Advertisement
If you have a new account but are having problems posting or verifying your account, please email us on hello@boards.ie for help. Thanks :)
Hello all! Please ensure that you are posting a new thread or question in the appropriate forum. The Feedback forum is overwhelmed with questions that are having to be moved elsewhere. If you need help to verify your account contact hello@boards.ie
Hi all! We have been experiencing an issue on site where threads have been missing the latest postings. The platform host Vanilla are working on this issue. A workaround that has been used by some is to navigate back from 1 to 10+ pages to re-sync the thread and this will then show the latest posts. Thanks, Mike.
Hi there,
There is an issue with role permissions that is being worked on at the moment.
If you are having trouble with access or permissions on regional forums please post here to get access: https://www.boards.ie/discussion/2058365403/you-do-not-have-permission-for-that#latest

COVID-19 technical discussion

  • 10-03-2020 11:43am
    #1
    [Deleted User]
    Posts: 8,647 ✭


    https://www.thelancet.com/lancet/article/S0140-6736(20)30566-3

    Thought this was an interesting article. An out of range d-dimer denotes a poor prognosis. Wonder what the pathophysiology is, is a side effect of COVID-19 due to increased PEs/DVTs? As an aside. I've found the Lancet articles as of late to be top notch.


«1

Comments

  • #2
    [Deleted User]
    Posts: 8,647 ✭ [Deleted User]


    https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3548774

    This makes for grim reading if you are over 70 and have co-morbidities.


  • #3
    amandstu
    Registered Users, Registered Users 2 Posts: 3,778 ✭✭✭amandstu


    I understand that gargling with salt water is considered a myth in connection with Covid-19.

    Does this also mean that it has no beneficial effects at all on the evolution of the illness?

    It seems that Chlorine is said to kill the virus and Salt does contain chlorine (I am no chemist) ...

    Could there be any benefit to this practice ? (I also snort it up the nostrils whenever I have a cold)


  • #4
    sporina
    Registered Users, Registered Users 2 Posts: 6,939 ✭✭✭sporina


    whats with the stock piling though please? i don't get it - at all..


  • #5
    fryup
    Registered Users, Registered Users 2 Posts: 18,067 ✭✭✭✭fryup


    ^^ news images of Wuhan i guess

    ...how often should we wash our hands?


  • #6
    sporina
    Registered Users, Registered Users 2 Posts: 6,939 ✭✭✭sporina


    fryup wrote: »
    ^^ news images of Wuhan i guess

    ...how often should we wash our hands?

    wer there images of people stocking piling in China?


  • Advertisement
  • #7
    grindle
    Registered Users, Registered Users 2 Posts: 6,026 ✭✭✭grindle


    sporina wrote: »
    wer there images of people stocking piling in China?

    Images and videos of stockpiling, people dropping dead and others being locked into their apartments by the local constabulary are on the internet.

    Panic buying is retarded, but people are thinking "They could announce tougher protocol tomorrow!", especially in an excessive authoritorian state like China. Makes less sense here but even then if we're given a couple of days notice the shops would be proper bananas if there was a full lockdown. But the situation would have to be much much worse than currently. Like, maybe in a couple of weeks or a month or something.

    This is a more serious forum I think though, this chat is OT and probably belongs in the main COVID thread.


  • #8
    Vanar
    Registered Users Posts: 7 ✭Vanar


    Deleted User wrote: »

    Thought this was an interesting article. An out of range d-dimer denotes a poor prognosis. Wonder what the pathophysiology is, is a side effect of COVID-19 due to increased PEs/DVTs? As an aside. I've found the Lancet articles as of late to be top notch.

    Re the D-dimer levels

    "Contributory mechanisms include systemic pro-inflammatory cytokine responses that are mediators of atherosclerosis directly contributing to plaque rupture through local inflammation, induction of procoagulant factors, and haemodynamic changes, which predispose to ischaemia and thrombosis. In addition, angiotensin converting enzyme 2, the receptor for SARS-CoV-2, is expressed on myocytes and vascular endothelial cells, so there is at least theoretical potential possibility of direct cardiac involvement by the virus."


    Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.


