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Victoria 2 completo series#
In conclusion, we advise caution in relation to making any inferences regarding the preventive or therapeutic efficacy of HCQ for SARS-CoV-2 based on this case series alone. 3 During the H1N1 influenza pandemic in 2009, despite treatment with oseltamivir, poor outcomes were reported in an immune-suppressed cancer population. For example, while there are no head-to-head comparisons of antiviral response, immune-compromised patients with influenza have higher viral loads, higher frequency of viral mutation, prolonged viral shedding, and hence poorer treatment response and outcomes than immunocompetent hosts. It is indeed possible that such high burden of comorbidities and concomitant immunosuppressive treatment may have overcome any protective effect of hydroxychloroquine. Other comorbidities in this series of patients included cerebrovascular and cardiovascular disease, hypertension, malignancy and chronic lung disease. Second, we note the high burden of comorbidity and immunosuppressive medications among these patients with SLE, with 59% being obese, 47% having chronic kidney disease and 41% being treated with immunosuppressant drugs. Moreover, as hydroxychloroquine is a staple maintenance treatment in the majority of patients with SLE, it may not be possible to source valid comparator groups who are not on hydroxychloroquine, and matching for other pertinent risk factors may not be possible across disease groups, such as rheumatoid arthritis and ankylosing spondylitis, as the demography of these diseases and their intrinsic impact on the immune system are distinctly different from those of SLE. 2 For example, having 17 infections among several thousand individuals at risk may indeed be consistent with some protective effect of hydroxychloroquine. Notwithstanding occupation and travel, presently, the risk of exposure to the virus differs from one geographical location to another, even within each country. The denominator of all patients with lupus on hydroxychloroquine who are ‘at risk’ of COVID-19 in this setting is unknown and may indeed be impossible to even estimate as it would need to be adjusted for risk of exposure to SARS-CoV-2. While the authors have correctly acknowledged the limitations of this case series report, we wish to emphasise several important points that impact the interpretation of the findings. 1 In a context where there is substantial interest in the role of hydroxychloroquine (HCQ) as a potential preventive or therapeutic agent for severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2), these cases are noteworthy.
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Our hand cut fries topped with house made salsa and crumbled goat cheese.We thank Mathian et al for reporting the outcomes of COVID-19 disease in a series of 17 patients with systemic lupus erythematosus (SLE) from several hospitals across France. Hand cut fries with tomato-cilantro salsa, mashed avocado, jalepeno-lime crema, and house made hot sauce. Served with mashed avocado and our very own hot sauce and crema. Hand cut fries, refried beans, and aged cheddar, topped with our house made salsa. Topped with goat cheese, our house vinaigrette, and drizzled with our jalapeno-lime crema. Iceberg, half an avocado, tomato, onion and cucumber. House made tortilla chips served with mashed avocado, tomato-cilantro salsa, house hot sauce and crema. Finished with our house hot sauce, jalapeno-lime crema, mashed avocado, refried beans, fresh salsa, and shredded cheddar.Īs above but with our veggie patty. * ADD BEANS OR AVO!ģ house-made hardshell tacos with your choice of steak, pork or chorizo. Vegan = no mayo.Īged cheddar, roasted red pepper sauce and house hot sauce.Īged cheddar, diced tomato, refried beans, mashed avocado, roasted red pepper sauce, and house made hot sauce.Ī heaping box of our hand cut fries and your choice of steak, pork, chorizo, or our house made veggie patty, topped with two sunny side eggs, tomato-cilantro salsa and our house hot sauce. Our house made chick pea/black bean patty on a toasted bun with cucumber, diced tomato, mashed avocado, mayo, roasted red pepper sauce and our house hot sauce.
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* ADD CHEESE OR AN EGG!Īn organic, all beef hot dog with house made salsa, mashed avocado, lots of mayo, and our house hot sauce. Your choice of thinly sliced and grilled steak, pork, or chorizo sausage on a toasted bun with diced tomato, mashed avocado, lots of mayo, roasted red pepper sauce and our house made hot sauce.