15 ms·

The neuroinvasive potential of SARS-CoV2

403 points by processing 7y ago

nswest23 7y ago
don't forget that the title includes the following: "...may be at least partially..."
daenz 7y ago
Who wants to help make a design file for 3d printed nose plugs? If blocking the intranasal path is effective in preventing the CNS infection, as this paper suggests, nose plugs should be effective here.
Santosh83 7y ago
I thought papers dealing with this virus were to be made available publicly?
- 3JPLW 7y ago
  It is.
- pkaye 7y ago
  Click on the "Full Text Article" link on the right.
- dpwm 7y ago
  There seems to be a PDF link floating around: https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25728 https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25728 [edit] Or you can just click the very tiny "PDF" link on the linked page that I apparently missed the first time.
- rolph 7y ago
  go here: https://sci-hub.se/10.1002/jmv.25728 https://sci-hub.se/10.1002/jmv.25728 keep in mind this is a preliminary, the grammar used in this paper needs to be revised so as to avoid as much as possible, people coming to errant conclusions after misinterpreting poorly written phrases. so that means that while reading this paper one should not skim but should take the effort to interpret this paper. there is an absence of references in the abstract, this makes it hard to examine the basis for statements in abstract
  - rolph 7y ago
    if you head down to page 4 of the paper there is where you will find references to background literature cited regarding "neuroinvasive potential" [1] Glass WG, Subbarao K, Murphy B, Murphy PM. Mechanisms of host defense following severe acute respiratory syndrome-coronavirus (SARS-CoV) pulmonary infection of mice. J Immunol 2004;173:4030-4039. https://doi.org/10.4049/jimmunol.173.6.4030 https://doi.org/10.4049/jimmunol.173.6.4030 [11] Li, Y.-C., Bai, W.-Z., Hirano, N., Hayashida, T., Taniguchi, T., Sugita, Y., … Hashikawa, T. (2012). Neurotropic virus tracing suggests a membranous-coating-mediated mechanism for transsynaptic communication. https://doi.org/10.1002/cne.23171 https://doi.org/10.1002/cne.23171
john_moscow 7y ago
PDF (link buried within the page): https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.25728 https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.25728
newsbinator 7y ago
If it did turn out this virus is neuroinvasive and that is what causes acute respiratory problems, how would this be prevented/mitigated/treated, theoretically?
- pbourke 7y ago
  Perhaps more aggressive early antiviral therapies?
- DailyHN 7y ago
  > Considering the potential neuroinvasion of SARS-CoV-2, antiviral therapy should be carried out as early as possible to block its entry into the CNS. Airway inhalation of antiviral agents will be the first choice at the early stage of infection, which will inhibit the replication SARS-CoV-2 in the respiratory tracts and lung and prevent from its subsequent neuroinvasion. It is also urgent to find effective antiviral drugs that can cross the blood-brain barrier. Moreover, corticosteroids, which are used frequently for severe patients, may have no treatment effect, but rather accelerate the replication of the virus within the neurons.
  - cryoshon 7y ago
    >corticosteroids may have no treatment effect isn't the point of the corticosteriods to rapidly reduce widespread pulmonary inflammation that would otherwise kill the patient?
    - Enginerrrd 7y ago
      Yes, but it suggests that it could be important to distinguish whether the cause of their decline and hypoxia is CNS respiratory depression or issues with lung function before making that call.
- csears 7y ago
  The full text mentions masks being particularly effective and inhaled antiviral meds that could slow the spread of the virus in airways. It also talks about the need for antiviral agents capable of crossing the brain-blood barrier. See the last 3 paragraphs of the full text.
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aazaa 7y ago
From the paper: > If the neuroinvasion of SARS-CoV-2 does take a part in the development of respiratory failure in COVID-19 patients, the precaution with masks will absolutely be the most effective measure to protect against the possible entry of the virus into the CNS. It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally. The possible neuroinvasion of SARS-CoV-2 may also partially explain why some patients developed respiratory failure, while others not. It is very possible that most of the persons in Wuhan, who were the first exposed to this previously unknown virus, did not have any protective measure, so that the critical patients is much more in Wuhan than in other cities in China. This is a good example of why writing off COVID-19 as no more dangerous than the flu is itself so dangerous. I should also point out that most people in the US face similar conditions to those in Wuhan. The extent of infection is not known, and therefore protective measures are not in place. We have been actively discouraged from "buying masks" and told that they are ineffective.
- 99_00 7y ago
  >I should also point out that most people in the US face similar conditions to those in Wuhan. I don't think that's true.
- morpheuskafka 7y ago
  Yes, only a N95 or better mask would protect you from incoming, as opposed to outgoing, viruses, and these masks are both impractical for everyday wear and need to be conserved for public health users.
  - bluGill 7y ago
    I have a small box of N95 masks in my shop - bought last summer for dust protection. When is the right time for me to put them on my family. Part of this is how long will they last before I must replace them. Or should I put them on eBay for a million dollars and hope I life to enjoy my new found wealth?
    - 7y ago
xenonite 7y ago
The link should be changed to the publisher‘s page where the pdf is linked. https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25728 https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25728
- mobilefriendly 7y ago
