OtherGround Forums OG doc. AMA on COVID-19

4/6/20 8:31 AM
10/23/05
Posts: 3265
BJ Penn Forever - 

I'm listening to Dr. Vuong on youtube... he is saying even being 40 lbs overweight is a huge issue for this virus and will result in a lot more deaths than otherwise.

 


Answered this on your thread.

He's right that obesity is a risk factor but much less so than age. I'm happy to present why mathematically if there is interest.

In essence: if you're 300lbs but 30 yo your risk of dying is MUCH less than a 80 year old who is slim.

4/6/20 8:34 AM
1/1/01
Posts: 37567
mataleo1 -
BJ Penn Forever - 

I'm listening to Dr. Vuong on youtube... he is saying even being 40 lbs overweight is a huge issue for this virus and will result in a lot more deaths than otherwise.

 


Answered this on your thread.

He's right that obesity is a risk factor but much less so than age. I'm happy to present why mathematically if there is interest.

In essence: if you're 300lbs but 30 yo your risk of dying is MUCH less than a 80 year old who is slim.

Thanks for spelling out the risk factor in the other thread.

And as I said before, hope you are getting some down time and staying as safe as possible.

4/6/20 8:45 AM
2/18/20
Posts: 176

mataleo1,

 

Just wanted to say THANK YOU again for this thread and all that you are doing on the front lines.

 

Stay safe.

4/6/20 8:52 AM
10/23/05
Posts: 3268

As an update, I've been asked to participate on 2 guidelines related to COVID.

One is about treatment of HCQ toxicity (because people are self medicating and we're seeing more overdose).

The other is on the treatment of HCQ in severe patients (focusing on pharmaceuticals).

Will force me to read more :)

Edited: 4/6/20 10:49 AM
2/4/09
Posts: 10847
mataleo1 -
NoNeed4aScreenName - 

Sorry one more question. I know you mentioned it before but I cant exactly recall and this thread is huge now. 

 

Did you ever mention that you observe sudden decreases in blood pressure in some Covid-19 admissions in the ICU?


I haven't yet answered your questions on ACE-2 because science is moving fast and trying to catch up on the literature.

BP is not lower for COVID patients than for others with respiratory viruses, at least in terms of my experience. It may go down, but that much is true for any ICU patient with an infection

That's fine. I'm surprised you're not tired of my questions yet. 

 

I just feel like potentially ACE2 is at the center of this. Especially considering its many roles in the cirus uptake and lung injury protection. 

 

I'm just wondering if, going back to enzyme kinetics, if it would be possible for the receptor to get saturated and then that's when the worst symptoms appear. 

 

I just thought at some point BP crashed if it could be related to ACE2

4/6/20 10:54 AM
1/13/10
Posts: 47620

Apparently the 5G towers in different parts of the world have been releasing radiation, which has been weakening people’s immune system. This is why so many people have been getting sick and dying. 
 

I got my answer Docs, no need for this thread anymore 

Edited: 4/6/20 10:59 AM
2/4/09
Posts: 10848

One more question. I guess this is more so in regards to binding the heme like some are saying the virus can do. 

 

In order for that to happen wouldn't the virus need to enter the bloodstream? Have you seen any evidence of the virus being found there?

4/6/20 11:49 AM
5/22/15
Posts: 11075

Serious question here.
How is it that the "common flu" which has a new vaccine distributed en masse every year, having a greater mortality rate than any global pandemic purported throughout centuries of civilization deemed less of a threat to society than shoveling in immigrants that practice poor hygiene?

Edited: 4/6/20 3:16 PM
11/23/10
Posts: 182
NoNeed4aScreenName -

One more question. I guess this is more so in regards to binding the heme like some are saying the virus can do. 

 

In order for that to happen wouldn't the virus need to enter the bloodstream? Have you seen any evidence of the virus being found there?

Low level viraemia has been reported in a few percent of symptomatic patients. And also in urine (probably just spillover from blood filtration in the kidneys). Here are a few links - It’s mostly small studies, so the magic of small numbers may apply, and they haven’t tested if the RNA detected was actively infectious or inactivated:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext?fbclid=IwAR21v_Wz-pmaEN9TwZd1aVhOLMU6YesDciWbVkZYZAvhrX5Eru23uYA_jLk

https://jamanetwork.com/journals/jama/fullarticle/2762688

https://jamanetwork.com/journals/jama/fullarticle/2762997

Edit: I don’t know how to interpret this with regards to heme-, but it seems not a lot of systemic viral dissemination happens. 

