No we are currently live

Are the association crude estimates or adjusted?

I may have missed it, but were d-dimers all measured at the same time (baseline)?

at what point does the st Anne’s protocol increase the dose enoxaparin to therapeutic doses

That question is from Mark Dixon

In case your hospital is trending d-dimer levels, it would be important to look at d-dimer level changes versus mortality

how long do you anticoagulate? do you continue anticoagulation post d/c for some patients?

Any differences between D-Dimers levels and Gender?

Have you followed up the patients to explore the association, if any, of D-Dimer and long Covid?

If patient has normal D-Dimer levels on admission, do you still give anticoagulation?

In our center we give prophylactic anticoagulation for patients with severe COVID-19 regardlesa of d-dimer level

Is the raise in D Dimer consistent / parallel with raise in other inflammatory markers?

These are preliminary data ---- we should be able to give a more comprehensive analysis as we go along. Watch this space!!!

Comorbidities like Heart failure will present with elevated D Dimers, how do you take care of those as they’ll have this elevated level anyways?

What was the median DDimer level in the group that died as compared to the survivors??

I look forward to the final write up after complete data analysis. Otherwise good work.

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Prof Mulenga, do you think the prevalence of Covid-19 in Zambia may have changed between July and Dec or it remains relatively the same?

Prof Mulenga. What could explain increased detection rate of Sars Cov2 infection using Serology compared to Elisa in nakonde? As shown by the graphs.

Dr Morton, for the patients that were PCR positive but seronegative, what was the duration of symptoms, did they present earlier than most of the patients in this study?

The testing algorithms for SAR-CoV 2 has been confusing for the practitioner. Most centres now rely mainly on radiology. Adding antibody testing may assist

Dr Morton, what would the likely cause of SARI in RT-PCR neg patients, is it still part of Covid-19 symptoms or another infection

some data suggests that anti bodies are detectable 2 - 3week after acquiring the infection. isnt this a little late for clinical intervention?

To any of the presenters:Do we know if serological tests can actually differentiate between Ssars-cov-2 and environmental corona viruses? We know corona like viruses are responsible for around 20% of the colds. Therefore serological kits must differentiate COVID from common cold due to corona-like viruses

Prof Mwandumba: the median time to presentation for PCR+ve antibody. -ve patients was 4 days so no different to PCR+ve population in this study. Small numbers though so I think your hypothesis can’t be discounted

@ dr Duncan, were you able as well compare the severity of COVID-19 among ART naïve and ART experienced PLHIV?

Dr Mburu: We know that severe COVID disease is mediated by “immunothrombosis” and doesn’t necessarily correlate with viral load. Complications commonly come after viral clearance. I don’t think there has been a trial looking at dexamethasone for patients who have SARI, PCR-ve and antibody+ve. I think our data supports the case for an evaluation within this subgroup

Dr Oscar - I hope my previous answer addresses your question too

Dr Chanda, among the studies that have looked at HIV and COVID-19, only the SA study and now the WHO platform preliminary analysis demonstrate an association between HIV and COVID-19 disease severity and or mortality. Would CD4 count be a better predictor that the HIV status per say? I note that majority of your HIV participants were virally suppressed.

Dr. Morton; is this 4 days from onset of symptoms or presentation to the hospital?

Dr Oscar: Patient reported onset of symptoms to hospital admission

Duncan thanks for this important study; did you store samples so you can look at immune responses to support the clinical observations

Dr Chanda, in Sub-Saharan Africa, HIV is not being associated with more mortality/morbidity in Covid-19 unlike what others had predicted. Could ARTs be helping from getting severe complications in HIV patients with Covid?

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Dr Chanda, what was the BMI in HIV reactive patients who presented with severe disease as compared to those with mild disease.

great presentations. Well done presenters

Agree, these are very high quality and informative talks, great work from the presenters. Probing questions from the audience too!

Dr. ERIC ARIS

Dr Chanda. Was there any coleration between disease severity and type of ART for example those on protease inhibitors

Yes we can

Great presentation Prof Ferrand

Thank you so much

Thank u Prof Ferrand. Is chloroquine still recommended for clinical management for COVID-19?

No it isn't - chloroquine should NOT be used for COVID19 management

What do you think is responsible for the slimy beefy lung in Covid, is it simply rich proteinaceous exudate?

There is no evidence that choloroquine has any impact and in fact it may be dangerous

Thanks for the Presentations

is the pathological finding of the kidneys a consequence of Covid inflection or a risk factor to development of clinic

clinical covid ?

It is likely to be both

For the brave at heart, given the autopsy findings of those mucus pigging and bronchial obstruction, should how about bronchoscopic clearance of these obstructing plugs?

Dr Kalungi, any findings in the heart as its been reported Covid-19 can infect the heart directly? Again is the solid lung the same finding one would find in non Covid-19 ARDS eg cardiac cause of ARDS?

could the findings of fatty liver disease simply be from pre-existing conditions of diabetes and diabetes especially since obesity and diabetes are common predisposing factors in the critical cases?

Chris - it would be difficult to access the smaller airways and there is a lot of leakiness and inflammation--- so i imagine the risk of bleeding would be high

some pulmonologist have been performing bronchoscopic clearance with good patient outcomes in icu but respiratory physicians/ Pulmonologist can give robust evidence of such an intervention given the autopsy findings in the lungs presentation given and low resource settings of most our patients in Africa to afford

Dr Mateyo, there are some Covid-19 patients who go to cardiac arrest immediately after intubation and succumb. What would be the cause and how can the cardiac arrest be prevented?

