- Leonardo Seoane M.D., F.A.C.P. - Chief Academic Officer & Vice President - Ochsner Health - Associate Vice Chancellor Academic Affairs - LSUHSC-Shreveport

1. SARS CoV-2 Up to Date
Hispanic Chamber of Commerce
• Leonardo Seoane M.D., F.A.C.P.
• Chief Academic Officer & Vice
President
• Ochsner Health
• Associate Vice Chancellor Academic
Affairs
• LSUHSC-Shreveport

2. COVID-19 Statistics
Global USA Louisiana
Total Confirmed
Cases
13,349,744 3,431,744 82,042
Total Death 579,335 136,468 3,337
Johns Hopkins COVID data July 15, 2020

3. “This is not the end, this is not even the
beginning of the end, this is just perhaps the
end of the beginning.”
–Winston S. Churchill

4. SARS-CoV-2 Prevalence by Parish
All
825,057
Jefferson Parish
434,051
Orleans Parish
391,006
Weighted
Prevalence
Projected
Infected
Weighted
Prevalence
Calculated Infected
Weighted
Prevalence
Calculated Infected
Total 7.8% 64,529 6.8% 29,515 9.0% 35,014
Caucasian 5.9% 24,580 6.9% 19,524 3.7% 5,056
African
American
10.3% 36,720 6.8% 8,322 12.1 28,398
Asian 6.4% 1906 4.5% 830 9.4% 1076
Ethnicity
Hispanic
Prevalence 14.4% of population 5.5% of population
7.5% 8.7% 3.9%

5. Unadjusted
Prevalence %
0.9% 1.1% 4.9%
Prevalence n 7,299 8,922 39,741
Silent Shedders 5,677 3,123 14,704

7. Vaccine, expose body to antigen,
provoke immune response to block virus
if person infected.
• Over 100 different candidates
being evaluated
• Vast majority target “Spike”
protein
• Virus inactivated or weakened
• Viral Vector
• Replicating
• Non-replicating
• Protein Based
• Protein sub-unit
• Virus like particles
• Nucleic Acid
• DNA, RNA

8. Treatment
• Remdesivir (Antiviral)
• National Institute of Allergy and Infectious Disease Trial
• 800 patients
• Decreased time to recovery (Hospital without Oxygen, Home with minimal oxygen, Home with no
limitations)
• The sooner after symptoms the better
• Hydroxychlororquine
• Many early trials showed no benefits
• One trial demonstrated benefit for some
• HERO trial underway to see if helpful as a prophylaxis

9. Treatment
• Convalescent Plasma
• Too early to tell
• Currently collecting plasma from recovered patients
• Tocilizumab (anti-inflammatory)
• Ochsner enrolled first patient in the U.S.
• Mesenchymal Stromal Cell therapy (anti-inflammatory in lung)
• In Partnership with Cleveland Clinic Surgical Trials Network
• Steroids
• Recent study demonstrated survival benefit for those with respiratory failure

10. Characteristics of
3,481 Patients
who Tested Positive
for COVID-19
• 70% were Black, non-Hispanic
• Compared to white non-Hispanics, higher
proportion of black patients
• Were tested in the emergency
department (65.3% vs. 38.0%)
• Medicaid insurance (3x higher)
• Lived in low-income areas (2x higher)
• Have obesity (53.9% vs. 39.5%),
diabetes (18.5% vs. 10.9%),
hypertension (33.8% vs. 23.9%), and
chronic kidney disease (9.4% vs. 4.6%)
• Presented with fever, cough and
shortness of breath at the time of
COVID-19 testing
https://www.nejm.org/doi/full/10.1056/NEJMsa2011686

11. In-Hospital
Mortality
• Unadjusted case fatality rate
• 30.1% of white patients (96 out of
319)
• 21.6% of black patients (230 out of
1063)
• However, after adjusting for
sociodemographic and clinical
characteristics, in-hospital death did not
differ between the black and white
population
• Age
• Respiratory/breathing rate
• Signs of organ damage
• Inflammatory markers
• Low blood counts
https://www.nejm.org/doi/full/10.1056/NEJMsa2011686

12. 12
Shift in COVID Age Demographic
0
800
1,600
2,400
3,200
0-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 90+
March
1.8%
9.7%
15.5%
18.2%
20.7%
16.7%
8.9%
3.7%
4.8%
0
200
400
600
800
1,000
0-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 90+
July
13.3%
20.7%
16.6%
14.4%
12.9%
10.4%
7.1%
3.5%
1.1%
Positives
Positives
0
800
1,600
2,400
3,200
0-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 90+
May
7.7%
13.6%
14.6%
13.5% 13.9% 13.3%
10.5%
8.5%
4.4%
Positives
Source: R. Milani 7.8.20