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vineet_chopra's profile
Vineet Chopra
Vineet Chopra
Vineet Chopra
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@vineet_chopra

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Vineet ChopraVerified account

@vineet_chopra

Chief, Researcher, Author, Editor @AnnalsofIM, Prof @UMICH 〽️Focus: #ptsafety #vascularaccess #PICCs #MAGIC #Mindfulness #Mentorship #Leadership #GoBlue

United States
improvepicc.com
Joined March 2012

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    1. Vineet Chopra‏Verified account @vineet_chopra 19 Mar 2020

      There’s a lot of doom and gloom out there when it comes to #CoVID19. It’s true / it’s a bad disease. But we discharged three people home this week after short hospital stays. All felt great at discharge. I’ll count that as a win.

      48 replies 275 retweets 2,137 likes
      Show this thread
    2. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      Following up on @leorahorwitzmd great views on clinical care, here is what we have seen caring for #COVID19 @umichmedicine 1\ Our hospitalists have now cared for over 100 #COVID19 critically and non-critically ill patients.

      4 replies 68 retweets 175 likes
      Show this thread
    3. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      2\ There appear to be 2 phenotypes of disease: A) Those with mild-mod hypoxia, need 02 and improve slowly over time. B) Those with rapidly escalating 02 needs proceeding quickly to intubation. Presentation doesn’t depend on age, health. This dz doesn’t discriminate.

      3 replies 23 retweets 75 likes
      Show this thread
    4. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      Clinical symptoms vary but high grade, hectic, oscillating fevers are common. Cough and shortness of breath also up there. GI symptoms much less frequent but def exist. Hypoxia and rapid 02 needs are hallmarks of the dz. CXR with periph hazy GGOs key.

      3 replies 11 retweets 39 likes
      Show this thread
    5. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      The lung injury from #coronavirus leads to high 02 requirements, even in clinically stable patients. This is a single organ dz for the most part. Not uncommon to see young, healthy people with no med probs end up on the vent. This last part is scary. Hard to predict course.

      3 replies 26 retweets 61 likes
      Show this thread
    6. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      Sky high d dimers and #VTE appears common. I wonder how many cardiac arrests (mostly PEA/Asystole) were actually PE rather than myocarditis. We have started to pharmacologically prophylax critically ill patients given this observation.

      4 replies 11 retweets 68 likes
      Show this thread
    7. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      Have not seen a lot of myocarditis; but some pts do develop worsening cardiac dysfunction days after extubation. Almost all of these have been patients with pre existing structural or ischemic heart dz.

      1 reply 5 retweets 34 likes
      Show this thread
    8. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      During recovery, pts continue to have a high PEEP requirement. Lung compliance doesn’t seem to be affected much during illness, but the need for prolonged positive pressure is peculiar. Take them off PEEP too early, and Sats drop precipitously.

      1 reply 8 retweets 38 likes
      Show this thread
    9. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      Toci and other IL6 blockers really seem to work - if you give it early enough in the dz. Peri intubation is too late. We follow biomarkers and 02 needs when making this decision. Also talk to #ID and #IDPharm who are our besties. FYI - we are a trial site for Sarilumab.

      5 replies 13 retweets 61 likes
      Show this thread
      Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

      Really have not seen any clinical benefit from hydroxychloroquine. Rather have seen a lot of GI ADRs and LFT bumps coming out of it. Not sure this has as much of a role in disease care TBH.

      7:42 AM - 31 Mar 2020
      • 38 Retweets
      • 89 Likes
      • Betollanosbustamante J vazquez Rhonda Gwyther Dedicating Ruckus Countblah76 Erin Symons 🍀 nothings monstered Melissa Levine gmopundit (David Tribe Ph.D.) Vinceremo
      9 replies 38 retweets 89 likes
        1. New conversation
        2. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

          There is profound physical weakness during recovery. Those that get better need help with basic ADLs. Yes, even a 30 yr old needs assist to get up and go to the bathroom. Early PT and ambulation is key.

          2 replies 25 retweets 83 likes
          Show this thread
        3. Vineet Chopra‏Verified account @vineet_chopra 31 Mar 2020

          Finally, I have never seen a dz that needs so many of us to come together to deliver care. #COVID19 care needs MDs, RNs, resp therapists, APPs, pharmacists, PT, Social workers, sub specialties and palliative care. It takes a village to fight - fortunate to have one @UMich.

          10 replies 30 retweets 197 likes
          Show this thread
        4. End of conversation
        1. New conversation
        2. Judy Stone‏ @DrJudyStone 31 Mar 2020
          Replying to @vineet_chopra

          Thx for being a voice of reason on the insane prescribing of #hydroxychloroquine and your great thread. Pls submit any Rx cases http://cure.ncats.io  #DrugRepurposing database by @ncats_nih_gov, FDA. It's a forum for MDs/#ID #pharmacists to exchange info on Rx #CUREID app

          2 replies 0 retweets 6 likes
        3. The Monarch Diaries‏ @monarchdiaries 31 Mar 2020
          Replying to @DrJudyStone @vineet_chopra @ncats_nih_gov

          THANK YOU! I love the database and forum. Please continue promoting - I will as well!!

          0 replies 0 retweets 1 like
        4. End of conversation
        1. Sarah Adams‏ @sayrahsaarah 31 Mar 2020
          Replying to @vineet_chopra

          Is it prescribed with azythromycin & zinc?

          0 replies 0 retweets 3 likes
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        1. New conversation
        2. TruthBeTold‏ @TruthBe50643193 31 Mar 2020
          Replying to @vineet_chopra

          Diarrhea & liver damage are known to be caused by COVID-19, yet you blame it on the #chloroquine. The dr. in the previous thread you referred to also dismissed it, while admitting she’s not even using it because...she thinks it doesn’t work. Where is the logic in any of this?

          1 reply 0 retweets 1 like
        3. TruthBeTold‏ @TruthBe50643193 31 Mar 2020
          Replying to @TruthBe50643193 @vineet_chopra

          https://pubmed.ncbi.nlm.nih.gov/32170806/ 

          1 reply 0 retweets 1 like
        4. Show replies
        1. New conversation
        2. George Stanchev‏ @gstanchev 1 Apr 2020
          Replying to @vineet_chopra

          Do you apply HCQ/AZ early?

          2 replies 0 retweets 2 likes
        3. Zinc & Vitamin D3 | COVID-19 Game Changers‏ @LukeMor19529310 1 Apr 2020
          Replying to @gstanchev @vineet_chopra

          Dr. Chopra, can you answer this question? Do you see a difference in the patient illness stage with HCQ? Most reports indicate that better results for HCQ come in the early illness stage.

          0 replies 0 retweets 0 likes
        4. End of conversation
        1. Defend Santa Cruz‏ @Save_SantaCruz 2 Apr 2020
          Replying to @vineet_chopra @kausmickey

          Cool, more for us.

          0 replies 0 retweets 0 likes
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