  • #9
    Breezer
    Registered Users, Registered Users 2 Posts: 3,228 ✭✭✭Breezer


    Vanar wrote: »
    Re the D-dimer levels

    "Contributory mechanisms include systemic pro-inflammatory cytokine responses that are mediators of atherosclerosis directly contributing to plaque rupture through local inflammation, induction of procoagulant factors, and haemodynamic changes, which predispose to ischaemia and thrombosis. In addition, angiotensin converting enzyme 2, the receptor for SARS-CoV-2, is expressed on myocytes and vascular endothelial cells, so there is at least theoretical potential possibility of direct cardiac involvement by the virus."


    Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.

    Have ACE inhibitors been used in treatment at all? I’ve only heard about hydroxychloroquine and some antivirals, and to avoid steroids and NSAIDs. I’m more trying to keep up with the day to day primary care side of things to be honest, I haven’t been looking at the pharmacology.


  • #10
    Miike
    Registered Users, Registered Users 2 Posts: 2,021 ✭✭✭Miike


    Breezer wrote: »
    Have ACE inhibitors been used in treatment at all? I’ve only heard about hydroxychloroquine and some antivirals, and to avoid steroids and NSAIDs. I’m more trying to keep up with the day to day primary care side of things to be honest, I haven’t been looking at the pharmacology.

    As I understand it ACE inhibitors up-regulate ACE2 - hypothetically increases risk of severe disease.


  • #11
    Vanar
    Registered Users Posts: 7 ✭Vanar


    Miike wrote: »
    As I understand it ACE inhibitors up-regulate ACE2 - hypothetically increases risk of severe disease.

    Yes theoretically there may be a link, but currently it's not recommended to change medications on this basis. More information here

    nephjc.com/news/covidace2


  • Advertisement
  • #12
    sullivlo
    Registered Users, Registered Users 2 Posts: 9,994 ✭✭✭sullivlo


    Miike wrote: »
    As I understand it ACE inhibitors up-regulate ACE2 - hypothetically increases risk of severe disease.

    Which is why people who take ace inhibitors for blood pressure are a higher risk factor.


  • #13
    [Deleted User]
    Posts: 8,647 ✭ [Deleted User]


    sullivlo wrote: »
    Which is why people who take ace inhibitors for blood pressure are a higher risk factor.

    I don't believe we can say that with any certainty. In fact, the expression of ACE2 has shown to have vasodilatory effects in lung tissue due to angiotensin 1-7.

    The big problem.is they we.dont have the studies yet to actually figure out out a lot of these answers.


  • #14
    Vanar
    Registered Users Posts: 7 ✭Vanar


    Deleted User wrote: »
    I don't believe we can say that with any certainty. In fact, the expression of ACE2 has shown to have vasodilatory effects in lung tissue due to angiotensin 1-7.

    The big problem.is they we.dont have the studies yet to actually figure out out a lot of these answers.

    Yes if you look at the link in my previous post it goes into further detail on why we can't say for sure either way yet, and why these medications might actually be beneficial. The European Society of Cardiology has issued a position statement noting that there are cases of people discontinuing meds because of the speculation, and that this is definitely not to be recommended given the adverse effects of stopping and the fact that we don't know yet if the medication is actually beneficial or harmful for Covid-19.


  • #15
    sullivlo
    Registered Users, Registered Users 2 Posts: 9,994 ✭✭✭sullivlo


    Deleted User wrote: »
    I don't believe we can say that with any certainty. In fact, the expression of ACE2 has shown to have vasodilatory effects in lung tissue due to angiotensin 1-7.

    The big problem.is they we.dont have the studies yet to actually figure out out a lot of these answers.
    Vanar wrote: »
    Yes if you look at the link in my previous post it goes into further detail on why we can't say for sure either way yet, and why these medications might actually be beneficial. The European Society of Cardiology has issued a position statement noting that there are cases of people discontinuing meds because of the speculation, and that this is definitely not to be recommended given the adverse effects of stopping and the fact that we don't know yet if the medication is actually beneficial or harmful for Covid-19.

    I was basing it off a paper I read last week comparing the method of action of the current Coronavirus strain and the 2002 SARS strain, and how they have similar mechanisms in terms of ace activation.