  It's important to see the NIH summary though. Gives the study credibility.
  - searine 7y ago
    That is just the abstract as indexed by pubmed. NIH has no oversight on the content.
  - CamperBob2 7y ago
    Which is actually a problem. Not uncommon to see obvious sham science propagated with an official-looking PubMed link at nih.gov. "I'm allergic to WiFi." "No, you're not. Nobody is allergic to WiFi." "Yes, I am. Here's an official PubMed citation: https://www.ncbi.nlm.nih.gov/pubmed/26372109 https://www.ncbi.nlm.nih.gov/pubmed/26372109 . Why do you hate science?"
    - whatshisface 7y ago
      >Provocation studies on EMF have yielded different results, ranging from where people with EHS cannot discriminate between an active RF signal and placebo, to objectively observed changes following exposure in reactions of the pupil, changes in heart rhythm, damage to erythrocytes, and disturbed glucose metabolism in the brain. The paper you linked admits that there are studies that show it's the same as a placebo. Just because most people aren't qualified to realize that the studies in the first half of the sentence might be more reliable than the studies in the second half doesn't mean the paper shouldn't be published.
      - CamperBob2 7y ago
        So? You can say exactly the same things about ESP or dowsing. Run enough studies, even properly-conducted ones, and some of them will yield the results you're hoping for. At that point, all you have to do is either ignore the others altogether, or leverage them to argue in favor of "teaching the controversy," as is done in this particular paper. This strategy is meaningless in terms of scientific value, but it certainly sounds authentic enough to non-specialists.
majos 7y ago
Not a biologist, but reading the paper, the chain of reasoning appears to be summarized in this section: > Taken together, the neuroinvasive propensity has been demonstrated as a common feature of CoVs. In light of the high similarity between SARS-CoV and SARS-CoV2, it is quite likely that SARS-CoV-2 also possesses a similar potential. Based on an epidemiological survey on COVID-19, the median time from the first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to the intensive care was 8.0 days 15. Therefore, the latency period is enough for the virus to enter and destroy the medullary neurons. As a matter of fact, it has been reported that some patients infected with SARS-CoV-2 did show neurologic signs such as headache (about 8%), nausea and vomiting (1%). There's also this rather disquieting anecdote used as evidence of a link to the nervous system: > According to the complaints of a survivor, the medical graduate student (24 years old) from Wuhan University, she must stay awake and breathe consciously and actively during the intensive care. She said that if she fell asleep, she might die because she had lost her natural breath. Supposing that this neurological link is real, > the precaution with masks will absolutely be the most effective measure to protect against the possible entry of the virus into the CNS. It may also be expected that the symptoms of the patients infected via facal-oral [sic?] or conjunctival route will be lighter than those infected intranasally. The possible neuroinvasion of SARS-CoV-2 may also partially explain why some patients developed respiratory failure, while others not. It is very possible that most of the persons in Wuhan, who were the first exposed to this previously unknown virus, did not have any protective measure, so that the critical patients is much more in Wuhan than in other cities in China. So let me ask a dumb question for someone with actual biomedical knowledge. Are they saying that infection of the CNS is somehow easier through the nose, in which case high-quality face masks actually do matter? I'm also confused by this sentence in the introduction, which appears to contradict the hypothesis that the upper respiratory tract is a high-impact area? > However, different from SARS-CoV, SARS-CoV-2-infected patients rarely showed prominent upper respiratory tract signs and symptoms, indicating that the target cells of SARS-CoV-2 may be located in the lower airway. I will note that, unlike some other papers on this topic, this one has been peer-reviewed in what seems to be a legitimate medical journal (Journal of Medical Virology), so there should be some genuine substance here.
- chinathrow 7y ago
jxy 7y ago
I see a lot of "may", "possible", "if", ... Is this how people typically write a paper to Medical Virology?
- shanxS 7y ago
  > Is this how people typically write a paper to Medical Virology? I wont assume that (I am software engg.) I see where you are coming from. Here is my perspective, think of this like a outage of your service. No one has exact answers so team starts to dive in and starts sharing what they find. These findings mostly prune the "solution space" of the problem.
  - DantesKite 7y ago
    I love that phrase: "...prune the 'solution space' of the problem." Feels like a new weapon was added to my cognitive toolkit.
- hackeer 7y ago
  Recently I started listening twiv.tv podcast and that's how they talk. For instance, they said there are many videos in social media of people dropping unconscious to the floor, but the virologists said not to trust those videos because "it's social media". I stopped listening to their podcast. These people don't reason unless they are shown a peer reviewed paper saying people drop unconscious. I mean, how likely is it that those videos are being faked?
  - majewsky 7y ago
    > how likely is it that those videos are being faked? I see it's your first day on the internet. Welcome!
    - deleted 7y ago
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- deleted 7y ago
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liquidforce 7y ago
If I understand this correctly, could wearing nose clips and only mouth breathing be an effective strategy to reduce impact?
- sspencer 7y ago
  > It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally. That seems like the hypothesis they suggest. Interesting implications.
