Critical Care

Should remdesivir be utilized for severe COVID-19?

As the number of COVID-19 cases rises drastically and the global pandemic continues to change life as we know it, we are all hoping for news of effective treatment. Approximately 15 percent of patients infected with SARS-CoV-2 develop pneumonia requiring supplemental oxygen and an additional 5 percent progress to critical illness and acute hypoxemic respiratory failure. Although numerous drugs have been investigated, only dexamethasone has demonstrated improved survival in patients hospitalized with COVID-19 in a randomized controlled trial design. We now have data from 3 randomized controlled trials to guide the use of remdesivir for severe COVID-19.  

 

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TTP: Rapid diagnosis and management

You are working at a tertiary care center and a 55-year-old woman is transferred to you from an outside hospital for severe persistent thrombocytopenia of unknown origin. On arrival, she is mildly confused and tachycardic. The platelet count is 7K and the hemoglobin is 5.8. Peripheral blood smear demonstrates schistocytes consistent with microangiopathic hemolytic anemia. The diagnosis of thrombotic thrombocytopenic purpura (TTP) is suspected. TTP is a hematologic emergency: what are the next steps in management?

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