Edited: 4/7/20 1:33 AM
11/23/10
Posts: 183

Another update from over here, and some preliminary findings from rolling out antibody testing to blood donors, which I thought I’d share.

Curves of hospital admissions are still slowly and steadily falling. Still a stable influx from the ordinary wards into the ICUs which approximately balances daily deaths. So far so good - the plan is to begin the first phase of gradual reopening of the country on april 15th: that’s just nurseries, daycare, kindergardens and schools up to 5th grade. All other lockdown measures stay in place at least another month. Large gatherings are banned until the end of august.

PPE has been been getting scarce, especially outside of hospitals. PCR-testing capacity is really taking off, though, so that’s good. Problems with false-negative results due to sampling of upper airways are becoming evident, with a few examples of clusters of healthcare workers in hospital wards getting infected as a result.

They started rolling out antibody-testing of blood donors for COVID-19 a few days ago. It’s too early to make an estimate of the true case numbers, and it’s probably a skewed sample of the population, but still interesting. It seems not a lot of people have been infected, at least compared to what I expected, since testing had been very limited and selective until recently:

In the capital region, with a current cumulative incidence of confirmed cases of 1241 per million of population - that’s around 0.1 - 0.15 percent -  they found seropositivity in 2.7 percent of blood donors (edit: adjusted for false negative rate, and including tests from a few more days, seropositivity was 3.5 percent). For perspective, the number of patients hospitalized due to COVID-19 there maxed out (so far, knock on wood) at around 140 patients per million inhabitants.

I’m no fan of herd immunity as a strategy (it’s planning to fail, unless you have a vaccine), but I had expected/hoped for a larger proportion of immune in the population, even though we were quick to lock down the country and kept the epidemic decently controlled. The effects of a partial herd immunity (with maybe 50% of the population being immune) will be a big part of the solution to going back to a normal, open society. We’re far from those figures here, unless the blood donors are extremely misrepresentative of the overall population.

Edited: 4/6/20 4:29 PM
11/1/03
Posts: 21735

NY gov Cuomo just said the test with 1100 patients showed anectotally good results. Said it was not scientifically proved but looked promising and their getting more. Sounds like good news. 

4/6/20 5:03 PM
3/6/06
Posts: 31189
Upperfaggot -

Serious question here.
How is it that the "common flu" which has a new vaccine distributed en masse every year, having a greater mortality rate than any global pandemic purported throughout centuries of civilization deemed less of a threat to society than shoveling in immigrants that practice poor hygiene?

I think its because the part you made up about the common flu having a higher mortality rate than any global pandemic is untrue.  it's just something you made up in your head out of thin air.

4/6/20 5:33 PM
10/14/11
Posts: 338

So off the wall question.  My wife probably had covid starting around 10th of march. Went to er,  was told she probably had it but didn't qualify for testing.  Kids and I have shown little to no symptoms. Kids had 99.5 to 100 fever.  Me nothing.  I'm guessing I got it and was asymptomatic.  It has been long enough I shouldn't be contagious.  

With no medical training is there anything above staying inside that I could do to help?

4/6/20 6:33 PM
1/1/01
Posts: 11721
jpm995 - 

NY gov Cuomo just said the test with 1100 patients showed anectotally good results. Said it was not scientifically proved but looked promising and their getting more. Sounds like good news. 




Test for what?
4/6/20 7:21 PM
11/1/03
Posts: 21741
prof -
jpm995 - 

NY gov Cuomo just said the test with 1100 patients showed anectotally good results. Said it was not scientifically proved but looked promising and their getting more. Sounds like good news. 




Test for what?

Coumo said 2 weeks ago they would test 1100 covid patients with the drug hydroxychloroquine with zpac drug combo. He said today that although it cant be scientificly proved the results were encouraging. He said the feds will approve more shipments of the drugs asap. I was disappointed he didn't give any results numbers. They give stats for everything but not this. Of course no one asked about it.

4/6/20 10:25 PM
1/1/01
Posts: 11722
Ok, thanks for clarifying about the test.
4/7/20 12:38 AM
4/26/13
Posts: 4680

Idiot chiming in - does anybody have a good resource showing U.S. prediction models vs. what the actual reported numbers are?  Outside of NY and Lousiana the narrative seems to be empty emergency rooms just waiting for the "peak".  Would be interested to see how we're comparing to predictions but can't find anything

4/7/20 4:46 AM
3/17/14
Posts: 2747
jpm995 -
prof -
jpm995 - 

NY gov Cuomo just said the test with 1100 patients showed anectotally good results. Said it was not scientifically proved but looked promising and their getting more. Sounds like good news. 