  - adatavizguy 7y ago
    All the people who were made fun of in middle school for being a 'mouth breather' will have the last laugh.
    - W4ldi 7y ago
      'mouth breathing' is actually really bad for you.
      - Kiro 7y ago
        How so?
        throwanem 7y ago
        Your nasal passages include structures called "conchae" which, among other purposes, secrete mucus to capture small and potentially disease-carrying particles from incoming air. [1] It's not a perfect defense, of course, but better to have it than not - and when you breathe through your mouth, you don't get the benefit. [1] https://en.wikipedia.org/wiki/Nasal_concha#Immunological_role https://en.wikipedia.org/wiki/Nasal_concha#Immunological_rol...
    - confiscate 7y ago
      can't laugh when you are breathing with your mouth, my friend :)
thijsvandien 7y ago
As a side observation: most reporting seems rather binary, i.e. you either die or survive, period. What interests me the most, however, is how often survival means full recovery, especially now that the nervous system comes up. Are there any long term effects? Should one generally expect to come out of it worse, the same, or stronger? I'm much less afraid to die from this than to end up with chronic respiratory and/or neurological issues.
- Proziam 7y ago
  EDIT - Just to be clear, I'm not saying that people shouldn't take precautions or that it's not worth protecting vulnerable groups. I'm simply suggesting that perhaps there is news coverage about other things (remember the whole Hong Kong situation that we aren't hearing about suddenly?) that might still deserve some air time. The media is profiting off this story big time. It's like when the plane went missing and a news station actually put some moron on the air who said there's technically a chance a black hole swallowed the plane. It's disgraceful, to be honest. That said, it looks like the rate of fatalities is overblown significantly [0](0.2% in a healthy population (COMPARED WITH THE 3.4% NUMBER BEING SPOUTED ALL OVER THE PLACE). I've yet to see coverage that is remotely reputable about long-term health effects after recovery. EDIT 2 - Case in point about premature statements being made. > [1]“I think it is likely we’ll see a global pandemic,” said Marc Lipsitch, a professor of epidemiology at Harvard T.H. Chan School of Public Health. “If a pandemic happens, 40% to 70% of people world-wide are likely to be infected in the coming year. What proportion of those will be symptomatic, I can’t give a good number.” followed by: > [2]"Because I am now less certain of where the R0 will end up (and how it may vary geographically) I am going to revise downward the range of outcomes I consider plausible to 20%-60% of adults infected. This involves subjectivity about what range of R0 may turn out to be true." [0] https://institutefordiseasemodeling.github.io/nCoV-public/analyses/first_adjusted_mortality_estimates_and_risk_assessment/2019-nCoV-preliminary_age_and_time_adjusted_mortality_rates_and_pandemic_risk_assessment.html https://institutefordiseasemodeling.github.io/nCoV-public/an... [1]https://www.wsj.com/articles/how-many-people-might-one-person-with-coronavirus-infect-11581676200?mod=rsswn https://www.wsj.com/articles/how-many-people-might-one-perso... [2]https://twitter.com/mlipsitch/status/1234879949946814464 https://twitter.com/mlipsitch/status/1234879949946814464
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vorticalbox 7y ago
Question what effect is vaping having on the spread? Walking in a city in the UK I see people leave large plumes of vaper which seems to me be an excellent transport system. Warm and wet.
- geggam 7y ago
  Score one for the cigar / tobacco smoker
  - SketchySeaBeast 7y ago
    As it would seem to affect smokers harder, I'd call that a draw.
    - geggam 7y ago
      Cigar smokers FTW...they dont inhale ;)
      - SketchySeaBeast 7y ago
        In that case, it seems like an even weirder affect to take on - none of the nicotine, all of the bad breath and mouth cancer.
        mrob 7y ago
        Nicotine can be absorbed through the nose and mouth. It's not as effective as through the lungs, but cigars have much higher dosage than cigarettes.
        geggam 7y ago
        You absorb nicotine in the mouth. You dont get tar in your lungs. No smoking is good for you but then again the leading cause of death is birth so enjoy the time you have. If cigars are your thing smoke it up
citboin 7y ago
Great. I work in an E.R. and my neurological system is already being ravaged by M.S. I'm not sure that I would not just walk off of the job if we are inundated with COVID-19 patients.
clon 7y ago
Would this explain the apparent sudden collapse of people on the streets in China and Iran? [1] [1] https://www.snopes.com/fact-check/people-collapsing-coronavirus/ https://www.snopes.com/fact-check/people-collapsing-coronavi...
- theseadroid 7y ago
  In your own source it is said unproven with detailed explanation: >If we strip the above-displayed videos of their captions, we can take a look purely at what the videos show. In one case, it looks like a person was the victim of a traffic accident. In another, it appears that a man suffered a head injury. But since these videos appeared online during heightened hysteria about an outbreak of an illness, it’s easy to see how a passerby may have made the assumption that these incidents were connected to the coronavirus.
- viggity 7y ago
  Folks, if you see someone collapse on the street and they're wearing a mask. TAKE THE MASK OFF OF THEM. They're not getting enough oxygen. It is taxing to breath through an N95 mask. Source: I passed out when I put on a surgical mask while my wife was getting an epidural. Not from seeing the needle because I didn't even see the needle, and I don't get squeamish anyway. I have low blood oxygen and it was too hard to breath through the mask.
  - sdinsn 7y ago
    Perhaps I'm selfish, but if I see someone wearing a mask and they collapse, the last thing I'm going to do is get near them...
