Betacoronavirus pandemicum - Revision history

Aidan: /* Immunocompromised Patients With Persistent Infection */

2026-04-07T19:26:45Z

Immunocompromised Patients With Persistent Infection

← Older revision		Revision as of 19:26, 7 April 2026
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	** [https://doi.org/10.1093/infdis/jiaa666 10.1093/infdis/jiaa666]: lymphoma with 3 admissions over 4 months, treated with two courses of [[remdesivir]] and convlescent plasma		** [https://doi.org/10.1093/infdis/jiaa666 10.1093/infdis/jiaa666]: lymphoma with 3 admissions over 4 months, treated with two courses of [[remdesivir]] and convlescent plasma
	** [https://doi.org/10.1016/j.ijid.2020.12.050 10.1016/j.ijid.2020.12.050]: follicular lymphoma post treatment with 2 months of COVID, got [[remdesivir]] twice (second time 10 days) as part of trials, as well as IVIG		** [https://doi.org/10.1016/j.ijid.2020.12.050 10.1016/j.ijid.2020.12.050]: follicular lymphoma post treatment with 2 months of COVID, got [[remdesivir]] twice (second time 10 days) as part of trials, as well as IVIG
			* A larger systematic review: Efficacy and safety of antiviral therapies for the treatment of persistent COVID-19 in immunocompromised patients since the Omicron surge: a systematic review, ''J Antimicrob Chemother''. 2025;80(3):633-644, doi: [https://doi.org/10.1093/jac/dkae482 10.1093/jac/dkae482]
			** "Based on very low certainty evidence, combining one direct antiviral with passive immunization resulted in high rates of viral clearance and few recurrences. AEs occurred in cases treated with at least two direct antivirals. Controlled studies are needed."

	==Prevention==		==Prevention==

Aidan: /* Critical Disease (High-Flow or Mechanical Ventilation) */

2025-05-06T14:51:38Z

Critical Disease (High-Flow or Mechanical Ventilation)

← Older revision		Revision as of 14:51, 6 May 2025
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	* Patients requiring ventilatory support, including high-flow nasal oxygen, non-invasive ventilation, invasive mechanical ventilation, or ECMO		* Patients requiring ventilatory support, including high-flow nasal oxygen, non-invasive ventilation, invasive mechanical ventilation, or ECMO
	* [[Dexamethasone]] 6 mg p.o./IV daily for 10 days		* [[Dexamethasone]] 6 mg p.o./IV daily for 10 days
	** Can consider 12 mg dosing in patients unable to receive IL-6 inhibitors
	* [[Tocilizumab]] or [[baricitinib]] for patients on [[dexamethasone]]		* [[Tocilizumab]] or [[baricitinib]] for patients on [[dexamethasone]]
	* Do ''not'' treat with therapeutic anticoagulation, [[remdesivir]], monoclonal antibodies, or [[nirmatrelvir-ritonavir]]		* Do ''not'' treat with therapeutic anticoagulation, [[remdesivir]], monoclonal antibodies, or [[nirmatrelvir-ritonavir]]

Aidan: /* Severe Disease (Low-Flow Supplemental Oxygen) */

2025-05-06T14:51:28Z

Severe Disease (Low-Flow Supplemental Oxygen)

← Older revision		Revision as of 14:51, 6 May 2025
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	*For patients requiring new or increased supplemental oxygen		*For patients requiring new or increased supplemental oxygen
	*[[Dexamethasone]] 6 mg PO/IV daily for 10 days, which has a mortality benefit		*[[Dexamethasone]] 6 mg PO/IV daily for 10 days, which has a mortality benefit
	*[[Remdesivir]] 200 mg IV once on day one followed by 100 mg PO daily for 4 more days		*[[Remdesivir]] 200 mg IV once on day one followed by 100 mg IV daily for 4 more days
	*If progressing to critical disease despite [[dexamethasone]], add [[tocilizumab]]		*If progressing to critical disease despite [[dexamethasone]], add [[tocilizumab]]
	**If tocilizumab is unavailable, then [[baricitinib]] 4 mg p.o. daily for 14 days or until hospital discharge		**If tocilizumab is unavailable, then [[baricitinib]] 4 mg p.o. daily for 14 days or until hospital discharge

