Bennyonesix1 wrote: ↑Tue Sep 01, 2020 6:32 pm
This is all beyond me but I've been assured by people who would know that M cells and Mucosal Immunity(or lack thereof) is what explains the bacterial infections and cutokine storm re:covid.
I have no idea and probably never will understand it but here is a paper on it:
I don't want to put down the research on smallest details of the functioning of the immune system, but in my view clinical research has much more value. Black box if you will: if you do this - that happens. Or, do this, and this, and this, and this - that happens.
We have a very vague idea how anaesthetic agents work, but are able to get a patient trough surgery unconscious. The example of black box.
That's fair. And a good point. I agree.
I'd just say that the treatments for covid aren't at the success level of anaesthesiology.
Until it gets there, research like this is important in my opinion.
Btw, are the docs in AUS checking covids for anaerobic bacterial infections? I know the bottle test is a pain and not regularly performed, but there really could be something there. The weirdly low O2 levels (etc etc) could be explained by O2 sequestration by anaerobes.
True all that. As far as anaerobic infections are concerned - honestly I don't know. There aren't many cases in Australia, and I am yet to see one.
Sangoma wrote: ↑Wed Sep 02, 2020 9:04 am
True all that. As far as anaerobic infections are concerned - honestly I don't know. There aren't many cases in Australia, and I am yet to see one.
Crazy you're in medicine and you haven't crossed paths with Covid here yet.
Go figure. My hospital cancelled all elective surgery in March and set up COVID on call shifts. Intubation, ventilation, intensive care is right up in my field. So I would sleep in the hospital from 1900 till 700 and go home. I did get a phone call at night once, to help the paediatrics sort out a sick eight months old kid. No covid, simple bronchopneumonia. The whole team went trough full dress up routine.
You should go catch it and contribute to herd immunity
Interesting local news...
Wayne Sebastianelli — Penn State’s director of athletic medicine — made some alarming comments about the link between COVID-19 and myocarditis, particularly in Big Ten athletes. Sebastianelli said that cardiac MRI scans revealed that approximately a third of Big Ten athletes who tested positive for COVID-19 appeared to have myocarditis, an inflammation of the heart muscle that can be fatal if left unchecked.
“When we looked at our COVID-positive athletes, whether they were symptomatic or not, 30 to roughly 35 percent of their heart muscles (were) inflamed,” Sebastianelli said. “And we really just don’t know what to do with it right now. It’s still very early in the infection. Some of that has led to the Pac-12 and the Big Ten’s decision to sort of put a hiatus on what’s happening.”
nafod wrote: ↑Thu Sep 03, 2020 6:12 pm
You should go catch it and contribute to herd immunity
Interesting local news...
Wayne Sebastianelli — Penn State’s director of athletic medicine — made some alarming comments about the link between COVID-19 and myocarditis, particularly in Big Ten athletes. Sebastianelli said that cardiac MRI scans revealed that approximately a third of Big Ten athletes who tested positive for COVID-19 appeared to have myocarditis, an inflammation of the heart muscle that can be fatal if left unchecked.
“When we looked at our COVID-positive athletes, whether they were symptomatic or not, 30 to roughly 35 percent of their heart muscles (were) inflamed,” Sebastianelli said. “And we really just don’t know what to do with it right now. It’s still very early in the infection. Some of that has led to the Pac-12 and the Big Ten’s decision to sort of put a hiatus on what’s happening.”
nafod wrote: ↑Thu Sep 03, 2020 6:12 pm
You should go catch it and contribute to herd immunity
Interesting local news...
Wayne Sebastianelli — Penn State’s director of athletic medicine — made some alarming comments about the link between COVID-19 and myocarditis, particularly in Big Ten athletes. Sebastianelli said that cardiac MRI scans revealed that approximately a third of Big Ten athletes who tested positive for COVID-19 appeared to have myocarditis, an inflammation of the heart muscle that can be fatal if left unchecked.