This was a powerful presentation. I wish the presenter was allowed more time. The presentation is heavy with very important clinical insights that may help our patients

Great presentation! thank you

thank you can we get access to the slides

very insightful presentation indeed

To Dr Kalungi Wha was the likely cause of Lung swelling was it fluid, diposition or lung parenchymal cell Hypertophy?

Great presentation Dr Mateyo!

excellent presentations

is there role of escalating the dose of steroids in patients in whom disease continue to progressive despite being on the recommended 6mgs/day?

Dr. Kalungi

Dr Kalungi thank you! comment on the oxygen therapy vs your findings on PM

Dr Mateyo, in order to avoid post Covid lung fibrosis, comment on role of antifibrotic drugs and when they should be administered.

For Prof Mateyo, does the pathology finding

May l have the registration link.

What are the likely causes of the beefy lung? Is it reversible? Could reversing the pathology improve outcomes?

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Prof Mateyo, can one predict during the acute illness which patients are likely to develop post Covid-19 fibrotic lung diseases?

For Prof Mateyo, does the pathology finding of heavy beefy lungs have implications for the ventilation settings ,could it explain the poor outcomes for patients on vent?

Excellent talks Kondwelani, very informative indeed, a lot of learning points.

excellent presentations Dr Mateyo and Dr Kalungi.

Dear Prof Mateyo, thanks for this informative presentation.

how best can you manage long CORVID?

great presentation, thank you

thank you for the very useful information about ct chest and PE recommendations

Thanks all

Great presentation Dr Mateyo

Thankyou Dr mateyo very informative..

thanks for the great presentation Dr Mateyo. any evidence that steroids reduce these post covid syndromes especially fibrosis?

how can one gain access to these presentations?

Illuminating presentations from both presentors Dr Kalungi and Prof Mateyo. More questions

The presentations will be made available on the college website

How long do you anticipate ate after recovery?Do you anticipate need for long term oxygen therapy(LTOT) with fibrotic sequelae?

How long do you anticoagulate after recovery? When do you stop?

Dr Kalungi was there fibrosis in the lung Post mortems

Dr Kalungi’s pathological findings in the lung was interesting. Has beefy lung been described in postmortem series from resource-rich countries?

haven't seen registration link

Dr.Kansiime i hope i answered your question as posed by Dr.Namarika

The host should mute everyone!!!!!!

The host has the capacity to mute everyone

Yes professor Mateyo it generated a new question of how to identify clinically which patient has beefy lung befor e they are dead .

Bronchoscope toilet is also used in Pulmonary Alveolar Proteinosis but not confirmed in Covid

Exactly Dr.Kansiime!

so i think patients who have incrased work of breathing probably correlates with bef lung

In most of our facilities in Tanzania we did not have CQ available, by default we did not use it

Is it necessary to give azithromycin + oral corticosteroids in patients that have just been diagnosed and asking for some form of treatment especially if they are anxious?

Excellent presentation Dr Omonge

What is yr comment on use of Ivermectin?

excellent prof Omonge ..Thank.you

it looks like treatment of COVID 19 depends on phases, severity of symptoms and capacity of facility. it is highly individualised

Thank you Prof. Omonge. Have antihistamines shown any benefit in managing the COVID associated cytokine storm? What would be the role of anti-VEGF sorafenib in aborting COVID ARDS?

Excellent talk Prof Omonge, very insightful and a comprehensive rationale behind current Covid therapeutics. Thank you.

Presenter, please use slide show

Excellent presentation Prof. Omonge

Dr Kirenga at which point should plasma be collected post Covid to get the highest yield?

I see high HCV prevalence overall (8%), was this HCV antibody test? It is really strange that HCV>HBV

Afternoon, Pancho Mulongeni (Namibia, Bulgaria) joining form London.

Which Antibody IgM or IgG?

@Dathan, that is true, HCV p is really high.

How long does the body retain memory of Covid-19

Excellent work,Bruce and team

does re-infection with SARS Cov-2 happen? and how long does the immunity last?

fantastic works!

Brilliant and insightful work Prof Kirenga!

We look forward to the results!

DR. KABWERU WILBERFORCE M. Mulago National Referral Hospital-CTU wmkabweru@gmail.com, Good Afternoon colleagues.

It is great to see the broad spectrum of exciting work taking place in the region, exciting work Dr Kirenga, well done and thank you for sharing your data.

Thanks Dr Kirenga for an interesting concept and presentation. Africa's experience with Convalescent plasma my be different from the Western one. Does your crude analysis suggest correlation with Wesern findings of "no benefit" or does it look like there is benefit like China's?

@Florence Aweyo, i find this Emory guide for post-discharge thromboprophylaxis useful: https://www.emoryhealthcare.org/ui/pdfs/covid/medical-professionals/VTE%20mgmt%20COVID.pdf

Regarding TPE, did the replacement solution (albumin vs plasma) influence the outcomes?

regarding TPE , the usual question is do we also remove the ‘good ‘ cytokines?

Dr Aggrey, was this an observational study since I didn't hear of a control group?

TPE Dr Aggeey... your profiles for demised patients was quite diverse what do you make of that since comorbidities have really been touted as increasing bad outcomes?

we had high mortality in patients of asian origin

of course depending on the membrane you re using, TPE removes good cytokines too

we had no control

Thank you to all the presenters for sharing your knowledge and experiences.

Great presentation Aggrey!

thank you all

Great conference! Thank you to all presenters!

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great conference thanks

10J45 HERE IN LONDON

Dr. Ivan Kimuli, Makerere University

Anyone in London?

Great conference! Thank you organising committee!