OT: COVID-19 Presentation from CROI Meeting

[uconnbill]

Nobody forget that @pj believes that COVID was “most likely” a man-generated as a bioterrorist weapon

are you saying that is not possible?
The Chinese have not been honest anytime through this pandemic since it started in late Nov-early December. They wouldn't let in outside scientist come in early on and didn't share much info at all.
Anything is possible when it comes to the biggest risk nation in the world. China is not out friend, and never will be.

 

[mussels]

there’s this new thing called a cost to benefit ratio. Is this really a hill you’re ready do die on? Spending time and resources on products that are trivially effective relative to basic hand hygiene?

again, you’re not half as smart as you think you are

lmao have you considered the time and cost of production of billions of masks? Does “billions” mean anything to you?

probably not, because you’re at best some gnome in a lab with no critical thinking skills. Wow I forgot a second that it’s beyond a doubt to you that this virus is a biochemical weapon

Some info/opinion on masks and the current situation

Opinion | Why Telling People They Don’t Need Masks Backfired (Published 2020)

To help manage the shortage, the authorities sent a message that made them untrustworthy.

www.nytimes.com

 

[ScottBonz]

Here's a scientist's comment on Losartan for coronavirus:

AT1R blocker losartan is being tested based on a proposal that it will upregulate the SARS-CoV-2 receptor ACE2,
preventing loss of ACE2 function which may be protective against the acute respiratory distress syndrome that is one cause of death by SARS and COVID-19 (Pubmed 32129518) (www.startribune.com/university-of-minnesota-to-testthree-drugs-for-covid-patients/568766632/)
– This only deals with lung injury secondary to viral replication, not the virus itself.
– This comes from an old hypothesis (2005) that SARS lethality was due to downregulation of ACE2
(www.nature.com/articles/nrd1830) whose validity I’m not too confident about, since it was based on injecting massive amounts of viruses into mice (who are pretty different from humans in their cardiovascular regulation).
– Others have suggested that upregulating the receptor for the virus with losartan might increase susceptibility to the initial infection; this probably doesn’t matter either because a virus particle isn’t going to care if the cell it’s sitting on has 100 or 300 receptor molecules when it’s stuck on the surface and has time to swim around
(www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext).
– I think it’s better to concentrate on specific antiviral medications and not worry about the complex ACE2/AT1R pathway.

This. There have been some studies out there so far with ACE-I/ARBs that haven't shown to reduce lung inflammation.

Hydroxychlorquine looks interesting as it has some anti-viral capabilities and some T-Cell modulating affect to possibly reduce the T-Cell storm that causes alot of the fluid build up in the lungs.

The on the fly compassionate use trial of remdesivir is going to be interesting as well.

 

[JustbrewitMan]

This is serious, I think the government has been downplaying how serious it is for over a month and now it's out of control.

Although at least some element of this is indeed possible, it is not likely that COVID-19 was running rampant throughout the U.S. in the month of February and through early March.

If it was the case, there would have been HUGE front-line warning and concerns voiced from hospitals throughout the US to local government, local news, social media etc. about how it's probably "rampant" due to the huge uptick seen in hospitals with patients presenting with unusual interstitial pneumonias/ARDS.

I'm not aware of that happening in any critical mass and I have a lot of front-line clinician "channels" (listservs, colleagues throughout the US, etc.) that would have sounded alarms about this.

We are not in perfect shape, and there have been some important glitches, but the response time and ramp-up for such an unprecedented event of this social/medical magnitude is at least "pretty good" all things considered, IMHO

 

[JustbrewitMan]

Have you seen any more on correlation between hypertension drugs and COVID-19 morbidity?

When I did some internet sleuthing I found an article that suggests that ARB's May be useful in blocking the virus from binding to receptor sites.

Full disclosure: I am looking this up because I manage hypertension with Losartan.

Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics. - PubMed - NCBI

This Lancet letter to the editor was one of the primary drivers for the concern ("hysteria"?):

https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf

In response, the European Society for Cardiology has already published a position paper essentially saying DON'T STOP TAKING YOUR ACE INHIBITOR OR ARB MEDICATIONS:

Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers

Your access to the latest cardiovascular news, science, tools and resources.

www.escardio.org

There are some extrapolatory data that do suggest that ARBs might provide some protection from severe outcomes from SARS-CoV-2 infections.

