Now, having said that, we've got colchicine since I wrote this question, but it's not yet with peer review, and no doubt we'll have final review of some more tocilizumab and other IL-6 inhibitors. So here I am, I'm trying to not ignore the dominant disease in our ICUs the year we're writing SEEK, but maybe it'll all be relevant next year, and I'm interested in your thoughts about it. Jesse, the Act 4 Baricitinib looks like it's going to be positive, but you know what we could do is just update it right before it goes to publication, we've done that before too. Yeah, I was actually thinking exactly that, or at least refine it, not rewrite it, but refine it, and then also add a thing, you know, this is a happening area, it's changing the usual that we did for some of the others. I mean, it seemed to me odd that we would put out a SEEK and never mention COVID other than it's a setup for statistics questions, but I don't know how to, you know, wrap my head around it, certainly around treatment. I think you're going to have to update it right before you go to publication, because it's going to change several times, but I think what you have here is a solid background to it, and then you can put a paragraph in with an update. Yeah, of the choices given, I don't, that's what I finally kind of sat on, I sort of thought at first I put teslizumab up there, but that's, you know, that's moving up and down the list. So I left that off, you know, conceivably the antibodies will find a role too, at some point. You know, I think even if, you know, we get this thing under better control with a vaccine, there's still going to be outbreaks, and this will be here, we will be taking care of COVID in some way, maybe to a lesser extent in subsequent years. Jesse, I have a couple of comments. The first one is, this is a pneumonia. This is not a pneumonitis only. So this is a real entity. If you really put in pneumonia, you will find that the COVID-19 spectrum goes to the disease. We never talk about influenza pneumonitis or anything like that. We always talk about this entity as a pneumonia. Second, I think it's a little bit, according to the NIH definition, the moderate, it is not with oxygen. And I think the caveat about dexamethasone is the utilization of oxygen, because the people that didn't get the oxygen therapy didn't do good when they received dexamethasone. Therefore, I will focus on the severe COVID-19 part and remove the moderate, because the moderate, by definition, is a room air and could create a little bit of confusion. Is that true? Yeah, the recovery trial said that moderate was patients who were not yet on oxygen. So, yes. I think I actually, in the discussion, comment that the dexamethasone benefit was not seen in patients receiving, not receiving respiratory support at randomization. Yeah, I think the question is just the word moderate. And should that be, yeah, that's all. When you look at the recovery trial, and I looked at it a couple of times, they don't actually specifically define how they measure hypoxemia, because I think there were so many centers in the UK that they could not standardize it. Because my question was, is there a certain pulse oximetry level? Is it on room air? How much could you be on two liters nasal cannula when they measure those kind of things? I couldn't find it. Maybe I missed it. I even looked at the online supplements. So I'm just going to raise that issue. I think this, we have to have a COVID question. I think as long as Jesse promises not to add five figures and four tables and stick within kind of this length, we can update pre-publication when we review it. And then at the PDF time, if it needs to, if it needs to. Could you at least add for the antibodies that they're of benefit in preventing hospitalization and outpatients? I really think we may be using them more, especially if we have another outbreak. So you might just add a little bit about the positive data there, even though it's not germane for this patient. Yeah, well, this will probably, I mean, Darcy, so is our last shot at tweaking it mid-February? No, later. It'll be, probably we'll see mid-February, we're going to make sure everybody did the changes, but we're going to see a PDF, a draft PDF, correct me Martha, maybe in May. And as long as we stick, we don't all start playing around with pages, we can revise them, correct Martha? Yep, correct. That, yeah, that's good because, you know, February, I'm not sure it gives me enough more time, you know, we'll barely have the Colchicine paper. We probably want to put a sentence in. If that turns out to change mortality, it'd be really bad not to comment on that, even if it's not a choice. All right, that's fine by May. I think I can take a little bit before that and then work on it in the PDF in May and not, you know, violate the editorial guidelines for how much change a PDF gets at that point.

COVID-19 treatments

updating content

pneumonia

dexamethasone

PDF draft