Aidan: /* Severe Disease (Low-Flow Supplemental Oxygen) */

2025-05-06T14:51:08Z

Severe Disease (Low-Flow Supplemental Oxygen)

← Older revision		Revision as of 14:51, 6 May 2025
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	*For patients requiring new or increased supplemental oxygen		*For patients requiring new or increased supplemental oxygen
	*[[Dexamethasone]] 6 mg PO/IV daily for 10 days, which has a mortality benefit		*[[Dexamethasone]] 6 mg PO/IV daily for 10 days, which has a mortality benefit
	*[[Remdesivir]] 200 mg IV once on day one followed by 100 mg PO daily for 5 days~~, which has not been shown to have a mortality benefit~~		*[[Remdesivir]] 200 mg IV once on day one followed by 100 mg PO daily for 4 more days
	*If progressing to critical disease despite [[dexamethasone]], add [[tocilizumab]]		*If progressing to critical disease despite [[dexamethasone]], add [[tocilizumab]]
	**If tocilizumab is unavailable, then [[baricitinib]] 4 mg p.o. daily for 14 days or until hospital discharge		**If tocilizumab is unavailable, then [[baricitinib]] 4 mg p.o. daily for 14 days or until hospital discharge

Aidan at 14:48, 6 May 2025

2025-05-06T14:48:23Z

Show changes

Aidan at 14:11, 3 February 2025

2025-02-03T14:11:00Z

← Older revision		Revision as of 14:11, 3 February 2025
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			{{DISPLAYTITLE:''Betacoronavirus pandemicum''}}

	==Background==		==Background==
	===Microbiology===		===Microbiology===

Aidan: Aidan moved page SARS-CoV-2 to Betacoronavirus pandemicum over redirect: new binomial nomenclature

2025-02-03T14:10:44Z

Aidan moved page SARS-CoV-2 to Betacoronavirus pandemicum over redirect: new binomial nomenclature

← Older revision	Revision as of 14:10, 3 February 2025
(No difference)

Aidan: /* Management */ added small section for mabs

2022-11-17T19:22:57Z

Management: added small section for mabs

← Older revision		Revision as of 19:22, 17 November 2022
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	* For steroid exposure, 10 days of dexamethasone +/- tocilizumab is considered substantial risk		* For steroid exposure, 10 days of dexamethasone +/- tocilizumab is considered substantial risk
	* See also [https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-7-8-july-august-2021/covid-19-treating-strongyloides-ivermectin-patients.html Ivermectin treatment for ''Strongyloides'' infection in patients with COVID-19] from the CCDR		* See also [https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-7-8-july-august-2021/covid-19-treating-strongyloides-ivermectin-patients.html Ivermectin treatment for ''Strongyloides'' infection in patients with COVID-19] from the CCDR

			=== Anti-SARS-CoV-2 Monoclonal Antibodies ===

			* Effectiveness varies by strain/lineage
			* Refer to https://www.covid19treatmentguidelines.nih.gov/tables/variants-and-susceptibility-to-mabs/ for up-to-date table of effectiveness

	=== Immunocompromised Patients With Persistent Infection ===		=== Immunocompromised Patients With Persistent Infection ===

