TagCOVID19

#MSCOVID19: ostrich

Do you want to know if you have been infected with SARS-CoV-2 the coronavirus strain that causes COVID-19? With 25-50% of infections being asymptomatic or very mild you will need an antibody test to find out.  If you are found to have antibodies to SARS-CoV-2 would you not want to know the titre or amount of antibody in your blood? And whether or not these antibodies are so-called...

#MSCOVID19: Lymphopaenia

I am giving an MS Academy masterclass webinar today on the topic of lymphopaenia and its relevance to managing MS during the COVID-19 pandemic. My talk goes back to basics and tries to explain how the normal range and WHO grading system came about and includes the important topic of immunosenescence. You are welcome to sign-up for the webinar. If you can’t manage to log-on to the live...

#MSCOVID19: immunosuppression & vaccine-readiness

It is always a good idea to learn from others. We have stressed that the uneventful recovery from COVID-19 involves two processes. Firstly, an appropriate antiviral response, which is needed to clear the virus and secondly an anti-inflammatory response to prevent the delayed immunological damage to the lung that triggers ARDS (acute respiratory distress syndrome), which is the main cause of death...

#MSCOVID19: frontline

Working on the COVID-19 frontline comes with risks, not only personal risks but risks to your family, fellow NHS staff and for other patients who you have to see in face-to-face encounters on the wards or in urgent clinics. This explains why healthcare workers are so anxious. It is now clear that COVID-19 is a bit of a lottery; most people survive, a few scrape through and tragically some...

#MSCOVID19: inequality

We all focus on the obvious risk factors that predict who will and who won’t die of severe COVID-19, but the one that needs a deep think is deprivation the main social determinant of health. The latest data that has just been released from the ONS (Office for National Statistics) is a grim reminder that survival during COVID-19 is not only dependent on physical factors but social factors as well...

#MSCOVID19 asymmetry

Many of my colleagues have criticised and reprimanded me for being over-enthusiastic in stating that immunosuppressive MS DMTs are relatively safe for pwMS if they happen to develop COVID-19 whilst on treatment. However, the issue has been asymmetry of knowledge. I have known that patients on DMTs who get COVID-19 are doing well. This is based on knowledge acquired from multiple sources albeit...

#MSCOVID19: pulse oximetry

If you are single I suggest going to extraordinary lengths to protect yourself if you have to self-isolate with COVID-19. You may have heard about the tragic death of a young surgical trainee who died alone at home from COVID-19 in Belfast last week. He probably died from pulmonary complications of COVID-19 that had gradually crept up on him and by the time he needed hospitalisation and...

#MSCOVID19: vitamin D & zinc

I have already made the case for pwMS to prehabilitate, i.e. to prepare themselves for getting COVID-19. You can read my proposed prehabilitation programme on MS-Selfie. One of the topics I cover is diet and I mention that you should ensure that you are vitamin D (vD) replete. There are three ways to do this. (1) The first is to get a healthy daily exposure to sunshine (~20mins of upper body...

#MSCOVID19 – cladribine

This post explains why I have started to refer to cladribine as a small molecule anti-CD20/CD19 therapy and why oral cladribine should be part of the exit strategy to treat MS during the tail of the COVID-19 pandemic. Although we use cladribine as an immune reconstitution therapy and often compare it to alemtuzumab it is, in fact, closer to anti-CD20 therapies in terms of its immunodepletion...

#MSCOVID19: wow!

I am on call at the Royal London Hospital and sitting in my office digesting some of my daily COVID-19 reading. However, something has just hit me between the eyes and I have to say wow aloud!  WOW!! The paper and editorial below show you just how infective SARS-CoV-2 really is and why we are not going to win this battle for our vulnerable people without an effective anti-viral and/or...

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