yow!
(Excerpted)
Thanks, anonymous.
COVID-19 never killed anybody
by Ted Noel MD July 7, 2020 in Healthcare, Opinions
If all you get is the Wuhan Flu, you may get a bit sick, but you wont even need to go to the hospital. Youll get over it. Thats because you dont get a Cytokine Storm.
In plain English, CS is a different disease process. Its an uncontrolled release of signaling molecules that engage the immune system at ludicrous speed. A number of different infections can trigger it. An infection is needed before the Storm can start, but the Storm is a different process.
Once its underway, it drives the train. We know that the risk of dying from CS following COVID-19 in Florida if you are under age 25 is 0.02%, but if you are over 85, its 24.5% (FL Dept. of Health as of July 6).
That 1,225x difference in risk proves that something else is in play. The infection is necessary, but its not sufficient. CS requires something more than just infection such as COVID-19, SARS, or H5N1 flu.
In general, age and infirmity are correlated with bad outcomes, but we dont know in any detail what factor within those categories is needed. What we do know is that the interventions that work dont have all that much to do with antiviral effects.
Multiple studies have shown that hydroxychloroquine works to reduce severity and duration of the infection complex (COVID + CS) if given in the earlier stages of the disease. We also know that HCQ has both antiviral and immune modulating effects. Which of its effects is important with COVID-19 is not entirely clear.
But as we look further, studies have shown that dexamethasone, a common, inexpensive steroid, has beneficial effects, most likely by reducing CS. And new reports indicate that early administration of budesonide, an inhaled steroid that only gets to the lungs, can rapidly reverse the onset of CS.
The common feature of these treatments is an anti-inflammatory effect. HCQ is a mild anti-inflammatory, inhaled budesonide works the same way in the lung, and dexamethasone is a more potent systemic anti-inflammatory.
If we add suggestive data that non-steroidal anti-inflammatories may reduce inflammatory symptoms of respiratory virus infections, we start to see a strongly suggestive picture that CS is the major culprit.
When we look at drugs with antiviral effects, the picture isnt so clear. A search of PubMed reveals no strong candidates for therapy. Lay news reports have remdesivir reducing hospital stays, but detailed studies are still in the pipeline.
In short, antivirals dont seem to be all that useful in advanced COVID-19 cases. At the same time, viral load on admission does not seem to match outcome. - But viral load does match inflammatory markers in critically ill patients.
Putting the viral load data together doesnt tell us much. That suggests that antiviral therapy isnt likely to be terribly helpful in the critically ill patient. And that seems to be what were seeing. - The disease that kills people is CS, not COVID-19.
https://noqreport.com/2020/07/07/covid-19-never-killed-anybody/