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5TH ECSACOP Scientific Conference : 11th -12th December 2020 - Shared screen with speaker view
Juliana Bitarabeho
01:35:51
No we are currently live
Dathan Byonanebye
01:50:40
Are the association crude estimates or adjusted?
Dathan Byonanebye
01:51:01
I may have missed it, but were d-dimers all measured at the same time (baseline)?
Dathan Byonanebye
01:54:13
at what point does the st Anne’s protocol increase the dose enoxaparin to therapeutic doses
Dathan Byonanebye
01:54:22
That question is from Mark Dixon
Dathan Byonanebye
01:55:32
In case your hospital is trending d-dimer levels, it would be important to look at d-dimer level changes versus mortality
Mugerwa Oscar
01:55:37
how long do you anticoagulate? do you continue anticoagulation post d/c for some patients?
Jean Mburu
01:55:44
Any differences between D-Dimers levels and Gender?
Henry Mwandumba
01:56:55
Have you followed up the patients to explore the association, if any, of D-Dimer and long Covid?
Jean Mburu
01:57:12
If patient has normal D-Dimer levels on admission, do you still give anticoagulation?
James Kayima
01:58:33
In our center we give prophylactic anticoagulation for patients with severe COVID-19 regardlesa of d-dimer level
* Dr Hanif *
01:59:17
Is the raise in D Dimer consistent / parallel with raise in other inflammatory markers?
Leolin Katsidzira
02:00:08
These are preliminary data ---- we should be able to give a more comprehensive analysis as we go along. Watch this space!!!
Neil Naik
02:00:28
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?
Agnes Moses
02:00:34
What was the median DDimer level in the group that died as compared to the survivors??
ssekiswa Lwanga Zimwanguyiza
02:01:26
I look forward to the final write up after complete data analysis. Otherwise good work.
INFECTIOUS DISEASES INSTITUTE MULAGO
02:08:09
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Jean Mburu
02:18:54
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?
Teddy Kajimotu
02:21:36
Prof Mulenga. What could explain increased detection rate of Sars Cov2 infection using Serology compared to Elisa in nakonde? As shown by the graphs.
Henry Mwandumba
02:26:32
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?
James Kayima
02:27:09
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
Jean Mburu
02:28:42
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
Mugerwa Oscar
02:31:44
some data suggests that anti bodies are detectable 2 - 3week after acquiring the infection. isnt this a little late for clinical intervention?
Dathan Byonanebye
02:35:56
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
Ben Morton
02:40:21
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
ssekiswa Lwanga Zimwanguyiza
02:43:46
@ dr Duncan, were you able as well compare the severity of COVID-19 among ART naïve and ART experienced PLHIV?
Ben Morton
02:43:51
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
Ben Morton
02:44:47
Dr Oscar - I hope my previous answer addresses your question too
Francis Kiweewa
02:45:44
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.
Mugerwa Oscar
02:46:43
Dr. Morton; is this 4 days from onset of symptoms or presentation to the hospital?
Ben Morton
02:47:28
Dr Oscar: Patient reported onset of symptoms to hospital admission
Bruce Kirenga
02:52:00
Duncan thanks for this important study; did you store samples so you can look at immune responses to support the clinical observations
Jean Mburu
02:55:01
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?
INFECTIOUS DISEASES INSTITUTE MULAGO
02:57:46
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Agnes Moses
02:57:46
Dr Chanda, what was the BMI in HIV reactive patients who presented with severe disease as compared to those with mild disease.
Ndaziona Peter Kwaanjo Banda
03:00:52
great presentations. Well done presenters
Henry Mwandumba
03:02:03
Agree, these are very high quality and informative talks, great work from the presenters. Probing questions from the audience too!
Dr. ERIC ARIS
03:07:19
Dr. ERIC ARIS
Paul Zulu
03:09:52
Dr Chanda. Was there any coleration between disease severity and type of ART for example those on protease inhibitors
Faith Naddunga
03:38:03
Yes we can
Kondwelani Mateyo
03:38:35
Great presentation Prof Ferrand
Rashida Ferrand
03:39:23
Thank you so much
Africano Kamugisha
03:41:09
Thank u Prof Ferrand. Is chloroquine still recommended for clinical management for COVID-19?
Rashida Ferrand
03:44:03
No it isn't - chloroquine should NOT be used for COVID19 management
Henry Mwandumba
03:45:19
What do you think is responsible for the slimy beefy lung in Covid, is it simply rich proteinaceous exudate?