sombremesa 7y ago
I've only read the abstract, and it seems to clearly say that the virus can get to the brain via the lungs. So I have no idea what people ITT are on about regarding purposeful infection or masks for prevention. Regardless, this abstract also does not explain the mildness of the disease except for the immunocompromised and elderly, which to me renders the link between how you get the infection and fatality a bit suspicious.
- TheAdamAndChe 7y ago
  If you read more than the abstract, it explains that animals that are infected nasally have much higher rates of brain infection than the fecal-oral route of infection. Edit: changed "oral/fecal" to "fecal-oral," thanks calmworm. Also removed a period.
  - calmworm 7y ago
    *facal-oral
  - champagneben 7y ago
    I don't think that was calmworm's qualm with it. Heh.
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daun 7y ago
I was actually wondering about this because both the Spanish Flu and the 2009 H1N1 pandemics left life-long brain damage for some survivors in the form of narcolepsy with cataplexy. The vaccine for H1N1 caused it in a very small amount of patients as well. After the Spanish Flu they called it "encephalitis lethargica". It appears that it damages the hypothalamus.
vernie 7y ago
How many fucking names does this thing have?
- rimliu 7y ago
  SARS-CoV-2 for the virus, COVID for the disease it causes.
- nkohari 7y ago
  Yes, it's a little confusing. [0] 2019-nCoV (2019 Novel Coronavirus) was a temporary name. SARS-CoV-2 (Severe Acute Respiratory Syndrome-related Coronavirus 2) is the official name for the virus. COVID-19 (Coronavirus Disease 2019) is the official name for the disease that the virus causes. [0] https://www.sciencemag.org/news/2020/02/bit-chaotic-christening-new-coronavirus-and-its-disease-name-create-confusion https://www.sciencemag.org/news/2020/02/bit-chaotic-christen...
hirenj 7y ago
Whether you believe this or not comes down to whether you believe references 32-34 from the paper. I haven't read the stuff about transgenic expression of human ace2 in mice, but it would sound a lot more like it was aberrantly expressed, so I'm not counting that. "More evidence needed" is the correct interpretation here, I believe. There's other literature out there saying ACE2 is ubiquitously expressed (including brain) - so that means one of two things: People saying it's expressed everywhere are wrong, or SARS-COV-2 requires more than ACE2 for infection. There are papers saying that transfecting cell lines with ACE2 doesn't always render the cells susceptible, so it's probably a good idea to consider the requirement for a co-receptor. Like anything, the true answer probably lies in between all these possibilities.
vilhelm_s 7y ago
> According to the complaints of a survivor, the medical graduate student (24 years old) from Wuhan University, she must stay awake and breathe consciously and actively during the intensive care. She said that if she fell asleep, she might die because she had lost her natural breath Sounds like something from a horror movie!
- airstrike 7y ago
  Couldn't agree more. I can't seem to forget this sentence...
- Exuma 7y ago
  Ugh... horrifying. That makes me feel sick considering 20% of people will get pneumonia...
- minxomat 7y ago
  Reminiscent of the Polio outbreak/iron lung era. A survivor described the sound of clicking tounges in iron lung rooms after the electricity had failed and a few nurses needed to rotate between devices, manually pumping air. Tounge clicking because no one had the ability to exhale air and produce vocal sounds.
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hannob 7y ago
This is almost a week old, I haven't read about it anywhere else. I have read and heard plenty of interviews with scientists involved in this in the past few days and noone has mentioned anything in that direction. Anyone has any link to secondary sources where other scientists try to put this in perspective?
endorphone 7y ago
It is interesting how absolutely passionate some people are about masks. There is a pretty heady contingent here that seems to be of the "I DID MY PART" sort (by mindlessly pushing an absurd anti-science anti-mask angle -- I was one of the silly minority countering it a few days ago, to very little effect). "If you wear a mask your testicles will shrink and everyone will hate you!" But the more important question: Is it time to stop trimming nose hairs?
Leader2light 7y ago
Meanwhile, stocks rally. We are beyond fucked.
biolurker1 7y ago
Was this forced to second page?
pombrand 7y ago
Airborne viral particle protection: N95 masks may only be effective used with eye protection. Surgical masks may not help at all. Looked for interventional studies testing whether face masks and eye protection work in humans to protect against airborne viral particles. A critical issue with many such studies is that medical staff only use masks and/or eye protection at work, opening them to being infected outside of work. Found a small study [1] getting around this problem by exposing subjects (n = 28, avg age 30.5 years) to monodispersed live attenuated influenza vaccine particles by placing them in front of a vibrating-orifice aerosol generator for 20 minutes, subsequently testing for infection using RT-PCR and culture in nasal washes. Surgical mask: 3M 1818 | N95 mask: 3M 1860/1860S | Eye Protection: Z87 Uvex non-vented ----------------------------------------------- RESULTS ----------------------------------------------- No precautions: 4 out of 4 infected. Ocular exposure only: 4 out of 4 infected. Surgical mask only: 5 out of 5 infected. Surgical mask + eye protection: 5 out of 5 infected. N95 mask only: 3 out of 5 infected. N95 mask + eye protection: 1 out of 5 infected. 1. Bischoff WE, Reid T, Russell GB, Peters TR. Transocular entry of seasonal influenza-attenuated virus aerosols and the efficacy of n95 respirators, surgical masks, and eye protection in humans. J Infect Dis. 2011;204(2):193–199.

