Managing COVID-19 Respiratory Distress Acute respiratory stress syndrome is one of the primary ways COVID-19 infection manifests in the patient. COVID-19 injures the vascular endothelium, which can lead to multiorgan failure even in young patients without any comorbidities. A wide variation in mortality rates indicates that the key to improving outcomes of ventilatory support could be in a case-adjusted management approach.  The goal of ventilatory support in ARDS i...

Can We Trust COVID-19 Research? The COVID-19 pandemic has inspired an unprecedented amount of healthcare-related research in various fields, from drug and vaccine development to epidemiological modelling. Preprints abound, but some warn about the dangers of releasing research without proper verification. You may also like: Warnings about Potential Treatments for COVID-19 “I am impressed by how quickly the scientific community has put together a lot...

EDITORIAL Inhibitors of the Renin–Angiotensin–Aldosterone System and Covid-19 John A. Jarcho, Julie R. Ingelfinger, Mary Beth Hamel, et al N Engl J Med May 1, 2020DOI: 10.1056/NEJMe2012924 SARS-CoV-2, the coronavirus that causes Covid-19, enters human cells by binding of its viral spike protein to the membrane-bound form of the aminopeptidase angiotensin-converting enzyme 2 (ACE2).1 From the viewpoint of human physiology, ACE2 plays an important regulator...

COVID-19 Pandemic: The Ethical Dilemma of Allocating Scarce Resources Coronavirus pandemic continues to intensify as does the shortage of ventilators and beds. In countries where cases are multiplying at a tremendous rate, a critical question that is being asked is: what criteria should be used to guide rationing decisions? What should be done when demand for ventilators and other intensive treatment exceeds the supply? A new viewpoint addresses these concerns and...

Practice Practice Pointer Interpreting a covid-19 test result Jessica Watson, Penny F Whiting, John E Brush BMJ 2020; 369: m1808 doi: https://doi.org/10.1136/bmj.m1808 (Published 12 May 2020) What you need to know Interpreting the result of a test for covid-19 depends on two things: the accuracy of the test, and the pre-test probability or estimated risk of disease before testingA positive RT-PCR test for covid-19 test has more weight than a negative t...

Editorials Remdesivir in covid-19 Robin E Ferner, Jeffrey K Aronson BMJ 2020; 369: m1610 doi: https://doi.org/10.1136/bmj.m1610 (Published 22 April 2020) A drug with potential—don’t waste time on uncontrolled observations The recent publication of an industry sponsored, open, non-randomised study of remdesivir in a heterogeneous patient population has added to the confusion surrounding the drug treatment of covid-19.1 The SARS-CoV-2 virus that causes cov...

News Covid-19: What is the evidence for cloth masks? Elisabeth Mahase BMJ 2020;369:m1422 doi: https://doi.org/10.1136/bmj.m1422 As the US Centers for Disease Control and Prevention has advised all Americans to wear cloth masks in public to prevent the spread of covid-19, The BMJ examines the evidence What has the CDC recommended? People should wear cloth face coverings in public places where social distancing measures are “difficult to maintain...

COMMENT|ONLINE FIRST Rational use of face masks in the COVID-19 pandemic Shuo Feng, Chen Shen, Nan Xia, et al Lancet Respir Med 2020 Published:March 20, 2020 DOI:https://doi.org/10.1016/S2213-2600(20)30134-X Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that caused coronavirus disease 2019 (COVID-19), the use of face masks has become ubiquitous in China and other Asian countries such as South Korea and Japan. Som...

Analysis Face masks for the public during the covid-19 crisis Trisha Greenhalgh, Manuel B Schmid,  Thomas Czypionka BMJ 2020; 369 doi: :m1435 https://doi.org/10.1136/bmj.m1435 (Published 09 April 2020) Trisha Greenhalgh and colleagues argue that it is time to apply the precautionary principle The precautionary principle is, according to Wikipedia, “a strategy for approaching issues of potential harm when extensive scientific knowledge on the matter is ...

Editorials Chloroquine and hydroxychloroquine in covid-19 Robin E Ferner, Jeffrey K Aronson BMJ 2020; 369:m1432 doi: https://doi.org/10.1136/bmj.m1432 (Published 08 April 2020) Use of these drugs is premature and potentially harmful TheBMJ in 1925 cautiously endorsed Moellgaard’s gold treatment for tuberculosis,1 although it found his pharmacological reasoning “both interesting and instructive.”2 We should be similarly cautious about proposed...