That video link I posted previously shows how if you take away ACE2's ability to do its job (hypothetically, the virus can bind it all up and might do this), you could end up with high Angiotensin II levels, which adversely affects your heart, kidneys, lungs, trigger inflammation, edema, electrolyte disturbances (increase risks for cardiac arrhythmias).

Fascinating stuff, to say the least, but no convincing data yet to guide treatment at this point.

 

[tdrink]

This Lancet letter to the editor was one of the primary drivers for the concern ("hysteria"?):

https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf

In response, the European Society for Cardiology has already published a position paper essentially saying DON'T STOP TAKING YOUR ACE INHIBITOR OR ARB MEDICATIONS:

Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers

Your access to the latest cardiovascular news, science, tools and resources.

www.escardio.org

There are some extrapolatory data that do suggest that ARBs might provide some protection from severe outcomes from SARS-CoV-2 infections.

That video link I posted previously shows how if you take away ACE2's ability to do its job (hypothetically, the virus can bind it all up and might do this), you could end up with high Angiotensin II levels, which adversely affects your heart, kidneys, lungs, trigger inflammation, edema, electrolyte disturbances (increase risks for cardiac arrhythmias).

Fascinating stuff, to say the least, but no convincing data yet to guide treatment at this point.

It is strange that a drug could both increase one’s chances of catching a virus and potentially minimize damage done by a virus if taken after being infected.

I have barely elevated blood pressure because it runs in my family and I am in otherwise excellent physical shape (apart from being in my 50's lol.) Not worried at all. But good to think about. I never like relying on pharmaceuticals.

 

[JustbrewitMan]

So here's the next COVID-19 thing that will probably make the "hype train" rounds on social media:

Does your blood type (A, B, AB, O) affect your risks of getting COVID-19 infection and does it determine if you'll have more severe infection?

A recently-uploaded pre-peer-reviewed article from China suggests that Blood Type "A" patients were over-represented in both the COVID-19 cases and the severe cases they analyzed (compared to the normal population distributions of blood type). There were fewer Type "O" patients that had more severe infections.

https://www.medrxiv.org/content/10.1101/2020.03.11.20031096v1

Not surprisingly a number of virtual "information" outlets have started running with it (and misinterpreting info, over-extrapolating info):

People with blood type A may be more vulnerable to coronavirus: study

Preliminary research in Wuhan and Shenzhen indicates patients with the blood group had a higher rate of infection and tended to get more severe symptoms.

www.scmp.com

People With Blood Type 'A' More Vulnerable To Coronavirus, 'O' At Low Risk: Study

Researchers found that blood type A patients showed a higher rate of infection and developed more severe symptoms of the novel Coronavirus.

news.abplive.com

Coronavirus: Your blood type may make you more vulnerable, says study

People with blood type A more vulnerable, finds Chinese research

gulfnews.com

***Keep this in mind:

A quick inspection of case rates and mortality rates amongst countries with fairly high prevalence of A blood type folks seems to fly against this hypothesis. If this was a strong factor, we might expect high overall case #'s and high case fatality rates:

Blood type distribution by country - Wikipedia

en.wikipedia.org

For example:

Norway: 3 deaths, 1438 cases
Switzerland: 26 deaths, 2650 cases
Portugal: 1 death, 448 cases

Total for these countries = 0.66% CFR


There are definitely some "higher Type "A" countries" with higher case fatality rates, but keep in mind that there are probably MANY other layered factors to consider that are impacting infection rates and severe infection rates...

At this point, I would not be panicking or taking more protective measures if I were a Type "A" blood type person (which I am).

But as with everything, we need to keep an eye on it am re-examine these possible hypotheses as the pandemic continues...

Best,
JBM

 

[Stinger92860]

You are wrong. A group of doctors reported her. She was is favor on NOT using the N-95’s because they are going through a lot.

EDIT: when the nurses walk due to safety concerns you can go help her.

It’s official, no masks....wow

 

[Stinger92860]

Yep, that's it.

We all want people to get sick, die, and have have permanent lung damage. We all want our money wiped out.

What we want and should expect is to be told the truth, to not minimize, to be much more prepared, to be given a coherent message.

We haven't gotten any of that.

I’ll tell you. I a lot of people will get sick and some willl die. However, you 401K will snap back. The people who will not die were those still in bars last night or the people on the beach.

 

[Dream Jobbed 2.0]

Can not believe the scenes in Florida...

 

[Dream Jobbed 2.0]

I suppose the bright side is we’re going to hit the sharper curve where it peaks in a months and 5 million Americans die right away instead of the long drawn out curve