TWiV 976: Clinical update with Dr. Daniel Griffin

This Week in Virology

Vincent Racaniello

Vincent, Microbe, Medicine, Microbiology, Racaniello, Infection, Virus, Virology, Pathogen, Infectious, Twiv, Science & Medicine

4.8 • 2.2K Ratings

🗓️ 21 January 2023

⏱️ 42 minutes

🔗️ Recording | iTunes | RSS

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Summary

In his weekly clinical update Dr. Griffin discusses China reporting almost 60,000 Covid-related deaths after abrupt shift in policy, detection of SARS-CoV-2 IgA and IgG in human milk and breastfeeding infant stool 6 months after maternal COVID-19 vaccination, effect of Fluvoxamine vs placebo on time to sustained recovery in outpatients with mild to moderate COVID-19, hyperimmune globulin for severely immunocompromised patients hospitalized with COVID-19, long COVID outcomes at one year after mild SARS-CoV-2 infection, long COVID: major findings, mechanisms and recommendations, a systematic review of trials currently investigating therapeutic modalities for post-acute COVID-19 syndrome and registered on World Health Organization international clinical trials platform, and the effect of using a structured pacing protocol on post-exertional symptom exacerbation and health status in a longitudinal cohort with the post-COVID-19 syndrome. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode China records almost 60,000 COVID-related deaths (SCMP) Detection of SARS-CoV-2 IgA and IgG in human milk and breastfeeding infant stool (Nature) Effect of Fluvoxamine vs placebo in outpatients with COVID-19 (JAMA) Hyperimmune Globulin for immunocompromised patients with COVID-19 (JID) Long COVID outcomes at one year after mild infection (BMJ) Major findings, mechanisms and recommendations for Long COVID (Nature) Review of trials investigating therapeutic modalities for post-acute COVID-19 (CMI) Effect of using a structured pacing protocol (JMV) Contribute to our MicrobeTV fundraiser at PWB Dr. Griffin’s treatment guide (pdf) Letters read on TWiV 976 Don’t crush Paxlovid (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to [email protected]

Transcript

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0:00.0	This week in virology, the podcast about viruses, the kind that make you sick.
0:10.2	From micro TV, this is TWIV, this week in virology, Episode 976, recorded on January 19th,
0:20.3	2023. I'm Vincent Rackenello and you're listening to the podcast all about viruses.
0:26.6	Joining me today from New York, Daniel Griffin. Hello everyone. How's your ICU looking these days, Daniel?
0:36.2	Yeah, it's sort of depressing that you bring that up. I just had a COVID patient die this morning
0:43.2	in the ICU. I have to say, I was a little bit surprised about the discussion, but I mentioned to
0:53.0	one of my colleagues that one of my patients in the ICU had COVID died. The first question,
0:59.4	and maybe you sort of guess, did they die with COVID or from COVID? Then I went and I was talking
1:05.1	to the ICU physician and they were like, hmm, so we went through the story. I'm like, okay,
1:09.6	let's think about the story. I was talking to this with Dr. Lee, one of my partners about this.
1:15.1	So this was a kidney transplant patient who was doing fine. Got COVID during the first week was
1:24.5	not treated with the whole, you know, you'll probably be just fine. By about day 8,
1:30.5	they started to get hypoxic and it ended up admitted to the hospital, started with low-flow oxygen.
1:37.3	This escalated. They were on steroids. They got to a salismab. They required intubation. They then
1:43.7	developed a secondary bacterial and looks like it may have also been a fungal infection. Then about
1:49.6	day 23 this morning, they died. It's really interesting because in my mind, that's a COVID death.
1:57.6	That's a death due to COVID. But there was this whole discussion, well, but they had to really
2:01.6	definitely die from the COVID. They died from that bacterial pneumonia that developed
2:05.5	during the end of the second week. I was like, well, I mean, this is what we saw, right? I mean,
2:10.2	this this channel, I was fine, got COVID 23 days later or so. They're not alive. So it is really
2:17.2	an interesting and, you know, challenging. Like, is this a COVID death? I would say yes. But not
2:23.3	everyone. So, yeah, sort of challenging. We try to get these numbers. And we're going to actually,
	...

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