403 points by processing 7y ago

don't forget that the title includes the following: "...may be at least partially..."

Who wants to help make a design file for 3d printed nose plugs? If blocking the intranasal path is effective in preventing the CNS infection, as this paper suggests, nose plugs should be effective here.

Santosh83 7y ago

I thought papers dealing with this virus were to be made available publicly?

3JPLW 7y ago
It is.
pkaye 7y ago
Click on the "Full Text Article" link on the right.
dpwm 7y ago
There seems to be a PDF link floating around: https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25728 https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmv.25728 [edit] Or you can just click the very tiny "PDF" link on the linked page that I apparently missed the first time.
rolph 7y ago
go here: https://sci-hub.se/10.1002/jmv.25728 https://sci-hub.se/10.1002/jmv.25728 keep in mind this is a preliminary, the grammar used in this paper needs to be revised so as to avoid as much as possible, people coming to errant conclusions after misinterpreting poorly written phrases. so that means that while reading this paper one should not skim but should take the effort to interpret this paper. there is an absence of references in the abstract, this makes it hard to examine the basis for statements in abstract
- rolph 7y ago
  if you head down to page 4 of the paper there is where you will find references to background literature cited regarding "neuroinvasive potential" [1] Glass WG, Subbarao K, Murphy B, Murphy PM. Mechanisms of host defense following severe acute respiratory syndrome-coronavirus (SARS-CoV) pulmonary infection of mice. J Immunol 2004;173:4030-4039. https://doi.org/10.4049/jimmunol.173.6.4030 https://doi.org/10.4049/jimmunol.173.6.4030 [11] Li, Y.-C., Bai, W.-Z., Hirano, N., Hayashida, T., Taniguchi, T., Sugita, Y., … Hashikawa, T. (2012). Neurotropic virus tracing suggests a membranous-coating-mediated mechanism for transsynaptic communication. https://doi.org/10.1002/cne.23171 https://doi.org/10.1002/cne.23171

john_moscow 7y ago

PDF (link buried within the page): https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.25728 https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.25728

newsbinator 7y ago

If it did turn out this virus is neuroinvasive and that is what causes acute respiratory problems, how would this be prevented/mitigated/treated, theoretically?

pbourke 7y ago
Perhaps more aggressive early antiviral therapies?
DailyHN 7y ago
> Considering the potential neuroinvasion of SARS-CoV-2, antiviral therapy should be carried out as early as possible to block its entry into the CNS. Airway inhalation of antiviral agents will be the first choice at the early stage of infection, which will inhibit the replication SARS-CoV-2 in the respiratory tracts and lung and prevent from its subsequent neuroinvasion. It is also urgent to find effective antiviral drugs that can cross the blood-brain barrier. Moreover, corticosteroids, which are used frequently for severe patients, may have no treatment effect, but rather accelerate the replication of the virus within the neurons.
- cryoshon 7y ago
  >corticosteroids may have no treatment effect isn't the point of the corticosteriods to rapidly reduce widespread pulmonary inflammation that would otherwise kill the patient?
  - Enginerrrd 7y ago
    Yes, but it suggests that it could be important to distinguish whether the cause of their decline and hypoxia is CNS respiratory depression or issues with lung function before making that call.
csears 7y ago
The full text mentions masks being particularly effective and inhaled antiviral meds that could slow the spread of the virus in airways. It also talks about the need for antiviral agents capable of crossing the brain-blood barrier. See the last 3 paragraphs of the full text.

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aazaa 7y ago

From the paper: > If the neuroinvasion of SARS-CoV-2 does take a part in the development of respiratory failure in COVID-19 patients, the precaution with masks will absolutely be the most effective measure to protect against the possible entry of the virus into the CNS. It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally. The possible neuroinvasion of SARS-CoV-2 may also partially explain why some patients developed respiratory failure, while others not. It is very possible that most of the persons in Wuhan, who were the first exposed to this previously unknown virus, did not have any protective measure, so that the critical patients is much more in Wuhan than in other cities in China. This is a good example of why writing off COVID-19 as no more dangerous than the flu is itself so dangerous. I should also point out that most people in the US face similar conditions to those in Wuhan. The extent of infection is not known, and therefore protective measures are not in place. We have been actively discouraged from "buying masks" and told that they are ineffective.

