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10-03-2020, 10:43   #1
The_Dazzler
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COVID-19 technical discussion

https://www.thelancet.com/lancet/art...736(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.

Last edited by The_Dazzler; 10-03-2020 at 10:48.
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10-03-2020, 11:04   #2
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https://papers.ssrn.com/sol3/papers....act_id=3548774

This makes for grim reading if you are over 70 and have co-morbidities.
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13-03-2020, 14:41   #3
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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)
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13-03-2020, 21:40   #4
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whats with the stock piling though please? i don't get it - at all..
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13-03-2020, 22:25   #5
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^^ news images of Wuhan i guess

...how often should we wash our hands?

Last edited by fryup; 13-03-2020 at 22:28.
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13-03-2020, 22:32   #6
sporina
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^^ news images of Wuhan i guess

...how often should we wash our hands?
wer there images of people stocking piling in China?
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13-03-2020, 22:40   #7
grindle
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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.
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14-03-2020, 15:17   #8
Vanar
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Originally Posted by The_Dazzler View Post

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.
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15-03-2020, 01:30   #9
Breezer
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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.
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15-03-2020, 03:09   #10
Miike
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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.
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15-03-2020, 10:41   #11
Vanar
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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

Last edited by Vanar; 15-03-2020 at 10:43. Reason: URL
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15-03-2020, 10:44   #12
sullivlo
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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.
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15-03-2020, 10:59   #13
The_Dazzler
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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.
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15-03-2020, 12:48   #14
Vanar
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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.
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15-03-2020, 13:43   #15
sullivlo
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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.
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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.
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