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

Interesting thread
https://twitter.com/user/status/1285618977654407169

 

I don't quite understand this paper. Of 50,000 suspected covid cases/ hospital staff they screened from March to July 2020, approx 40% had Sars-Cov-2 antibodies detected using their ELISA test (Mount Sinai).

Yet, by their conclusions the authors seem to be ignoring the 60% who had no antibodies detected.

SARS-CoV-2 infection induces robust, neutralizing antibody responses that are stable for at least three months

 

I disagree that they're ignoring them. A 40% test positivity rate is still very high, given people presenting with mild non-specific respiratory infection symptoms. An examination of the sensitivity/specificity of their test is not the basis of this current study (was covered in previous studies).

Yes they didn't test the entire 50,000 with PCR tests, but of those that were tested:

The data provided in Supplemental Table 1 is a bit weak due to sample size, but more so for specificity than sensitivity. Hence an assumption that the test is at least 90% sensitive is justified.

 

The people with hidden immunity against Covid-19

This arrived in my inbox on 24th July, so not sure if it's been posted already. I regret to say I haven't had time to read it completely yet (life is chaotic since we arrived at the caravan) but it looks to me like a fairly clear sum up of what we know about Covid-19 concerning antibodies and the immune system. Hopefully this post will remind me to go back and read it fully!

 

Nature: Longitudinal analyses reveal immunological misfiring in severe COVID-19 - by Carolina Lucas et al

Abstract

Recent studies have provided insights into the pathogenesis of coronavirus disease 2019 (COVID-19)1–4. Yet, longitudinal immunological correlates of disease outcome remain unclear. Here, we serially analysed immune responses in 113 COVID-19 patients with moderate (non-ICU) and severe (ICU) disease.

Immune profiling revealed an overall increase in innate cell lineages with a concomitant reduction in T cell number. We identify an association between early, elevated cytokines and worse disease outcomes. Following an early increase in cytokines, COVID-19 patients with moderate disease displayed a progressive reduction in type-1 (antiviral) and type-3 (antifungal) responses. In contrast, patients with severe disease maintained these elevated responses throughout the course of disease. Moreover, severe disease was accompanied by an increase in multiple type 2 (anti-helminths) effectors including, IL-5, IL-13, IgE and eosinophils.

Unsupervised clustering analysis identified 4 immune signatures, representing (A) growth factors, (B) type-2/3 cytokines, (C) mixed type-1/2/3 cytokines, and (D) chemokines that correlated with three distinct disease trajectories of patients.

The immune profile of patients who recovered with moderate disease was enriched in tissue reparative growth factor signature (A), while the profile for those with worsened disease trajectory had elevated levels of all four signatures. Thus, we identified development of a maladapted immune response profile associated with severe COVID-19 outcome and early immune signatures that correlate with divergent disease trajectories.

 

Your Coronavirus Antibodies Are Disappearing. Should You Care? New York Times, 26 July 2020.

Declining antibody levels do not mean less immunity, experts say. Besides, two widely used tests may detect the wrong antibodies.

 

An interesting account from a pulmonologist who survived covid:

https://www.salon.com/2020/04/05/what-it-feels-like-to-survive-covid-19s-dreaded-cytokine-storm/

 

Updates on various aspects, particularly

Coronavirus infectiousness wanes by day nine; long ICU stays linked with nerve damage

http://www.msn.com/en-gb/news/world...rve-damage/ar-BB17kZ83?li=BBoPWjQ&ocid=ASUDHP

 

The UK Sepsis Trust:
Why do I still feel breathless even though my oxygen levels are normal? (Youtube video)

Code:

https://www.youtube.com/watch?v=lZ0cC7IZBr0&feature=youtu.be

Youtube transcript:

 

That transcript sums up our problem so well it has made me tear up. There is a normal test and the patients feel ill but instead of being asked about childhood trauma, told they are converting emotional distress, seeking the benefits of the sick role, there is a long list of biological reasons for what is happening.

Psychological therapies may not do much harm, maybe, but they close the door on anyone looking elsewhere and that is where the real harm lies.

 

This is quite an interesting article on various symptoms and some of the research that is starting up.

https://www.sciencemag.org/news/202...ovid-19-s-lingering-problems-alarm-scientists

 

Does coronavirus linger in the body? What we know about how viruses in general hang on in the brain and testicles

I've seen a lot of people complaining about testicular pain. Not super common but not just a rare blip. Good to see it's finally noticed.

https://theconversation.com/does-co...ral-hang-on-in-the-brain-and-testicles-142878

Hello, familiar viruses that we see all the time as potential triggers for ME-like disease.

This is why the dogmatic belief systems over the psychosomatic nature of most neurological symptoms is facing disaster with the real world. Here is the quote about privileged sites:

There's also the fact that the CNS is basically connected to every single part of the body. As privileged sites go, this is basically a multipass.

 

How does he know he had a cytokine storm when is cytokine levels weren't measured? He was also taking an IL-6 inhibitor, suggesting that something other than a cytokine storm was going on.

Cytokine storms are not simply high levels of inflammation, they are a specific condition.

So far clinical studies of cytokine levels of severe COVID-19 patients have shown high levels indicative of inflammation, but not so high to be indicative of a cytokine storm.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767939

 

Yes, I agree that there was no proof of this. I guess I should have been more clear and said that I found his account of the symptoms interesting.

 

My total lack of trust in the medical profession has never been more justified :

Title : Covid-19 Has Turned Public Health Into a Lethal, Patient-Killing Experimental Endeavor

Link : https://ahrp.org/covid-19-has-turne...lethal-patient-killing-experimental-endeavor/

I had read little snippets about this massive overdose of hydroxychloroquine being used in experiments. What I cannot understand is why a drug which was first approved for medical use in 1955, whose side-effect profile is understood, whose dosing is also understood, has been given at such massive doses. I can only assume that it was designed to stop a cheap, out-of-patent drug being used as a possible treatment while pharma companies were working on new, more expensive, and more profitable drugs.

 

I would advise against taking that piece too seriously. It looks like a crackpot conspiracy theorist site - as much disinformation as Mr Trump saying hydroxychloroquine was a cure.

There is no reason why doses in a trial like this should be the standard daily dose for chronic usage. The author points out that there is a sink where the drug accumulates outside plasma so a loading dose makes total sense. From memory chloroquine and hydroxychloroquine both have longish half lives so if used in an emergency a loading dose would be expected. So the author seems not to know what she is talking about.

There is a lot of vested interest around but there is also an awful lot of completely phoney information written by people with an axe to grind.

 

It seems to be a conspiracy theory site with a major interest in anti-vax and also Nazi experimentation during the holocaust. (Not that the latter would be a conspiracy theory but it indicates a political agenda that probably has no relevance to current reality.) I don't think it is a site devoted to rational argument.