  • #16
    [Deleted User]
    Posts: 8,647 ✭ [Deleted User]


    sullivlo wrote: »
    I was basing it off a paper I read last week comparing the method of action of the current Coronavirus strain and the 2002 SARS strain, and how they have similar mechanisms in terms of ace activation.

    So. It's hard to quantify. The risk factors for severe disease tend to be diabetes/cardiovascular disease/been immunocompromised/existing resp diseases/ chronic kidney disease. So you are right that it seems to attach to ACE2 and theory is that by using ACEi we are increasing the amount of ACE2 so theoretically that might mean that there is more ACE2 receptor to facilitate infection.

    However, some studies have shown that increased ACE2 receptors has a respiratory protective feature through ANG1-7 which causes vasodilation.

    It certainly warrants further research but I would tend to think there is no substantial evidence at the moment they stopping ACEi/ARBs would be beneficial.


  • #17
    Vanar
    Registered Users Posts: 7 ✭Vanar


    In relation to the ACE / ARB discussion I see there is actually a pilot trial in Guangzhou to test recombinant human ACE2 as a treatment, and an ARB (losartan) is one of the drugs to be trialled in the US





    clinicaltrials.gov/ct2/show/NCT04287686


    startribune.com/university-of-minnesota-to-test-three-drugs-for-covid-patients/568766632/


  • #18
    Breezer
    Registered Users, Registered Users 2 Posts: 3,228 ✭✭✭Breezer


    Miike wrote: »
    As I understand it ACE inhibitors up-regulate ACE2 - hypothetically increases risk of severe disease.

    Cheers. It’s been a long time since I’ve done pharmacology; I accepted long ago that they’re good at lowering blood pressure and that’s served me well till now!


  • #19
    lalababa
    Registered Users, Registered Users 2 Posts: 1,736 ✭✭✭lalababa


    Apologies if I am out of my depth on this thread, but I have a question:
    What respiratory illness killed 30 people in Ireland in Dec/Jan?? I and some relatives had it. It had exactly the same symptoms as covid-19. I had all the symptoms except difficulty breathing, though the relatives had difficulty.


  • #20
    darjeeling
    Registered Users, Registered Users 2 Posts: 962 ✭✭✭darjeeling


    lalababa wrote: »
    Apologies if I am out of my depth on this thread, but I have a question:
    What respiratory illness killed 30 people in Ireland in Dec/Jan?? I and some relatives had it. It had exactly the same symptoms as covid-19. I had all the symptoms except difficulty breathing, though the relatives had difficulty.

    Flu - mostly type A strain H3N2, for which the vaccine apparently mismatched the circulating H3N2 strain.

    I've posted more on this in the coronavirus forum in a thread asking about this subject.
    Links:

    https://www.boards.ie/vbulletin/showpost.php?p=112868604

    https://www.boards.ie/vbulletin/showthread.php?p=112903763

    Edit: I had it too, and the symptoms were exactly like the last time I had flu over a decade earlier.


  • #21
    lalababa
    Registered Users, Registered Users 2 Posts: 1,736 ✭✭✭lalababa


    Many thanks ...are there any differences in symptoms between the flu and covid-19?


  • Advertisement
  • #22
    [Deleted User]
    Posts: 8,647 ✭ [Deleted User]


    Hot take: I don't believe the addition of azithromycin to hydroxychloroquine adds any benefit. The study was flawed and I don't how how pharmacologically azithromycin would have an effect on SARS-CoV-2.


  • #23
    darjeeling
    Registered Users, Registered Users 2 Posts: 962 ✭✭✭darjeeling


    https://www.reddit.com/r/COVID19/ is good for following the science.

    Posts are mostly about scientific papers, covering clinical reports, drug trials & lab studies, epidemiological studies, tests for active / previous infection, virology etc.
    Comments are moderated to keep mostly to discussion of facts, and can be quite well informed.


  • #24
    Kurtosis
    Registered Users, Registered Users 2 Posts: 2,881 ✭✭✭Kurtosis


    Deleted User wrote: »
    Hot take: I don't believe the addition of azithromycin to hydroxychloroquine adds any benefit. The study was flawed and I don't how how pharmacologically azithromycin would have an effect on SARS-CoV-2.

    It seems to have been roundly panned, e.g. [url] Only thing I can think of for azithromycin is if there was secondary bacterial pneumonia...


