A mysterious symptom may be the only sign of coronavirus in young people.
Doctors have discovered many younger patients are suffering from “COVID toes” — a series of red lesions or painful bumps on the feet.
Dr. Amy Paller, chair of the Department of Dermatology at Northwestern University Feinberg School of Medicine, is one of the medical experts who has witnessed the as-yet unexplained malady in otherwise asymptomatic youngsters.
“These are individuals who are often without any other sign of viral infection,” she said. “We are seeing this in unprecedented numbers.”
Although they aren’t sure of the cause, experts think it may be happening in response to the inflammation caused as part of the response to the COVID-19 virus.
“We don’t know for sure if it’s related to COVID-19, but when it’s so common right now during a pandemic and is occurring in otherwise asymptomatic or mildly affected patients, it seems too much of a coincidence not to be a manifestation of the virus for patients in their teens and 20s,” she added, per NBC Chicago.
If you are treating patients with acute coronary syndromes or acute strokes in the ED, you may want to quickly look for COVID Toes and Fingers, a clue indicating possible COVID-19 infection and need for enhanced PPE and precautions. https://t.co/oyBgQQk9Hq pic.twitter.com/9qyKKAEG0k
— Luciano Sposato (@SposatoL) April 19, 2020
— Peter Higgins (@ibddoctor) April 19, 2020
“Are #covidtoes the new anosmia?”
Nice work @DrEstherFreeman and @lindyfox1 representing the @AADskin effort in characterizing #covid19 #dermatology findings!#dermtwitter #medtwitter @AADmember @MedDermSoc @DermHospitalist https://t.co/HMUXwW1IX5
— Steven Chen (@DrStevenTChen) April 17, 2020
She said the lesions are “Sometime itchy, often times painful,” can appear on the top or bottom of the foot, on just one toe or all of them, and can turn from red to purple.
Thankfully, the symptom is as bad as it gets for most young people who display it, and typically does not herald a worsening condition; in fact, evidence suggest ‘COVID toes’ occurs when a patient is recovering from the virus.
“None of these teens or young adults have gone on to have any serious issues,” Dr Paller said. “They seem to resolve after a few weeks.”
“Many have had some mild viral symptoms in the week before and it might be a sign during the ‘convalescent’ healing period when no longer contagious,” she added. “We won’t understand the association until we can test this more broadly.”
However, with testing still limited, Dr Paller accepts that proving a correlation between the two may be difficult.
“We really need to save resources,” she said. “And we can’t be sending people who don’t have the classic signs for that kind of testing.”
She advised parents not to panic if they see the symptom on its own, and to photograph and document it.
She suggested otherwise healthy patents could get the antibody test where and when available; however if parents are concerned they should always contact their pediatrician.
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'No benefit' from hydroxychloroquine for virus: U.K. trial – CTV News
A major British clinical trial has found hydroxychloroquine has “no benefit” for patients hospitalised with COVID-19, scientists said Friday, in the first large-scale study to provide results for a drug at the centre of political and scientific controversy.
Hydroxychloroquine, a decades-old malaria and rheumatoid arthritis drug, has been touted as a possible treatment for the new coronavirus by high profile figures, including U.S. President Donald Trump, and has been included in several randomised clinical trials.
The University of Oxford’s Recovery trial, the biggest of these so far to come forward with findings, said that it would now stop recruiting patients to be given hydroxychloroquine “with immediate effect”.
“Our conclusion is that this treatment does not reduce the risk of dying from COVID among hospital patients and that clearly has a significant importance for the way patients are treated, not only in the UK, but all around the world,” said Martin Landray, an Oxford professor of medicine and epidemiology who co-leads the study.
The randomised clinical trial — considered the gold standard for clinical investigation — has recruited a total of 11,000 patients from 175 hospitals in the UK to test a range of potential treatments.
Other drugs continuing to be tested include: the combination of HIV antivirals Lopinavir and Ritonavir; a low dose of the steroid Dexamethasone, typically used to reduce inflammation; antibiotic Azithromycin; and the anti inflammatory drug Tocilizumab.
Researchers are also testing convalescent plasma from the blood of people who have recovered from COVID-19, which contains antibodies to fight the virus.
Researchers said 1,542 patients were randomly assigned to hydroxychloroquine and compared with 3,132 patients given standard hospital care alone.
They found “no significant difference” in mortality after 28 days between the two groups, and no evidence that treatment with the drug shortens the amount of time spent in hospital.
“This is a really important result, at last providing unequivocal evidence that hydroxychloroquine is of no value in treatment of patients hospitalised with COVID-19,” said Peter Openshaw, a professor at Imperial College London, in reaction to the results.
