Replies

PA, I think you are the one following the Neuro implications, correct? I know it’s from China, hopefully from doctors and not propaganda

JAMA: Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China

...

Results Of 214 patients (mean [SD] age, 52.7 [15.5] years; 87 men [40.7%]) with COVID-19, 126 patients (58.9%) had nonsevere infection and 88 patients (41.1%) had severe infection according to their respiratory status. Overall, 78 patients (36.4%) had neurologic manifestations. Compared with patients with nonsevere infection, patients with severe infection were older, had more underlying disorders, especially hypertension, and showed fewer typical symptoms of COVID-19, such as fever and cough. Patients with more severe infection had neurologic manifestations, such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]), and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]).

Published Online: April 10, 2020. doi:10.1001/jamaneurol.2020.1127

COVID-19 Oklahoma Test Results
Positive (In-State) 1,970
*Total Cumulative Negative Specimens 20,790
*Total Cumulative Number of Specimens to Date 22,511
Total Cumulative Hospitalizations 453
Deaths 96

COVID-19 Cases by Age Grouping
Age Group, Years COVID-19 Cases Deaths
00-04 19 0
05-17 31 0
18-35 348 2
36-49 400 3
50-64 499 14
65+ 673 77
Total 1,970 96
Age Range: 0-102 yrs Median Age: 56

https://coronavirus.health.ok.gov/

I think it is too early to tell because of the paucity of data.

Gait ataxia caught our attention, however hypoxia is one of the underlying causes. We'll have to wait for more studies.

The neuropathology of the adult cerebellum

The human brain is vulnerable to even brief interruptions of oxygen supply, and cerebral hypoxia occurs on a background of arrested circulation (ischemic or stagnant hypoxia), insufficient oxygen saturation of hemoglobin in circulating red blood cells (pure anoxia), or toxicity that interferes with oxygen transport or delivery.

Insufficient oxygen saturation is a common symptom of this virus (including glycated hemoglobin). I believe we are going to see ongoing issues with the brain, lung and kidneys in recovering patients .

An interesting paper involving high HbA1c and pulse oximetry oxygen saturation:

Elevated blood HbA1c levels lead to an overestimation of SaO2 by SpO2, suggesting that arterial blood gas analysis may be needed for type 2 diabetic patients with poor glycemic control during the treatment of hypoxemia.

Increased blood glycohemoglobin A1c levels lead to overestimation of arterial oxygen saturation by pulse oximetry in patients with type 2 diabetes

Finally, (once again) patients need to get their HbA1c under control. I don't like the 6.5 level as normal. That is based on a sick population average. Below 6 in the 5.5 range should be the target.

Best.