Aidan: /* Immunocompromised Patients With Persistent Infection */

2022-11-17T10:59:22Z

Immunocompromised Patients With Persistent Infection

← Older revision		Revision as of 10:59, 17 November 2022
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	* A few case studies		* A few case studies
	** [https://doi.org/10.1093/cid/ciac847 10.1093/cid/ciac847]: 60M CLL, got [[Paxlovid]] x5 days; recurred, got [[remdesivir]] x10 days; recurred, got betelovimab; was on concurrent high-dose steroids essentially throughout for organizing pneumonia; finally [[remdesivir]] and [[Paxlovid]] combination to 20 days, with negative NP swab and clinical resolution		** [https://doi.org/10.1093/cid/ciac847 10.1093/cid/ciac847]: 60M CLL, got [[Paxlovid]] x5 days; recurred, got [[remdesivir]] x10 days; recurred, got betelovimab; was on concurrent high-dose steroids essentially throughout for organizing pneumonia; finally [[remdesivir]] and [[Paxlovid]] combination to 20 days, with negative NP swab and clinical resolution
	** [https://doi.org/10.1093/ofid/ofac382 10.1093/ofid/ofac382]: 44 yo with [[GPA]] and [[hypogammaglobulinemia]] with 5 months of symptomatic infection treated with [[remdesivir]] to negative NP swab PCR, which took 30 days		** [https://doi.org/10.1093/ofid/ofac382 10.1093/ofid/ofac382]: 44 yo with [[GPA]] and [[hypogammaglobulinemia]] with 5 months of symptomatic infection treated with IVIG, convalescent plasma, and finally [[remdesivir]] to negative NP swab PCR, which took 30 days
	** [https://doi.org/10.1093%2Finfdis%2Fjiaa446 10.1093/infdi/jiaa446]: 50M with CLL post-treatment had relapse twice after 10-day courses of [[remdesivir]], finally resolved after infusion of convalescent plasma		** [https://doi.org/10.1093%2Finfdis%2Fjiaa446 10.1093/infdi/jiaa446]: 50M with CLL post-treatment had relapse twice after 10-day courses of [[remdesivir]], finally resolved after infusion of convalescent plasma
	** [https://doi.org/10.1136/bcr-2021-244768 10.1136/bcr-2021-244768]: child with [[Primary immunodeficiency\|PID]] eventually resolved with multiple courses of [[IVIG]]		** [https://doi.org/10.1136/bcr-2021-244768 10.1136/bcr-2021-244768]: child with [[Primary immunodeficiency\|PID]] eventually resolved with multiple courses of [[IVIG]]

Aidan: /* Management */ added persistent infection case studies

2022-11-17T10:54:59Z

Management: added persistent infection case studies

← Older revision		Revision as of 10:54, 17 November 2022
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	* Patients should be screened per CATMAT guidelines and treated if appropriate		* Patients should be screened per CATMAT guidelines and treated if appropriate
	* For steroid exposure, 10 days of dexamethasone +/- tocilizumab is considered substantial risk		* For steroid exposure, 10 days of dexamethasone +/- tocilizumab is considered substantial risk
	* See also [https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-7-8-july-august-2021/covid-19-treating-strongyloides-ivermectin-patients.html Ivermectin treatment for ''Strongyloides'' infection in patients with COVID-19] from the CCDR~~<br />~~		* See also [https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-7-8-july-august-2021/covid-19-treating-strongyloides-ivermectin-patients.html Ivermectin treatment for ''Strongyloides'' infection in patients with COVID-19] from the CCDR

			=== Immunocompromised Patients With Persistent Infection ===

			* A few case studies
			** [https://doi.org/10.1093/cid/ciac847 10.1093/cid/ciac847]: 60M CLL, got [[Paxlovid]] x5 days; recurred, got [[remdesivir]] x10 days; recurred, got betelovimab; was on concurrent high-dose steroids essentially throughout for organizing pneumonia; finally [[remdesivir]] and [[Paxlovid]] combination to 20 days, with negative NP swab and clinical resolution
			** [https://doi.org/10.1093/ofid/ofac382 10.1093/ofid/ofac382]: 44 yo with [[GPA]] and [[hypogammaglobulinemia]] with 5 months of symptomatic infection treated with [[remdesivir]] to negative NP swab PCR, which took 30 days
			** [https://doi.org/10.1093%2Finfdis%2Fjiaa446 10.1093/infdi/jiaa446]: 50M with CLL post-treatment had relapse twice after 10-day courses of [[remdesivir]], finally resolved after infusion of convalescent plasma
			** [https://doi.org/10.1136/bcr-2021-244768 10.1136/bcr-2021-244768]: child with [[Primary immunodeficiency\|PID]] eventually resolved with multiple courses of [[IVIG]]
			** [https://doi.org/10.1093/infdis/jiaa666 10.1093/infdis/jiaa666]: lymphoma with 3 admissions over 4 months, treated with two courses of [[remdesivir]] and convlescent plasma
			** [https://doi.org/10.1016/j.ijid.2020.12.050 10.1016/j.ijid.2020.12.050]: follicular lymphoma post treatment with 2 months of COVID, got [[remdesivir]] twice (second time 10 days) as part of trials, as well as IVIG

	==Prevention==		==Prevention==