Rashida Ferrand
03:45:27
There is no evidence that choloroquine has any impact and in fact it may be dangerous
Faith Naddunga
03:49:05
Thanks for the Presentations
Emmanuel Ssekasanvu
03:49:56
is the pathological finding of the kidneys a consequence of Covid inflection or a risk factor to development of clinic
Emmanuel Ssekasanvu
03:50:13
clinical covid ?
Rashida Ferrand
03:51:29
It is likely to be both
Christopher Pasi
03:51:36
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?
Jean Mburu
03:51:57
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?
Ivan Mubangizi
03:52:32
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?
Rashida Ferrand
03:57:19
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
Wisdom forward Mudombi
04:01:33
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
Jean Mburu
04:08:51
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?
Dathan Byonanebye
04:12:56
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
Pauline Byakika
04:14:01
Great presentation! thank you
Portia Ndhlumbi
04:14:21
thank you can we get access to the slides
Ndaziona Peter Kwaanjo Banda
04:14:46
very insightful presentation indeed
Jackson Kansiime
04:15:16
To Dr Kalungi Wha was the likely cause of Lung swelling was it fluid, diposition or lung parenchymal cell Hypertophy?
Duncan Chanda
04:15:49
Great presentation Dr Mateyo!
Mohamed Sood
04:16:28
excellent presentations
Mugerwa Oscar
04:16:44
is there role of escalating the dose of steroids in patients in whom disease continue to progressive despite being on the recommended 6mgs/day?
Apolo Balyegisawa
04:16:57
Dr. Kalungi
Pauline Byakika
04:17:16
Dr Kalungi thank you! comment on the oxygen therapy vs your findings on PM
Jean Mburu
04:17:40
Dr Mateyo, in order to avoid post Covid lung fibrosis, comment on role of antifibrotic drugs and when they should be administered.
Jackson Kansiime
04:18:11
For Prof Mateyo, does the pathology finding
Kwenzakwenkosi Ncube
04:18:44
May l have the registration link.
Apolo Balyegisawa
04:18:47
What are the likely causes of the beefy lung? Is it reversible? Could reversing the pathology improve outcomes?
INFECTIOUS DISEASES INSTITUTE MULAGO
04:19:08
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Henry Mwandumba
04:20:23
Prof Mateyo, can one predict during the acute illness which patients are likely to develop post Covid-19 fibrotic lung diseases?
Jackson Kansiime
04:20:57
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?
Henry Mwandumba
04:21:58
Excellent talks Kondwelani, very informative indeed, a lot of learning points.
Grace Kansiime
04:22:49
excellent presentations Dr Mateyo and Dr Kalungi.
James Mulindwa
04:23:03
Dear Prof Mateyo, thanks for this informative presentation.
Mugerwa Oscar
04:23:12
how best can you manage long CORVID?
DARIUS OWACHI
04:23:14
great presentation, thank you
Joan Rugemalila
04:23:23
thank you for the very useful information about ct chest and PE recommendations
Kondwelani Mateyo
04:23:33
Thanks all
Rashida Ferrand
04:23:44
Great presentation Dr Mateyo
Natasha Chenga
04:24:13
Thankyou Dr mateyo very informative..
Ivan Mubangizi
04:24:19
thanks for the great presentation Dr Mateyo. any evidence that steroids reduce these post covid syndromes especially fibrosis?
Atiki Jacob
04:24:29
how can one gain access to these presentations?
Jackson Kansiime
04:25:15
Illuminating presentations from both presentors Dr Kalungi and Prof Mateyo. More questions
Stella
04:25:19
The presentations will be made available on the college website
Florence Aweyo
04:25:49
How long do you anticipate ate after recovery?Do you anticipate need for long term oxygen therapy(LTOT) with fibrotic sequelae?
Florence Aweyo
04:26:53
How long do you anticoagulate after recovery? When do you stop?
Jackson Kansiime
04:27:53
Dr Kalungi was there fibrosis in the lung Post mortems
Henry Mwandumba
04:29:47
Dr Kalungi’s pathological findings in the lung was interesting. Has beefy lung been described in postmortem series from resource-rich countries?
James Kutosi
04:30:16
haven't seen registration link
Kondwelani Mateyo
04:30:32
Dr.Kansiime i hope i answered your question as posed by Dr.Namarika
Dathan Byonanebye
04:31:58
The host should mute everyone!!!!!!