99_00 7y ago
>I should also point out that most people in the US face similar conditions to those in Wuhan. I don't think that's true.
morpheuskafka 7y ago
Yes, only a N95 or better mask would protect you from incoming, as opposed to outgoing, viruses, and these masks are both impractical for everyday wear and need to be conserved for public health users.
- bluGill 7y ago
  I have a small box of N95 masks in my shop - bought last summer for dust protection. When is the right time for me to put them on my family. Part of this is how long will they last before I must replace them. Or should I put them on eBay for a million dollars and hope I life to enjoy my new found wealth?
  - 7y ago

xenonite 7y ago

The link should be changed to the publisher‘s page where the pdf is linked. https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25728 https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25728

mobilefriendly 7y ago
It's important to see the NIH summary though. Gives the study credibility.
- searine 7y ago
  That is just the abstract as indexed by pubmed. NIH has no oversight on the content.
- CamperBob2 7y ago
  Which is actually a problem. Not uncommon to see obvious sham science propagated with an official-looking PubMed link at nih.gov. "I'm allergic to WiFi." "No, you're not. Nobody is allergic to WiFi." "Yes, I am. Here's an official PubMed citation: https://www.ncbi.nlm.nih.gov/pubmed/26372109 https://www.ncbi.nlm.nih.gov/pubmed/26372109 . Why do you hate science?"
  - whatshisface 7y ago
    >Provocation studies on EMF have yielded different results, ranging from where people with EHS cannot discriminate between an active RF signal and placebo, to objectively observed changes following exposure in reactions of the pupil, changes in heart rhythm, damage to erythrocytes, and disturbed glucose metabolism in the brain. The paper you linked admits that there are studies that show it's the same as a placebo. Just because most people aren't qualified to realize that the studies in the first half of the sentence might be more reliable than the studies in the second half doesn't mean the paper shouldn't be published.
    - CamperBob2 7y ago
      So? You can say exactly the same things about ESP or dowsing. Run enough studies, even properly-conducted ones, and some of them will yield the results you're hoping for. At that point, all you have to do is either ignore the others altogether, or leverage them to argue in favor of "teaching the controversy," as is done in this particular paper. This strategy is meaningless in terms of scientific value, but it certainly sounds authentic enough to non-specialists.

majos 7y ago

Not a biologist, but reading the paper, the chain of reasoning appears to be summarized in this section: > Taken together, the neuroinvasive propensity has been demonstrated as a common feature of CoVs. In light of the high similarity between SARS-CoV and SARS-CoV2, it is quite likely that SARS-CoV-2 also possesses a similar potential. Based on an epidemiological survey on COVID-19, the median time from the first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to the intensive care was 8.0 days 15. Therefore, the latency period is enough for the virus to enter and destroy the medullary neurons. As a matter of fact, it has been reported that some patients infected with SARS-CoV-2 did show neurologic signs such as headache (about 8%), nausea and vomiting (1%). There's also this rather disquieting anecdote used as evidence of a link to the nervous system: > According to the complaints of a survivor, the medical graduate student (24 years old) from Wuhan University, she must stay awake and breathe consciously and actively during the intensive care. She said that if she fell asleep, she might die because she had lost her natural breath. Supposing that this neurological link is real, > the precaution with masks will absolutely be the most effective measure to protect against the possible entry of the virus into the CNS. It may also be expected that the symptoms of the patients infected via facal-oral [sic?] or conjunctival route will be lighter than those infected intranasally. The possible neuroinvasion of SARS-CoV-2 may also partially explain why some patients developed respiratory failure, while others not. It is very possible that most of the persons in Wuhan, who were the first exposed to this previously unknown virus, did not have any protective measure, so that the critical patients is much more in Wuhan than in other cities in China. So let me ask a dumb question for someone with actual biomedical knowledge. Are they saying that infection of the CNS is somehow easier through the nose, in which case high-quality face masks actually do matter? I'm also confused by this sentence in the introduction, which appears to contradict the hypothesis that the upper respiratory tract is a high-impact area? > However, different from SARS-CoV, SARS-CoV-2-infected patients rarely showed prominent upper respiratory tract signs and symptoms, indicating that the target cells of SARS-CoV-2 may be located in the lower airway. I will note that, unlike some other papers on this topic, this one has been peer-reviewed in what seems to be a legitimate medical journal (Journal of Medical Virology), so there should be some genuine substance here.

chinathrow 7y ago

jxy 7y ago

I see a lot of "may", "possible", "if", ... Is this how people typically write a paper to Medical Virology?

shanxS 7y ago
> Is this how people typically write a paper to Medical Virology? I wont assume that (I am software engg.) I see where you are coming from. Here is my perspective, think of this like a outage of your service. No one has exact answers so team starts to dive in and starts sharing what they find. These findings mostly prune the "solution space" of the problem.
- DantesKite 7y ago
  I love that phrase: "...prune the 'solution space' of the problem." Feels like a new weapon was added to my cognitive toolkit.
hackeer 7y ago
Recently I started listening twiv.tv podcast and that's how they talk. For instance, they said there are many videos in social media of people dropping unconscious to the floor, but the virologists said not to trust those videos because "it's social media". I stopped listening to their podcast. These people don't reason unless they are shown a peer reviewed paper saying people drop unconscious. I mean, how likely is it that those videos are being faked?
- majewsky 7y ago
  > how likely is it that those videos are being faked? I see it's your first day on the internet. Welcome!
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liquidforce 7y ago

