The biology of coronavirus COVID-19 - including research and treatments

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Do we have reliable evidence showing that IFNs are elevsted in ME?

 

So does that mean ACE inhibitors increase risk of complications/more severe illness in Covid-19? Or the opposite? I don't understand at all

 

I think we don't know if ACE inhibitors increase or decrease infection/severity yet. As far as I understand(I may be wrong), he is saying that IFNy and IFNa do increase risk. That's why I'm wondering if we have elevated levels or not.

 

Post moved from Coronavirus - worldwide spread and control

Yes, I've actually been looking for that in the past couple of days but it seems that there is no study that does this.

I've found this recent review by Yang et al. on the effect of comorbidities on outcomes of COVID-19 but as far as I can see none of the included studies looked at age as well at the same time, to see which one is most important or whether one might be partially explained by the other. Online you'll see graphs like the one below which shows rather terrifying case fatality rates for those with a health condition like hypertension or diabetes.



But these data, coming from the largest report on 44.000 Chinese cases, also didn't control for the effect of age. It doesn't give a clue into what the CFR might be for someone who is relatively young and has a comorbid condition. So it could be that the CFR is mostly determined by age and that the strong relationship with comorbidities might in part be due to older people having more comorbidities than young people (it could also be the other way around though - that older people are at risk because they have more comorbidities).

I've tried to summarise the data for Case fatality Rates per age group in the graph below. The data are from government reports in countries like China, Italy and South-Korea because in the scientific literature sample sizes are much lower and there's a huge time lag - making almost everything that is published a bit outdated.

• The Chinese data is from this government report from a while back. These were all Chinese confirmed cases as of 11 February.
• I took the South-Korean data from their latest daily report (19 march) in English, which can be found here.
• The Italian data comes from this government report from 16 March. It's in Italian, so I hope I've extracted the right numbers.

As you can see from the data there seems to be a very strong relationship between age and case fatality rate. So perhaps this could explain the connection between comorbidities and CFR: perhaps age is the main driver behind this correlation. That might explain why pretty much all comorbidities seem to result in a large increase in case fatality rates. If comorbidity was the main factor I would expect to see more differentiation between for example cancer and chronic respiratory disease on the one hand and diabetes and hypertension on the other. You might think the former is more of a risk factor for COVID-19 than the latter as many persons with diabetes and/or hypertension experience relatively few disabilities and symptoms that aren't directly related to respiratory distress.

Perhaps another clue is that pregnant women don't seem to have an increased risk. The WHO report wrote that "As opposed to Influenza A(H1N1)pdm09, pregnant women do not appear to be at higher risk of severe disease." Given the strong relationship with many common comorbidities, one could expect that pregnancy might be a risk factor as well.
Perhaps the evident explanation for such a lack of association is that age is the main factor and old people don't get pregnant.

 

https://www.thailandmedical.news/ne...lemia-present-in-almost-all-covid-19-patients

 

In animals 3% of its proteins are glycoproteins, in plants its more.

The virus has many spikes, maybe and presumably the elevated number is important for its virulence. According to German Wiki an important part of the spike is a glycoprotein.

So, if it would turn out that cases and deaths are elevated in countries with a lot of sugar consumption, this could be an explanation, couldn´t it?

 

Post moved from Coronavirus - worldwide spread and control

Some more information on the air pollution and coronavirus connection:

Some Italian researchers published a position paper where they say that there is a correlation between concentration of atmospheric particles and the spread of the virus. Viruses can attach to the particles and remain in the air for hours or days. Humidity increases the time a virus remains infectious, whereas higher temperatures and sunlight decrease the time. The regions most affected by the virus are also the ones with the most air pollution, in the north of the country. In contrast, Rome had some early cases of the virus but did not experience the same catastrophic spread as the cities in the north.

http://www.simaonlus.it/wpsima/wp-content/uploads/2020/03/COVID19_Position-Paper_Relazione-circa-l’effetto-dell’inquinamento-da-particolato-atmosferico-e-la-diffusione-di-virus-nella-popolazione.pdf

 

@spinoza577 It would be interesting then to know if a low carb / keto diet helped.

What about diabetics with good sugar control, are they faring better than those with poor control.

And we are told that the obese do less well, is that linked to potentially increased blood sugar levels?

