvania model predicting daily cases would more than triple in the largest Texas counties within the next four weeks, if there is no change in social distancing practices.

 

[Dr JIM]

Tme for some GOOD preliminary NEWS !

Phase I/II Study to Describe the Safety and Immunogenicity of a COVID-19 Vaccine Candidate .........

Study Design
- 45 of subjects received the vaccine while 9 received placebo

- Dosage was randomized into three cohorts 12 in each group

- Dosages of 10, 30 and 100ug were utilized in each cohort I, II and III respectively

- Median age 35 (range 19-54)

- Male to Female ratio approximated 50%

Results
- "Robust immunogenicity was observed after vaccination"

- The dose response curve favored group II as this 30ug group achieved RBD-IgG antibody titers that were higher than convalescent (recovered COVID-19 patients) sera.

- Adverse effects although common were largely dose dependent and mild and mimicked serum sickness in many respects (not surprising) to include PIP, malaise, joint, muscle pain etc. These symptoms peaked in 2 days and resolved by day 7.

Limitations
- "Convalescent sera was used as the comparator"

- "Subjects were relatively healthy without comorbidities"

- T-cell (long term) immunogenicity was not addressed, yet all subjects are to be followed longitudinally

JIM

 

[Dr JIM]

In Houston, the largest medical campus in the world has exceeded its base intensive care capacity. In the Rio Grande Valley, elected officials pleaded this week for military intervention to avoid a “humanitarian crisis.” And in several major cities, testing sites are overrun, with appointments disappearing in minutes and hundreds waiting in line for hours.

Eight weeks ago, the White House lauded Texas as a model for containing the COVID-19 pandemic.

Now, Gov. Greg Abbott’s plan to reopen the economy has unraveled as the state struggles to contain one of the worst outbreaks in the country.

Public health experts say the worst of the crisis was avoidable in Texas, where Abbott stripped local officials of the ability to manage their own outbreaks and until Thursday refused to mandate masks and other basic mitigation practices. The governor reopened before the state could adequately monitor the virus, health experts said, then ignored signs in late May that infections were beginning to run rampant.

If Abbott’s team does not quickly implement a new strategy to stanch the spread of the virus, the state could see a ghastly jump in deaths through the rest of the summer, warned Baylor College of Medicine immunologist Dr. Peter Hotez.

He cited a new Children’s Hospital of Pennsylvania model predicting daily cases would more than triple in the largest Texas counties within the next four weeks, if there is no change in social distancing practices.

While Gov Abbott underestimated the independence of Texas residents, with efforts to defund the police underway in many Texas cities, who would enforce the new strategy mentioned, but not outlined, by Dr Hotez??

How should law enforcement officers conduct themselves should lawbreakers refuse to wear a mask or practice social distancing while protesting?

I specifically mention protests because local Texas businesses are charged with monitoring and enforcing the NEW COVID-19 mitigation efforts.

Finally why isn't California mentioned in these panicked Tweets ----- BIAS!