“When we looked at our COVID-positive athletes, whether they were symptomatic or not, 30 to roughly 35 percent of their heart muscles (were) inflamed,” Sebastianelli said. “And we really just don’t know what to do with it right now. It’s still very early in the infection. Some of that has led to the Pac-12 and the Big Ten’s decision to sort of put a hiatus on what’s happening.”
What's the increment over the flu and pneu and other infections? What % resolve?
Because myocarditis is a common condition post infection.
I don't know...good question. I imagine you've seen the med journal papers on it too. It does seem to be worse compared to flu virus.
It's the potential long term problems that have worried me, I don't expect to die from it. My wife has chronic Lyme, and it sucks. I'd prefer not to get something chronic.
nafod wrote: ↑Thu Sep 03, 2020 6:12 pm
You should go catch it and contribute to herd immunity
Interesting local news...
Wayne Sebastianelli — Penn State’s director of athletic medicine — made some alarming comments about the link between COVID-19 and myocarditis, particularly in Big Ten athletes. Sebastianelli said that cardiac MRI scans revealed that approximately a third of Big Ten athletes who tested positive for COVID-19 appeared to have myocarditis, an inflammation of the heart muscle that can be fatal if left unchecked.
“When we looked at our COVID-positive athletes, whether they were symptomatic or not, 30 to roughly 35 percent of their heart muscles (were) inflamed,” Sebastianelli said. “And we really just don’t know what to do with it right now. It’s still very early in the infection. Some of that has led to the Pac-12 and the Big Ten’s decision to sort of put a hiatus on what’s happening.”
What's the increment over the flu and pneu and other infections? What % resolve?
Because myocarditis is a common condition post infection.
I don't know...good question. I imagine you've seen the med journal papers on it too. It does seem to be worse compared to flu virus.
It's the potential long term problems that have worried me, I don't expect to die from it. My wife has chronic Lyme, and it sucks. I'd prefer not to get something chronic.
The only paper I've seen showing it was withdrawn in shame because of errors. The republished paper showed no sig increment over other conditions.
But it's seemed to me all along that the covid itself is benign but the secondary bacterial infections are terrible for a small fraction of infected.
The most fear-mongering paragraph from the article:
Any such cardiac sequelae lingering weeks to months after the fact is clearly concerning, and we’re seeing more evidence of it. A German study found that 78 percent of recovered COVID-19 patients, the majority of whom had only mild to moderate symptoms, demonstrated cardiac involvement more than two months after their initial diagnoses. Six in 10 were found to have persistent myocardial inflammation. While emphasizing that individual patients need not be nervous, lead investigator Elike Nagel added in an e-mail, “My personal take is that COVID will increase the incidence of heart failure over the next decades.”
nafod wrote: ↑Thu Sep 03, 2020 8:21 pm
This article reasonably summarizes the concerns. It's a rapidly moving topic, as enough time has passed to see long term effects.
The most fear-mongering paragraph from the article:
Any such cardiac sequelae lingering weeks to months after the fact is clearly concerning, and we’re seeing more evidence of it. A German study found that 78 percent of recovered COVID-19 patients, the majority of whom had only mild to moderate symptoms, demonstrated cardiac involvement more than two months after their initial diagnoses. Six in 10 were found to have persistent myocardial inflammation. While emphasizing that individual patients need not be nervous, lead investigator Elike Nagel added in an e-mail, “My personal take is that COVID will increase the incidence of heart failure over the next decades.”
Yeah dude that is the paper the authors had to withdraw and re-publish because it was so bad.
nafod wrote: ↑Thu Sep 03, 2020 8:21 pm
This article reasonably summarizes the concerns. It's a rapidly moving topic, as enough time has passed to see long term effects
Yeah, that one was jumped on pretty hard. Wasn't it an age issue? All the people they looked at were like a year older than the average age of dying or something like that.
The collegiate football one, I'd like to examine in detail.
Shafpocalypse Now wrote: ↑Fri Sep 04, 2020 1:14 am
Yeah, that one was jumped on pretty hard. Wasn't it an age issue? All the people they looked at were like a year older than the average age of dying or something like that.
The collegiate football one, I'd like to examine in detail.