If I understand this correctly, could wearing nose clips and only mouth breathing be an effective strategy to reduce impact?

sspencer 7y ago
> It may also be expected that the symptoms of the patients infected via facal-oral or conjunctival route will be lighter than those infected intranasally. That seems like the hypothesis they suggest. Interesting implications.
- adatavizguy 7y ago
  All the people who were made fun of in middle school for being a 'mouth breather' will have the last laugh.
  - W4ldi 7y ago
    'mouth breathing' is actually really bad for you.
    - Kiro 7y ago
      How so?
      - throwanem 7y ago
        Your nasal passages include structures called "conchae" which, among other purposes, secrete mucus to capture small and potentially disease-carrying particles from incoming air. [1] It's not a perfect defense, of course, but better to have it than not - and when you breathe through your mouth, you don't get the benefit. [1] https://en.wikipedia.org/wiki/Nasal_concha#Immunological_role https://en.wikipedia.org/wiki/Nasal_concha#Immunological_rol...
  - confiscate 7y ago
    can't laugh when you are breathing with your mouth, my friend :)

thijsvandien 7y ago

As a side observation: most reporting seems rather binary, i.e. you either die or survive, period. What interests me the most, however, is how often survival means full recovery, especially now that the nervous system comes up. Are there any long term effects? Should one generally expect to come out of it worse, the same, or stronger? I'm much less afraid to die from this than to end up with chronic respiratory and/or neurological issues.

Proziam 7y ago
EDIT - Just to be clear, I'm not saying that people shouldn't take precautions or that it's not worth protecting vulnerable groups. I'm simply suggesting that perhaps there is news coverage about other things (remember the whole Hong Kong situation that we aren't hearing about suddenly?) that might still deserve some air time. The media is profiting off this story big time. It's like when the plane went missing and a news station actually put some moron on the air who said there's technically a chance a black hole swallowed the plane. It's disgraceful, to be honest. That said, it looks like the rate of fatalities is overblown significantly [0](0.2% in a healthy population (COMPARED WITH THE 3.4% NUMBER BEING SPOUTED ALL OVER THE PLACE). I've yet to see coverage that is remotely reputable about long-term health effects after recovery. EDIT 2 - Case in point about premature statements being made. > [1]“I think it is likely we’ll see a global pandemic,” said Marc Lipsitch, a professor of epidemiology at Harvard T.H. Chan School of Public Health. “If a pandemic happens, 40% to 70% of people world-wide are likely to be infected in the coming year. What proportion of those will be symptomatic, I can’t give a good number.” followed by: > [2]"Because I am now less certain of where the R0 will end up (and how it may vary geographically) I am going to revise downward the range of outcomes I consider plausible to 20%-60% of adults infected. This involves subjectivity about what range of R0 may turn out to be true." [0] https://institutefordiseasemodeling.github.io/nCoV-public/analyses/first_adjusted_mortality_estimates_and_risk_assessment/2019-nCoV-preliminary_age_and_time_adjusted_mortality_rates_and_pandemic_risk_assessment.html https://institutefordiseasemodeling.github.io/nCoV-public/an... [1]https://www.wsj.com/articles/how-many-people-might-one-person-with-coronavirus-infect-11581676200?mod=rsswn https://www.wsj.com/articles/how-many-people-might-one-perso... [2]https://twitter.com/mlipsitch/status/1234879949946814464 https://twitter.com/mlipsitch/status/1234879949946814464

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vorticalbox 7y ago

Question what effect is vaping having on the spread? Walking in a city in the UK I see people leave large plumes of vaper which seems to me be an excellent transport system. Warm and wet.

geggam 7y ago
Score one for the cigar / tobacco smoker
- SketchySeaBeast 7y ago
  As it would seem to affect smokers harder, I'd call that a draw.
  - geggam 7y ago
    Cigar smokers FTW...they dont inhale ;)
    - SketchySeaBeast 7y ago
      In that case, it seems like an even weirder affect to take on - none of the nicotine, all of the bad breath and mouth cancer.
      - mrob 7y ago
        Nicotine can be absorbed through the nose and mouth. It's not as effective as through the lungs, but cigars have much higher dosage than cigarettes.
      - geggam 7y ago
        You absorb nicotine in the mouth. You dont get tar in your lungs. No smoking is good for you but then again the leading cause of death is birth so enjoy the time you have. If cigars are your thing smoke it up

citboin 7y ago

Great. I work in an E.R. and my neurological system is already being ravaged by M.S. I'm not sure that I would not just walk off of the job if we are inundated with COVID-19 patients.

clon 7y ago

Would this explain the apparent sudden collapse of people on the streets in China and Iran? [1] [1] https://www.snopes.com/fact-check/people-collapsing-coronavirus/ https://www.snopes.com/fact-check/people-collapsing-coronavi...