Test for what?

Coumo said 2 weeks ago they would test 1100 covid patients with the drug hydroxychloroquine with zpac drug combo. He said today that although it cant be scientificly proved the results were encouraging. He said the feds will approve more shipments of the drugs asap. I was disappointed he didn't give any results numbers. They give stats for everything but not this. Of course no one asked about it.

unfortunately India has cut off 80% of their supply. India is a major hub of this drug.  If I can find the link ill post it

4/7/20 4:48 AM
5/30/05
Posts: 73794
Upperfaggot -

Serious question here.
How is it that the "common flu" which has a new vaccine distributed en masse every year, having a greater mortality rate than any global pandemic purported throughout centuries of civilization deemed less of a threat to society than shoveling in immigrants that practice poor hygiene?

I'm just laughing that your name got approved. Top men. lol

4/7/20 5:12 AM
3/17/14
Posts: 2748
Easters -

Idiot chiming in - does anybody have a good resource showing U.S. prediction models vs. what the actual reported numbers are?  Outside of NY and Lousiana the narrative seems to be empty emergency rooms just waiting for the "peak".  Would be interested to see how we're comparing to predictions but can't find anything

I would say most hospitals on the east coast  and Michigan are already highly impacted. of the 4000+ cases here in Maryland.. over 1000+ needed hospitalized. ill try to find some good charts on predictions 

Edited: 4/7/20 7:09 AM
2/27/11
Posts: 11244

Am I understanding correctly that this virus is kinda like a poison and if you are exposed to a LOT of it (example: long train ride sitting close to an infected who is coughing and sneezing) then you get a worse infection and more chances to die/go in critical condition as opposed to just catch "a little bit of it", maybe by touching a contaminated object with a small trace of virus on it and then you get infected but mildly with little to no symptoms?

This supppsing that the two subjects in the example have the same immune system strength.

 

4/7/20 7:44 AM
3/17/14
Posts: 2751

Influenza antiviral Avigan® (favipiravir) to enter Phase III trials in COVID-19 patients

4/7/20 7:59 AM
3/17/14
Posts: 2752

https://www.benzinga.com/pressreleases/20/04/n15752843/fda-clears-the-way-for-ridgeback-biotherapeutics-to-begin-human-testing-of-a-promising-potential-t

 

 

very good news here

4/7/20 9:00 AM
10/23/05
Posts: 3287
NoNeed4aScreenName - 
mataleo1 -
NoNeed4aScreenName - 

Sorry one more question. I know you mentioned it before but I cant exactly recall and this thread is huge now. 

 

Did you ever mention that you observe sudden decreases in blood pressure in some Covid-19 admissions in the ICU?


I haven't yet answered your questions on ACE-2 because science is moving fast and trying to catch up on the literature.

BP is not lower for COVID patients than for others with respiratory viruses, at least in terms of my experience. It may go down, but that much is true for any ICU patient with an infection

That's fine. I'm surprised you're not tired of my questions yet. 

 

I just feel like potentially ACE2 is at the center of this. Especially considering its many roles in the cirus uptake and lung injury protection. 

 

I'm just wondering if, going back to enzyme kinetics, if it would be possible for the receptor to get saturated and then that's when the worst symptoms appear. 

 

I just thought at some point BP crashed if it could be related to ACE2


I'm sure you've read some of the recent papers, including the one in NEJM

https://www.nejm.org/doi/full/10.1056/NEJMsr2005760

Decoy ACE2 receptors could be promising COVID-19 infection-preventing drug

https://www.the-scientist.com/news-opinion/blood-pressure-meds-point-the-way-to-possible-covid-19-treatment-67371

I wonder if there are any trials right now, I wasn't able to find much. People seem to focus on HCQ and antivirals and plasma.


I think you're on to something

4/7/20 9:03 AM
10/23/05
Posts: 3288
NoNeed4aScreenName - 

One more question. I guess this is more so in regards to binding the heme like some are saying the virus can do. 

 

In order for that to happen wouldn't the virus need to enter the bloodstream? Have you seen any evidence of the virus being found there?


No clue.

I guess this all shows my bias towards clinical research and my inherent weaknesses in fundamental microbiology.