  • #25
    lozenges
    Registered Users Posts: 290 ✭✭lozenges


    Yeah, I presumed that the azithromycin was for secondary prevention of bacterial pneumonia also. Have no idea of a mechanism by which it would affect the viral infection?


  • #26
    [Deleted User]
    Posts: 8,647 ✭ [Deleted User]


    Kurtosis wrote: »
    It seems to have been roundly panned, e.g. [url] Only thing I can think of for azithromycin is if there was secondary bacterial pneumonia...

    Problem with azithromycin, it is rarely used in clinical practice apart from for prophylaxis in patient's with recurrent chest infection ( and even here, the evidence is weak for the benefit)


  • #27
    Miike
    Registered Users, Registered Users 2 Posts: 2,021 ✭✭✭Miike


    Yesterdays news today:

    https://www.sciencedirect.com/science/article/pii/S0924857920300947?via%3Dihub

    I can say with all honesty, this is by far the most scared I've been going to work in my life. I would give anything to turn back the clock on this virus :(


  • #28
    palmcut
    Registered Users, Registered Users 2 Posts: 246 ✭✭palmcut


    The attached video is well worth a read. It is a presentation from South Korea. It is in sub-titles and takes a little over half an hour to read. It will be the best half hour that you spend.

    https://www.youtube.com/watch?time_continue=1&v=gAk7aX5hksU&feature=emb_logo


  • #29
    Black Swan
    Moderators, Category Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 47,334 CMod ✭✭✭✭Black Swan


    Across the pond (and globally) ventilators are in short supply; the need vastly exceeding the supply. Are Irish hospitals also lacking the necessary number of ventilators for COVID-19, or is Ireland keeping up with the demand?


  • #30
    palmcut
    Registered Users, Registered Users 2 Posts: 246 ✭✭palmcut


    Hydroxychloroquine (Plaquenil) and COVID. Summary of the recent French study published
    Summary of the recent French study published from Marseille (Gautret and colleagues)
    36 participants, 6 lost to follow up
    20 had hydroxychloroquine 200mg three times daily for 10 days.
    6 of this group received azithromycin for presumed secondary bacterial infection.
    They looked at clearance of the virus from the body at day 6 by using PCR, nasopharyngeal swabs and looking for a previously positive swab that then turned negative

    Results
    At day six 12.5% of the control group were clear of the virus
    57% of the hydroxychloroquine group were clear of the virus
    100% of the hydroxychloroquine plus azithromycin group were clear which suggested a synergistic response of these agents

    What this study adds (Gautret and colleagues)
    1. Highlights issues such as side effects and contraindications - there is a higher risk of side effects in the presence of renal and liver impairment, and there have been isolated reports of COVID-19 disease-causing renal and hepatic injury.



    Limitations of study (Gautret and colleagues)
    1. Sample size was underpowered to provide conclusive results which may cause exaggeration of effect sizes and false-positive results - 48 patients were necessary to achieve 85% power
    2. Six patients were lost to follow up (large % as only 36 patients) - the authors excluded these six patients and did not perform intention-to-treat analysis, which may have introduced bias
    3. Not a blinded or RCT so potential for bias. The trial did not randomise patients to the control and treatment group, thus potentially introducing allocation bias.
    4. With viral PCR status at Day 6 as the primary outcome, the trial lacks medium and long-term follow-up data. The authors report that one patient tested negative for the virus on Day 6, but subsequently tested positive on Day 8 - Such recurrences of positive test results demonstrate that long-term data is necessary to properly assess whether chloroquine/hydroxychloroquine are effective treatments.




    Ventricular arrhythmia risk (American College of Cardiology 29/3/20 (3 days ago))
    Both hydroxychloroquine and azithromycin prolong QT
    Azithromycin – there are 47 cardiovascular deaths which are presumed arrhythmic per 1 million completed courses

    see this link which is useful re QT prolongation crediblemeds.org/blog/recommendations-re-covid-19-treatments/

    Moderate risk of drug associated QT prolongation if score 7 (high risk if scores 11)
    • 68 year old female on a loop diuretic scores 3
    • Serum K 3.5 or below scores 2
    • Corrected QT interval on ECG scores 2
    • Heart failure scores 3
    • One QT prolonging drug scores 3

    Therefore need a baseline ECG/bloods (renal function with Magnesium levels) before azithromycin and hydroxychloroquine used.


