The St.Emlyn’s Podcast

Professor Rick Body is joined by Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynolds (NIHR Clinical Research Fellow), Prof Pam Vallely (Professor of Medical Virology), Dr Anisa Jafar (Academic Clinical Lecturer) and Prof Simon Carley (you know him...) to discuss six papers about COVID-19 infection.  03:10 - Paper 1 – Guan et al. Clinical characteristics of Coronavirus disease 2019 in China. NEJM Feb 28 2020 https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 16:54 Paper 2 – Zou et al. Single Cell RNA-SEQ Data Analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-NCOV infection. Frontiers of Medicine. Mar 12 2020. https://link.springer.com/content/pdf/10.1007/s11684-020-0754-0.pdf 21:43 Paper 3 – Gautret et al. Hydroxychloroquine and azithromycin treatment of COVID-19: Results of an open-label non-randomised clinical trial. International Journal of Antimicrobial Agents. 20 Mar 2020 https://www.sciencedirect.com/science/article/pii/S0924857920300996?via%3Dihub 25:25 Paper 4 – Cao et al. A trial of Lopinavir-Ritonavir in adults hospitalized with severe COVID-19. NEJM Mar 18 2020 https://www.nejm.org/doi/pdf/10.1056/NEJMoa2001282 29:35 Paper 5 – Cui et al. Prevalence of venous thromboembolism in patients with severe Coronavirus pneumonia. Journal of Thrombosis and Haemostasis. Apr 9 2020 doi:10.1111/jth.14830 https://onlinelibrary.wiley.com/doi/epdf/10.1111/jth.14830 34:14 Paper 6 – Lynarts et al. Prediction models for diagnosis and prognosis of COVID-19 infection: systematic review and critical appraisal. BMJ. Apr 7 2020 BMJ 2020;369:m1328 https://www.bmj.com/content/bmj/369/bmj.m1328.full.pdf

Iain and Simon discuss Covid19 and more in this review of the best of the blog from March 2020.

Simon interviews Dr John Rogers and Dr Nathan Lewis on respiratory infection prevention. John a Sports and Exercise Medicine Consultant in Manchester. He is also Chief Medical Officer for British Triathlon and Visiting Professor in Sport & Exercise Medicine at Manchester Metropolitan University. Nathan is lead performance nutrition scientist at the English Institute of Sport and at ORRECO. These two academics take us through how sports science might be able to support our wellbeing during the Covid19 pandemic.   References Recommendations to maintain immune health in athletes https://www.tandfonline.com/loi/tejs20 Probiotics https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006895.pub3/epdf/full  Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials https://pubmed.ncbi.nlm.nih.gov/23840373/ Vitamin C for prevention and treatment of pneumonia https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013134/full Vitamin C and common cold https://www.cochrane.org/CD000980/ARI_vitamin-c-for-preventing-and-treating-the-common-cold  Effect of Flavonoids on Upper Respiratory Tract Infections and Immune Function: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/27184276/ Vitamin C and Infections https://pubmed.ncbi.nlm.nih.gov/28353648/ Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage https://pubmed.ncbi.nlm.nih.gov/28515951/      

The world is consumed by the Coronavirus pandemic, but how do we look after ourselves? Liz and Iain discuss some strategies to stay well over the coming weeks and months. Recorded on 25th March 2020.

Simon chats to Sarah Thornton, consultant anaesthetist, intensivist and head of the NW school of anaesthesia on preparing to work in a critical care unit during the Covid-19 pandemic.

Iain and Simon chat about the current Corona pandemic and the blog in Feb 2020. Iain remains positive, but Simon thinks the glass is half full. Time will tell who is right (though in truth there is a lot of common ground).   S

Dr Roberto Cosentini is an old friend of St Emlyn's who works in Bergamo, in Northern Italy. He is right at the heart of the recent Covid19 outbreak. He kindly found an hour to record a podcast with us on his experiences. There are so many essential lessons in this podcast. Please share with clinical and non-clinical colleagues, as we need to plan NOW. Roberto is quite clear that if we don't train and get plans into place before the wave of cases hit us then both ourselves and our patients will suffer. In the interest of speed I'm not going to summarise the whole podcast. You have to listen to it all yourself to see what's relevant to you. These are some of my take away messages. Divide your department into resp patients and non-resp patients Wear PPE and know how to use it You will need clinicians who do not usually work in ED. Train and orientate them now (before you need them). Most patients are hypoxic and this responds to O2 and CPAP. You're going to need a lot of CPAP and how that happens could be tricky. They found hoods the best (Ed - but how many of those do we have?). Although hypoxic, patients have good lung compliance. They regularly saw diurnal variation with many patients presenting in the early afternoon. It's emotionally exhausting. Prepare yourself and your team psychologically and support them during the pandemic. Roberto's department has an embedded psychologist. Health care worker infections were quite low (because they wore PPE for all resp cases). Flow through the department and onto wards is absolutely vital. Flow out the the main hospitals to other units that can rehabilitate is vital. Decisions for ICU level care were similar to normal (in his hospital) We rarely declare one of our podcasts a 'must listen' but this is an exception. Please listen and share widely. Please think hard about the issues Roberto raises and PLEASE ACT NOW. vb S     How you can support St Emlyn's Join us for #stemlynsLIVE conference May 12th 2020 Subscribe to the blog (look top right for the link) Subscribe to our PODCAST on iTunes Follow us on twitter @stemlyns PLEASE Like us on Facebook Find out more about the St.Emlyn’s team Find out more about the MMU MSc in Emergency Medicine here. Download one of our FREE e-books here Shortcode

Iain is back on the podcast with Simon to talk through the best of the blog from January 2020.

Our regular round up of the best of the blog from December 2019. Published a little late, largely because of Coronavirus issues and general business.

The latest from the St Emlyn's blog