Dathan Byonanebye
04:32:19
The host has the capacity to mute everyone
Jackson Kansiime
04:34:03
Yes professor Mateyo it generated a new question of how to identify clinically which patient has beefy lung befor e they are dead .
Henry Mwandumba
04:34:26
Bronchoscope toilet is also used in Pulmonary Alveolar Proteinosis but not confirmed in Covid
Kondwelani Mateyo
04:34:40
Exactly Dr.Kansiime!
Jackson Kansiime
04:34:56
so i think patients who have incrased work of breathing probably correlates with bef lung
Joan Rugemalila
04:46:03
In most of our facilities in Tanzania we did not have CQ available, by default we did not use it
Max Patana
04:48:14
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?
Godfrey Mutashambara Rwegerera
04:48:30
Excellent presentation Dr Omonge
Louis Nyende
04:53:37
What is yr comment on use of Ivermectin?
Mohamed Sood
04:57:50
excellent prof Omonge ..Thank.you
Ali Ali
04:58:59
it looks like treatment of COVID 19 depends on phases, severity of symptoms and capacity of facility. it is highly individualised
Andrew Kazibwe
04:59:36
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?
Henry Mwandumba
05:00:00
Excellent talk Prof Omonge, very insightful and a comprehensive rationale behind current Covid therapeutics. Thank you.
Stephen Obbo
05:02:03
Presenter, please use slide show
Kondwelani Mateyo
05:03:24
Excellent presentation Prof. Omonge
Jean Mburu
05:13:05
Dr Kirenga at which point should plasma be collected post Covid to get the highest yield?
Dathan Byonanebye
05:16:19
I see high HCV prevalence overall (8%), was this HCV antibody test? It is really strange that HCV>HBV
Pancho Mulongeni
05:16:32
Afternoon, Pancho Mulongeni (Namibia, Bulgaria) joining form London.
Jackson Kansiime
05:16:50
Which Antibody IgM or IgG?
Pancho Mulongeni
05:17:15
@Dathan, that is true, HCV p is really high.
Claudine Mukashyaka
05:17:54
How long does the body retain memory of Covid-19
Duncan Chanda
05:18:20
Excellent work,Bruce and team
Max Patana
05:18:38
does re-infection with SARS Cov-2 happen? and how long does the immunity last?
Francis Mupeta
05:18:39
fantastic works!
Kondwelani Mateyo
05:18:51
Brilliant and insightful work Prof Kirenga!
Duncan Chanda
05:18:57
We look forward to the results!
DR. WILBERFORCE M. KABWERU
05:20:15
DR. KABWERU WILBERFORCE M. Mulago National Referral Hospital-CTU wmkabweru@gmail.com, Good Afternoon colleagues.
Henry Mwandumba
05:21:20
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.
Jackson Kansiime
05:25:53
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?
Kondwelani Mateyo
05:28:26
@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
Daniel Kiggundu
05:29:39
Regarding TPE, did the replacement solution (albumin vs plasma) influence the outcomes?
Ahmed Sokwala
05:30:18
regarding TPE , the usual question is do we also remove the ‘good ‘ cytokines?
Jean Mburu
05:30:25
Dr Aggrey, was this an observational study since I didn't hear of a control group?
Max Patana
05:31:35
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?
Aggrey Mweemba
05:33:04
we had high mortality in patients of asian origin
Aggrey Mweemba
05:33:57
of course depending on the membrane you re using, TPE removes good cytokines too
Aggrey Mweemba
05:34:05
we had no control
Pamela Chansa
05:34:21
Thank you to all the presenters for sharing your knowledge and experiences.
Kondwelani Mateyo
05:35:20
Great presentation Aggrey!
Aggrey Mweemba
05:37:39
thank you all
Pauline Byakika
05:37:55
Great conference! Thank you to all presenters!
INFECTIOUS DISEASES INSTITUTE MULAGO
05:38:05
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Ali Ali
05:38:38
great conference thanks
Pancho Mulongeni
05:38:45
10J45 HERE IN LONDON
Ivan Kimuli
05:38:50
Dr. Ivan Kimuli, Makerere University
Pancho Mulongeni
05:38:52
Anyone in London?
Pauline Byakika
05:40:16
Great conference! Thank you organising committee!