    Conclusion
    These medications should not be started in the community as there is not enough evidence to state they are effective in this cohort of the population. Hydroxychloroquine and azithromycin are both QT prolonging medications so unless ECG and bloods are performed prior to starting there may be a risk of ventricular arrhythmias in starting these medications.
    Given these considerable limitations of the current evidence, further clinical trials are required. More than twenty clinical trials are already registered for this purpose currently. No data from Chinese research on hydroxychloroquine and COVID has been published as of yet so results and conclusions can therefore not be peer-reviewed.
    Hydroxychloroquine is used in Ireland mainly for Systemic lupus erythematosus and rheumatoid arthritis. If these patients are deprived of this medication triggering a flare requiring po steroids they are immunosuppressed during a COVID pandemic.


  • Advertisement
  • #31
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    Out of my depth a bit here, but looking for answers:



    The current testing methods that we are using for this virus, can someone answer these questions in relation to it:

    What does the test specifically detect, as in does it detect prescence of coronavirus, Sars-Cov-2, or Covid 19


  • #32
    lozenges
    Registered Users Posts: 290 ✭✭lozenges


    dermob wrote: »
    Out of my depth a bit here, but looking for answers:



    The current testing methods that we are using for this virus, can someone answer these questions in relation to it:

    What does the test specifically detect, as in does it detect prescence of coronavirus, Sars-Cov-2, or Covid 19

    There are several (?5) different strains of coronavirus, most of which cause common cold type symptoms. Covid 19 is one of these. Sars-CoV-2 is the scientific name for Covid-19 i.e. they are identical.

    The tests we are using check only for the presence of Covid-19 ie not for the other 'common cold' type coronavirus.


  • #33
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    from what i understand, Covid 19 is the disease that is borne from the virus Sars-cov-2.

    How is it determined that you have covid 19?


  • #34
    lozenges
    Registered Users Posts: 290 ✭✭lozenges


    dermob wrote: »
    from what i understand, Covid 19 is the disease that is borne from the virus Sars-cov-2.

    How is it determined that you have covid 19?

    The terms are interchangeable, Covid 19 refers to the virus and also the disease, Sars CoV2 is the scientific name for it.

    The RNA (virus genes) are isolated, converted to a different form and amplified so that they are detectable. RT-PCR is the name of the process (Scientists feel free to correct me if this is inaccurate, to my knowledge this is the test currently in use).


  • #35
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    lozenges wrote: »
    The terms are interchangeable, Covid 19 refers to the virus and also the disease, Sars CoV2 is the scientific name for it.




    The RNA (virus genes) are isolated, converted to a different form and amplified so that they are detectable. RT-PCR is the name of the process (Scientists feel free to correct me if this is inaccurate, to my knowledge this is the test currently in use).

    i disagree with the above based on this https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

    i still dont know what the test actually test for?


  • #36
    lozenges
    Registered Users Posts: 290 ✭✭lozenges


    dermob wrote: »
    i disagree with the above based on this https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

    i still dont know what the test actually test for?

    Fair enough. Certainly in clinical practice currently Covid 19 is being used to refer to the virus/disease interchangeably, nobody is referring to the virus as Sars-CoV-2 and the disease as Covid-19.

    Re what the test checks for, I've answered as best I can as to how the test works so I'm not quite sure exactly what you're asking.


  • Advertisement
  • #37
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    Re what the test checks for, I've answered as best I can as to how the test works so I'm not quite sure exactly what you're asking.[/QUOTE]


    No worries on the name.

    Im askiing if the test is a positive or negative to any of the following:
    1. coronavirus
    2. Sars - Cov-2
    3. Covid 19


  • #38
    lozenges
    Registered Users Posts: 290 ✭✭lozenges


    dermob wrote: »
    Re what the test checks for, I've answered as best I can as to how the test works so I'm not quite sure exactly what you're asking.


    No worries on the name.

