This Daily Meeting & Webinar is a Physicians Collaborative between APPNA MERIT and Pakistani institutions to discuss updates and lessons learned daily for treatment of acute care or inpatient management of hospitalized patients with Coronavirus infections.
Topic: Stroke in COVID 19
Speaker:
Shahid Rafiq MD
Vascular neurologist & Chair, APPNA MERIT
APPNA Leadership:
1. Dr. Naheed Usmani, MD (President, APPNA)
2. Dr. Shahid Rafiq, MD (Chair, APPNA MERIT)
3. Danish Bhatti, MD FAAN (Co-Chair APPNA MERIT)
Register yourself using below link:
After registering, you will receive a confirmation email containing information about joining the webinar.
All information related to merit covid-19 webinars is now available on our website:
Some questions and comments by participants in this webinar:
1. Question from the Neurointecsivist, Neurologists and Neuropathologist and off course all. Based upon reading and seeing evidence the virus does seem to have a tropism for neuron in autopsies and case reports from Wuhan. A predilection for brainstorm neurons with ACE receptors especially controlling the cardiorespiratory rate and rhythm might translate into neuropathological description of respiratory compromises observed in florid disease. Could hypoagusia and hyposmia be the heralder of a retrograde virus transmission as of in Parkinson gut- brain hypothesis? Would be very much interested in inciting a debate among our expert APPNA panel about ‘Brain & Cotonaviruses.
2. Question concerning immunologists and research clinicians involved with clinical trials or compassionate use of repurposed drugs. Interferon Alpha and Beta have shown to be promising in resolution of pulmonary infiltrates, viral Clearance, the inflammatory markers like IL-6 and CRP in studies from Wuhan union hospital experience and past publications about it’s usefulness in SARS classical in 2003, JAMA references. Would it not be wise enough to use it with a broad spectrum antiviral like ARB/ Arbidol (Umifenovir) and inhaled or S/C the injections of Interferons in Pakistan or US experience? Doesn’t the Interferon as the Frontline warrior in all viral infections get to deserve this kind of attention? Concept is inspired by IUIS-Frontiers open access talks and articles.
3. Is it true that the latest on COVID pathogenesis is the thromboembolism of the blood vessels of the lung and not lung itself. Also it’s better to give anti-inflammatory drugs and antibiotics to restore the immune system along with steroids. Is there any research in Italy on this???
4. What about strokes and the incidence of heart disease in COVID 19
5. what is your anticoagulation strategy in stroke pts with covid 19?
6. is there a pattern of cns findings with covid 19 pt with stroke?
7. do you see generalized muscle weakness with covid 19 infection?
8. Isnt it stil lhard to establish a direct connectionof COVID-19 with Neurological diagnosis as they couldbe just like for examle Stroke with COVID-19 or Stroke from COVID-19. I mean is there some way to establish the connection.
9. A recent publication shared by Dr. Bhatti shows that Parkinson disease could be next on the list of COVID 19 patients with a propensity for aggressive course of disease. Should there be some dose adjustment advised in management of antiparkinsonian agents?
10. Use of anticoagulant, corticosteroid,and antiinflamatory drugs are useful in these pt?secondly pt of rheumatoid arthritis have less probability of getting covid infections?its pathophysiology is reverted from pneumonia to stoke and thromboembolism?
11. If the mechanism of stroke from covid 19, is hypercoagulable state, then don’t you think that anticoagulation would be a better choice rather than antiplatelets
12. In these stroke patients with covid 19 , Did you isolate novel corona virus 2 from nasopharyngeal swab or CSF
13. Is there any study in covid 19 cases. About measurements of the coagulation factors in the stroke patients. May be affected Liver in the situation,Thanks for PPE for PMA Gujraniwala
14. Have we used Remdesivir in COVID-19 and what was the take on that