Here's the dude who found the errors. He's annoying. But there were 7 major errors.
Here's his paraphrase of the subsequent interview he conducted with the author.
nafod wrote: ↑Thu Sep 03, 2020 8:21 pm
This article reasonably summarizes the concerns. It's a rapidly moving topic, as enough time has passed to see long term effects
Jfc lmao nafod pls respond.
It’s the talk of the town here.
The local school district had set a "tripwire" number of cases where they would likely pull the plug in in-class teaching for K-12, and we've passed it. But most of the cases are of course college students on campus. Question is, is that going to bleed over into the town population? They've given the students the day off to watch how the numbers will go this weekend.
Today the college reported 40 new cases, so not the direction they want it to go. Hopefully it will stay at that level or decrease. If it shows signs of exponential growth, we'll shut down.
Student-run twitter account, got the pulse of the U
Bennyonesix1 wrote: ↑Fri Sep 04, 2020 2:37 pm
Lol no pls respond to the Doc making shit up abt PSU football players and the German Paper being withdrawn.
Bennyonesix1 wrote: ↑Fri Sep 04, 2020 2:37 pm
Lol no pls respond to the Doc making shit up abt PSU football players and the German Paper being withdrawn.
You want me to defend them?
Fair point. I wanted you to respond as a decent guy would. My mistake.
Obv, this could mean what it seems to mean or not. Idk. But it looks absolutely terrible. Jfc.
"On a scale of one to 10, one being less concerned and 10 being the most concerned," said Daniel Taylor, an associate professor of accounting at the Wharton School, "this is an 11."
I guess if we are being incredibly generous, an absurdly high Ct level in the beginning was acceptable in an effort to minimize false negatives. But now?
And of course, this should have been disclosed. And every positive marked with the relevant Ct of the various tests which weren't std-ized.
The lack of standardization makes me think it was just incompetence which has been par for the course so far.
The data are suggestive of a relation between the time from collection of a specimen to test, cycle threshold (as a proxy for viral load) and symptom severity.
The quality of the studies was moderate with lack of standardised reporting.
Ten studies reported that Ct values were significantly lower and log copies higher in those with live virus culture.
Nine studies reported no growth in samples based on a Ct cut-off value. These values ranged from CT > 24 for no growth to Ct greater or equal to 34.
Two studies report a strong relationship between Ct value and ability to recover infectious virus and that the odds of live virus culture reduced by 33% for every one unit increase in Ct. A cut-off RT-PCR Ct > 30 was associated with non-infectious samples. One study that analysed the NSP, N and E gene fragments of the PCR result reported different cut-off thresholds depending on the gene fragment analysed. The duration of RNA shedding detected by PCR was far longer compared to detection of live culture.
Six out of eight studies reported RNA shedding for longer than 14 days. Yet, Infectivity declines after day 8 even among cases with ongoing high viral loads. A very small proportion of people re-testing positive after hospital discharge or with high Ct are likely to be infectious.
Conclusion Prospective routine testing of reference and culture specimens are necessary for each country involved in the pandemic to establish the usefulness and reliability of PCR for Covid-19 and its relation to patients factors.
Infectivity is related to the date of onset of symptoms and cycle threshold level.
A binary Yes/No approach to the interpretation RT-PCR unvalidated against viral culture will result in false positives with segregation of large numbers of people who are no longer infectious and hence not a threat to public health.
Results
Of 50 patients treated with calcifediol, one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50%) p value X2 Fischer test p < 0.001. Univariate Risk Estimate Odds Ratio for ICU in patients with Calcifediol treatment versus without Calcifediol treatment: 0.02 (95%CI 0.002-0.17). Multivariate Risk Estimate Odds Ratio for ICU in patients with Calcifediol treatment vs Without Calcifediol treatment ICU (adjusting by Hypertension and T2DM): 0.03 (95%CI: 0.003-0.25). Of the patients treated with calcifediol, none died, and all were discharged, without complications. The 13 patients not treated with calcifediol, who were not admitted to the ICU, were discharged. Of the 13 patients admitted to the ICU, two died and the remaining 11 were discharged.