    Im askiing if the test is a positive or negative to any of the following:
    1. coronavirus
    2. Sars - Cov-2
    3. Covid 19[/quote]

    It tests positive for bits of SARS -CoV-2 virus particles essentially. (SARS -CoV-2 is the same to me as Covid-19, but anyway)

    SARS -CoV-2 is one of a family of viruses called coronaviruses. The test only tests for that one kind of coronavirus, but not the other kinds in the family.

    Hope that makes sense


  • #39
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    It tests positive for bits of SARS -CoV-2 virus particles essentially. (SARS -CoV-2 is the same to me as Covid-19, but anyway)

    SARS -CoV-2 is one of a family of viruses called coronaviruses. The test only tests for that one kind of coronavirus, but not the other kinds in the family.

    Hope that makes sense[/QUOTE]




    Thanks, it doesnt really make sense.

    i know every country hase different testing methods and i cannot find any specific reference to what we are testing for in ireland.

    you state above that the test is specific to Sars - Cov -2, yet the FDA have published this https://www.fda.gov/media/136151/download, and extracted from this is the following, paragraph2, line 5 " Positive results do not rule out bacterial infection or co-infection with
    other viruses. The agent detected may not be the definite cause of disease"

    On this basis, as i understand it, your statement is incorrect.


  • #40
    TheChizler
    Registered Users, Registered Users 2 Posts: 9,474 ✭✭✭TheChizler


    dermob wrote: »
    Thanks, it doesnt really make sense.

    i know every country hase different testing methods and i cannot find any specific reference to what we are testing for in ireland.

    you state above that the test is specific to Sars - Cov -2, yet the FDA have published this https://www.fda.gov/media/136151/download, and extracted from this is the following, paragraph2, line 5 " Positive results do not rule out bacterial infection or co-infection with
    other viruses. The agent detected may not be the definite cause of disease"

    On this basis, as i understand it, your statement is incorrect.

    They're saying you can also be infected other things at the same time, which the test doesn't test for. The symptoms might be caused by something else, even though they are likely positive for COVID-19.


  • #41
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    Thanks Chizler, it states "The agent detected may not be the definite cause of disease"

    So by my reading the test indicates the prescence of Sors-Cov-2, but it could also indicate the prescence other virus.

    is this an incorrect asumption?


  • Advertisement
  • #42
    Breezer
    Registered Users, Registered Users 2 Posts: 3,228 ✭✭✭Breezer


    dermob wrote: »
    Thanks Chizler, it states "The agent detected may not be the definite cause of disease"

    So by my reading the test indicates the prescence of Sors-Cov-2, but it could also indicate the prescence other virus.

    is this an incorrect asumption?
    It doesn’t say anything at all about the presence of other viruses. It says whether RNA fragments (bits of genes) from the Sars-CoV-2 virus are detected on the swab that was taken.

    It can’t say that you definitely don’t have SARS-CoV-2 in your system, just whether or not it was detected on the swab.

    It can’t say whether or not you have other viruses or bacteria in your system, or whether the disease you have is being caused by these organisms or by Sars-CoV-2.

    This is standard reporting jargon for any type of microbiological test. In reality, PCR is an extremely sensitive test method, and will only miss Sars-CoV 2 if the swab wasn’t taken properly. And in reality, if you are presenting with the symptoms Sars-CoV-2 is known to cause, and only those symptoms, and you have a positive test, then your symptoms are due to that.

    All medical tests need to be interpreted in the context of the patient’s clinical presentation. It’s why a doctor will ask you questions and then examine you before ordering a test.


  • #43
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    Breezer wrote: »
    It doesn’t say anything at all about the presence of other viruses. It says whether RNA fragments (bits of genes) from the Sars-CoV-2 virus are detected on the swab that was taken.

    As far as i am aware i cannot find a test that that detects Sars-Cov-2 specifically, can you link information to this?


  • #44
    lozenges
    Registered Users Posts: 290 ✭✭lozenges


    dermob wrote: »
    Breezer wrote: »
    It doesn’t say anything at all about the presence of other viruses. It says whether RNA fragments (bits of genes) from the Sars-CoV-2 virus are detected on the swab that was taken.

    As far as i am aware i cannot find a test that that detects Sars-Cov-2 specifically, can you link information to this?