I’m also trying now to remember which way around the old adage goes about feeding during a cold, versus a fever. LOL.

 

I don't think so. As far as I know how much sugar you eat has absolutely nothing to do with the synthesis of glycoproteins. Sugars are made from fat in the body if sugar intake is less.

Diabetics get something called protein glycation - which is the abnormal addition of glucose molecules to otherwise normal proteins and has nothing to do with glycosylation, which is the addition of sugars to protein cores during the formation of normal glycoproteins. Most of the sugars in glycoproteins are not glucose - e.g mannose, galactose, n-acetyl glucosamine, sialic acid.

 

This is a handbook for health care workers on how to treat and manage COVID-19

"This handbook compared and analyzed the experience of other experts in China, and provides good reference to key departments such as hospital infection management, nursing, and outpatient clinics. This handbook provides comprehensive guidelines and best practices by China's top experts for coping with COVID-19."

"Technical strategies for preventing and treatment of the epidemic

Treatment methods to treat the critically ill

Efficient clinical decision-making strategies for frontline medical experts"

 

The link given (https://www.ncbi.nlm.nih.gov/nuccore/MN908947.3) is about the genome, I would think that the sort of sugar can be seen, but I - almost for sure - will be too stupid to figure out, if glucose is the sugar used in the spike.

And if so, I myself nevertheless would stay skeptical of course, but there might be a chance that peaks of glucose levels from this or that nutrition would boost the virus.


So I think the points @Keela Too made are interesting, especially the first two.

Additionally, maybe in case with high blood pressure an explanation would be that the pressure provides the cells with sugar very well?

 

An additional point to blood pressure is that that pregnant women didn´t get the illness (if I remember rightly), and now, in pregnancy blood pressure is low.
https://www.google.com/search? pregnancy blood pressure


More relevant would be that the elevated rate of patients with cancer could be explained by higher blood sugar levels.
https://www.google.com/search? cancer+blood+sugar+levels

 

A doctor describes what the illness does to people
https://www.propublica.org/article/...ilure-from-covid19-even-in-his-young-patients

An Italian doctor said that dying from covid-19 is like slowly drowning. This was on TV I think, not sure where I picked up that information.

 

Just found a study that puts comorbditiy and age in a multivariable regession. https://www.unboundmedicine.com/med..._of_patients_with_COVID_19_in_Shanghai_China_

The relationship with comorbidity was statistically significant associated with intensive care units admission in the univariate but not in the multivariate analysis, while age was significant in both. There were lots of other factors in their regression model though and even for age the data doesn't look particuarly persuasive, probably because only 22 patients were admitted in ICU.

 

Coronaviruses and immunosuppressed patients. The facts during the third epidemic
A mostly anecdotal report, but I thought it was interesting: https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/lt.25756

From the abstract:

 

I need help. Can anyone help answer this question?

What is a sensible self isolation period for someone with what may be a mild case of covid19 to avoid onward transmission?


UK 111 service and US CDC are saying 7 days from symptom onset. This seems short? (111 Doctors seem to be sticking to the official narrative - high temperature, dry persistent cough, shortness of breath - it’s as tbough other presentations don’t exist.)

I think I saw 14 days isolation on the WHO website, but can’t find that at all now, I seem to be going around in circles. Can anyone help with this?


I would also appreciate knowing what relevant research on this has to say and how reliable it might be, if there is any.

I appreciate that no one here can or should advise me, I just could really do with help getting to grips with the information and how reliable it is so we can make a decision about how much longer she isolates for. Today is day 7. We’d like her to come home when it’s sensible.

My cognitive function stamina is short and I’m stressed and confused - I could really do with some help.

 

Even when a lot is known I think there will be no absolute answer - it will be a matter of gradually reducing statistical risk. But I think you probably have a pretty good analysis already. Seven days from symptom onset seems risky, if only because the virus can survive on surfaces for a few days. I would be thinking more in terms of 7 days after being completely well or even more like 14. More than 14 seems unlikely to be necessary. Of course as things are at present the ideal advice would be not to change the make up of a household until we are over the current period of trying to reduce infection rates. The mild illness might not be Covid19 but she might pick it up the day she travels. On the other hand tricky decisions will need taking sometimes just to keep people sane.

 

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