He added that the drug was “quite toxic” so halting the trials would be of benefit to patients.
Hydroxychloroquine has been in use for years but it has a number of potentially serious side effects, including heart arrhythmia.
‘IT DOESN’T WORK’
Researchers from the Recovery trial said they would share their data with the World Health Organization (WHO), which on Wednesday restarted its own trials of hydroxychloroquine.
They were temporarily halted last month because of a now-retracted observational study in The Lancet medical journal that had suggested hydroxychloroquine and chloroquine, a related compound, were ineffective against COVID-19 and even increased the risk of death.
Authors of the Lancet research said on Thursday that they could no longer vouch for the integrity of its underlying data, in the face of serious concerns raised by fellow scientists over a lack of clarity about the countries and hospitals that contributed patient information.
The scandal cast a shadow over The Lancet and another top medical journal, but it did nothing to clear up the increasingly politicised question of whether or not hydroxychloroquine works as a treatment for COVID-19.
Openshaw said the Recovery trial should be credited with continuing the research until they could reach a definitive conclusion on hydroxychloroquine.
“Everyone regrets that it doesn’t work, but knowing that allows us to focus on finding drugs that actually help recovery from COVID-19,” he added.
Oxford professor Peter Horby, the lead investigator on the Recovery Trial, said there was probably a “very large number” of people around the world taking hydroxychloroquine for COVID-19, with countries including the U.S., China and Brazil authorising it.
A separate clinical trial on Wednesday in the U.S. and Canada found that taking hydroxychloroquine shortly after being exposed to COVID-19 does not work to prevent infection significantly better than a placebo.
City asking people to wear masks on buses, but not mandatory – GuelphToday
As the city prepares to allow more riders on Guelph Transit buses, it is asking riders to wear a non-medical mask or face covering.
They are not mandatory.
Free 30-minute Guelph Transit service will continue for the rest of June but the city says thta with more businesses reopening and more people heading back to work, Guelph Transit is preparing to resume fare collection and regular schedules later in the summer.
In a news release Friday morning, the city said the request is based advice from Wellington-Dufferin-Guelph Public Health.
“According to health officials, wearing a homemade face covering/non-medical mask is not a substitute for physical distancing and hand washing. Wearing a mask has not been proven to protect the person wearing it, but it can help protect others around you,” the release said.
“As the buses get busy again, physical distancing may not always be possible. We’re asking riders to wear a non-medical mask or face covering to help prevent the spread of COVID-19,” says Robin Gerus, general manager of Guelph Transit.
Guelph Transit is encouraging face coverings, not requiring them.
“It’s becoming more common to wear a mask on public transit in other cities, but it’s new for Guelph. Some riders may not be aware of or understand the latest guidelines from health officials. Some may not have resources to purchase or make a mask, or they may have a medical reason for not wearing one,” added Gerus. Everyone is welcome to use Guelph Transit, and we’re asking people to protect and respect each other as ridership increases.”
Since March, Guelph Transit made the following adjustments to slow the spread of COVID-19:
- free 30-minute service allows passengers to avoid using the farebox and board from the rear door
- plastic barrier between the driver and passengers
- hand sanitizing stations and cleaning supplies for drivers
- no more than 10 people per bus
- blocked several seats to encourage physical distancing between passengers
To prevent the spread of COVID-19, the City and Guelph Transit encourage riders to continue following the latest advice from Wellington-Dufferin-Guelph Public Health:
- wash your hands regularly or use hand sanitizer
- stay at least two metres away from people you don’t live with
- when you can’t maintain physical distancing, wear a non-medical mask or face covering
WHO resumes hydroxychloroquine trial on Covid-19 patients – ITIJ
On May 25, WHO suspended the trial of the drug, which is usually used to treat malaria patients, after a study published in medical journal The Lancet found that Covid-19 hospitalised patients treated with hydroxychloroquine had a higher risk of death, as well as an increased frequency of irregular heartbeats, than those who weren’t treated with it.
However, WHO officials have since asserted that there is no evidence that the drug reduces the mortality in these patients, and the study has since been retracted over data concerns.
“The executive group received this recommendation and endorsed the continuation of all arms of solidarity trial including hydroxychloroquine,” said WHO Director-General Tedros Adhanom Ghebreyesus during a press conference 3 June, adding that WHO planned to continue to monitor the safety of the therapeutics being tested in trials involving over 3,500 patients spanning over 35 countries.
“WHO is committed to accelerating the development of effective therapeutics, vaccines and diagnostics as part of our commitment to serving the world with science, solutions and solidarity,” Ghebreyesus said.
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