    Not sure how much use it will be to you, but this is a link for the RT-PCR kit in use in France. I don't know which kits are in use in Ireland but they are all the same just by different manufacturers.

    https://www.generon.ie/read/newsletter-26/ce-ivd-qpcr-covid-19-test-in-2-2261.html


  • #45
    Breezer
    Registered Users, Registered Users 2 Posts: 3,228 ✭✭✭Breezer


    dermob wrote: »
    As far as i am aware i cannot find a test that that detects Sars-Cov-2 specifically, can you link information to this?

    I can’t I’m afraid, I’m a clinician, not a lab scientist, and would have no idea where to find the specific information you’re looking for. My answer was based on my understanding of the principles of PCR, which is a highly sensitive and specific test based on knowledge of a microorganism’s unique genetic sequence.

    I hope you don’t mind me saying, but you seem highly suspicious of this test. Do you mind if I ask why?

    Edit: I found details of one test being used in Washington: [url] https://testguide.labmed.uw.edu/public/view/NCVQLT?tabs=no[/url]

    From the linked FAQ:
    How specific is the COVID RT-PCR test? Does it cross-react with the “coronavirus” test on an extended respiratory panel?

    All of the offered assays are highly specific for the SARS-CoV-2 virus, with no known cross-reactivity to either other human coronaviruses or to other human respiratory pathogens.

    I can’t find the details of the test the NVRL are using here in Ireland, but it would be based on similar principles.

    Still genuinely curious as to why you seem so sceptical (nothing wrong with that of course).

    Edit 2: So yeah, essentially what lozenges already said. Sorry, I’m tired.


  • #46
    TheChizler
    Registered Users, Registered Users 2 Posts: 9,474 ✭✭✭TheChizler


    dermob wrote: »
    Thanks Chizler, it states "The agent detected may not be the definite cause of disease"

    So by my reading the test indicates the prescence of Sors-Cov-2, but it could also indicate the prescence other virus.

    is this an incorrect asumption?

    No is says nothing about a different virus. Just that SarsCov2 was detected.

    Imagine someone has allergies that can result in flu-like symptoms, and at the same time gets infected by the SarsCov2 virus. If they end up with breathing difficulties it's possible that they're caused by the virus, the allergies, or something else entirely. The test shows they have the virus, but doesn't tell you what's causing symptoms. Doctors would have to use their judgement in that unlikely situation.

    Caveat, I'm not a health professional, just very familiar with technical documentation like that paper.


  • #47
    Miike
    Registered Users, Registered Users 2 Posts: 2,021 ✭✭✭Miike


    dermob wrote: »
    As far as i am aware i cannot find a test that that detects Sars-Cov-2 specifically, can you link information to this?

    The specific test you're looking for is Real-time Reverse Transcription Polymerase Chain Reaction or "rRT-PCR". Which in very simple terms is a test which is used to detect a very specific part the genetic material of a pathogen, and in this case it's part of the genetic material (RNA) unique to SARS-CoV-2 (the virus responsible for COVID19). The current problem cited in the literature with this test is the sensitivity and specificity of current testing methods (which has gotten better as the disease timeline moves on).

    For clarity:
    COVID19 = Coronavirus Disease 2019 (The ILLNESS)
    SARS-CoV-2 = Severe acute respiratory syndrome coronavirus 2 (the virus responsible for the illness)


  • #48
    dermob
    Registered Users, Registered Users 2 Posts: 110 ✭✭dermob


    My concerns/sceptisim are borne,initially over my parents being older and falling into the over 70 category and member of my family being immuno compromised. Some of them are quite scared and I was seeking to get my head around this situation in an attempt to offer some levels of comfort.

    also the fact that there are a lot of names on this thing and all are being talked about in mainstream media (coronavirus, Ncov, Sars-cov-2, Covid 19 etc). And i feel that its confusing to older people, including my parents.

    Some of the media i have seen are as follows, im not going to link as i dont want to add to confusion etc but namely:

    - the downgrading of Covid 19 by the uk goverment that its no longer classified as a HCID.
    - Italys publications on 99% of cases having previous conditions
    - Number of professiors comming out and questioning this pandemic.
    (Stanford’s John P.A. Ioannidis, Dr Sucharit Bhakdi)
    - the different approaches some countries are taking (sweden)

    The queries on testing are based on the fact that every country is using differnt methods (of the same test) to find the virus and im wondering is there any discrepencies in how they are reported or classified, and also the different view on mortality rates.

    I do think we are in a terrible situation, but there is a huge amount of contradicting information around about it, and just trying to make some sort of sense of it all.


  • #49
    lozenges
    Registered Users Posts: 290 ✭✭lozenges


    dermob wrote: »
    My concerns/sceptisim are borne,initially over my parents being older and falling into the over 70 category and member of my family being immuno compromised. Some of them are quite scared and I was seeking to get my head around this situation in an attempt to offer some levels of comfort.

    also the fact that there are a lot of names on this thing and all are being talked about in mainstream media (coronavirus, Ncov, Sars-cov-2, Covid 19 etc). And i feel that its confusing to older people, including my parents.

    Some of the media i have seen are as follows, im not going to link as i dont want to add to confusion etc but namely:

    - the downgrading of Covid 19 by the uk goverment that its no longer classified as a HCID.
    - Italys publications on 99% of cases having previous conditions
    - Number of professiors comming out and questioning this pandemic.
    (Stanford’s John P.A. Ioannidis, Dr Sucharit Bhakdi)
    - the different approaches some countries are taking (sweden)

    The queries on testing are based on the fact that every country is using differnt methods (of the same test) to find the virus and im wondering is there any discrepencies in how they are reported or classified, and also the different view on mortality rates.

    I do think we are in a terrible situation, but there is a huge amount of contradicting information around about it, and just trying to make some sort of sense of it all.

    Sure.
    Regarding Italy - I doubt it's 99%, but they have the second oldest population in the world after Japan, so it makes sense that they would have very high mortality rates and that many of those affected would have pre-existing conditions.

    Re different approaches taken by different countries - this is not really based on the biology of the virus. As I see it, it's more a political decision taken by each country's governments as to the balance of harm caused by the virus (hospitalisations, mortalities) compared to the harm caused to the economy by restrictions/lockdowns (job losses, possible recession etc).

    It also depends partly on social factors - e.g. in Italy multiple family generations living in one household is common, whereas Sweden apparently has a high proportion of one person households. So rapid spread would be more likely in the former situation than the latter.


  • #50
    sudzs
    Registered Users, Registered Users 2 Posts: 8,737 ✭✭✭sudzs


    Also out of my depth!

    There seems to be a lot of variability in the severity of this disease, from extremely severe and needing hospitalisation to extremely mild and having hardly any symptoms at all.

    I'm wondering what could be the contributing factors to this variety in the severity of the illness. Could it just be how much of the virus someone is exposed to? Is it differences in individuals immune systems? Or could it be that some people have some sort of 'semi-immunity' to it as a result of previous infections with another coronavirus, possibly one closely related to covid-19??


  • #51
    Breezer
    Registered Users, Registered Users 2 Posts: 3,228 ✭✭✭Breezer


    dermob wrote: »
    My concerns/sceptisim are borne,initially over my parents being older and falling into the over 70 category and member of my family being immuno compromised. Some of them are quite scared and I was seeking to get my head around this situation in an attempt to offer some levels of comfort.

    also the fact that there are a lot of names on this thing and all are being talked about in mainstream media (coronavirus, Ncov, Sars-cov-2, Covid 19 etc). And i feel that its confusing to older people, including my parents.

    Some of the media i have seen are as follows, im not going to link as i dont want to add to confusion etc but namely:

    - the downgrading of Covid 19 by the uk goverment that its no longer classified as a HCID.
    - Italys publications on 99% of cases having previous conditions
    - Number of professiors comming out and questioning this pandemic.
    (Stanford’s John P.A. Ioannidis, Dr Sucharit Bhakdi)
    - the different approaches some countries are taking (sweden)

    The queries on testing are based on the fact that every country is using differnt methods (of the same test) to find the virus and im wondering is there any discrepencies in how they are reported or classified, and also the different view on mortality rates.

    I do think we are in a terrible situation, but there is a huge amount of contradicting information around about it, and just trying to make some sort of sense of it all.
    All very understandable and relatable reasons. I hope you got some answers :)


  • Advertisement
Advertisement