theseadroid 7y ago
In your own source it is said unproven with detailed explanation: >If we strip the above-displayed videos of their captions, we can take a look purely at what the videos show. In one case, it looks like a person was the victim of a traffic accident. In another, it appears that a man suffered a head injury. But since these videos appeared online during heightened hysteria about an outbreak of an illness, it’s easy to see how a passerby may have made the assumption that these incidents were connected to the coronavirus.
viggity 7y ago
Folks, if you see someone collapse on the street and they're wearing a mask. TAKE THE MASK OFF OF THEM. They're not getting enough oxygen. It is taxing to breath through an N95 mask. Source: I passed out when I put on a surgical mask while my wife was getting an epidural. Not from seeing the needle because I didn't even see the needle, and I don't get squeamish anyway. I have low blood oxygen and it was too hard to breath through the mask.
- sdinsn 7y ago
  Perhaps I'm selfish, but if I see someone wearing a mask and they collapse, the last thing I'm going to do is get near them...

sombremesa 7y ago

I've only read the abstract, and it seems to clearly say that the virus can get to the brain via the lungs. So I have no idea what people ITT are on about regarding purposeful infection or masks for prevention. Regardless, this abstract also does not explain the mildness of the disease except for the immunocompromised and elderly, which to me renders the link between how you get the infection and fatality a bit suspicious.

TheAdamAndChe 7y ago
If you read more than the abstract, it explains that animals that are infected nasally have much higher rates of brain infection than the fecal-oral route of infection. Edit: changed "oral/fecal" to "fecal-oral," thanks calmworm. Also removed a period.
- calmworm 7y ago
  *facal-oral
- champagneben 7y ago
  I don't think that was calmworm's qualm with it. Heh.

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daun 7y ago

I was actually wondering about this because both the Spanish Flu and the 2009 H1N1 pandemics left life-long brain damage for some survivors in the form of narcolepsy with cataplexy. The vaccine for H1N1 caused it in a very small amount of patients as well. After the Spanish Flu they called it "encephalitis lethargica". It appears that it damages the hypothalamus.

vernie 7y ago

How many fucking names does this thing have?

rimliu 7y ago
SARS-CoV-2 for the virus, COVID for the disease it causes.
nkohari 7y ago
Yes, it's a little confusing. [0] 2019-nCoV (2019 Novel Coronavirus) was a temporary name. SARS-CoV-2 (Severe Acute Respiratory Syndrome-related Coronavirus 2) is the official name for the virus. COVID-19 (Coronavirus Disease 2019) is the official name for the disease that the virus causes. [0] https://www.sciencemag.org/news/2020/02/bit-chaotic-christening-new-coronavirus-and-its-disease-name-create-confusion https://www.sciencemag.org/news/2020/02/bit-chaotic-christen...

hirenj 7y ago

Whether you believe this or not comes down to whether you believe references 32-34 from the paper. I haven't read the stuff about transgenic expression of human ace2 in mice, but it would sound a lot more like it was aberrantly expressed, so I'm not counting that. "More evidence needed" is the correct interpretation here, I believe. There's other literature out there saying ACE2 is ubiquitously expressed (including brain) - so that means one of two things: People saying it's expressed everywhere are wrong, or SARS-COV-2 requires more than ACE2 for infection. There are papers saying that transfecting cell lines with ACE2 doesn't always render the cells susceptible, so it's probably a good idea to consider the requirement for a co-receptor. Like anything, the true answer probably lies in between all these possibilities.

vilhelm_s 7y ago

> According to the complaints of a survivor, the medical graduate student (24 years old) from Wuhan University, she must stay awake and breathe consciously and actively during the intensive care. She said that if she fell asleep, she might die because she had lost her natural breath Sounds like something from a horror movie!

airstrike 7y ago
Couldn't agree more. I can't seem to forget this sentence...
Exuma 7y ago
Ugh... horrifying. That makes me feel sick considering 20% of people will get pneumonia...
minxomat 7y ago
Reminiscent of the Polio outbreak/iron lung era. A survivor described the sound of clicking tounges in iron lung rooms after the electricity had failed and a few nurses needed to rotate between devices, manually pumping air. Tounge clicking because no one had the ability to exhale air and produce vocal sounds.

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hannob 7y ago

This is almost a week old, I haven't read about it anywhere else. I have read and heard plenty of interviews with scientists involved in this in the past few days and noone has mentioned anything in that direction. Anyone has any link to secondary sources where other scientists try to put this in perspective?

endorphone 7y ago

It is interesting how absolutely passionate some people are about masks. There is a pretty heady contingent here that seems to be of the "I DID MY PART" sort (by mindlessly pushing an absurd anti-science anti-mask angle -- I was one of the silly minority countering it a few days ago, to very little effect). "If you wear a mask your testicles will shrink and everyone will hate you!" But the more important question: Is it time to stop trimming nose hairs?

Leader2light 7y ago

Meanwhile, stocks rally. We are beyond fucked.

biolurker1 7y ago

Was this forced to second page?

pombrand 7y ago

Airborne viral particle protection: N95 masks may only be effective used with eye protection. Surgical masks may not help at all. Looked for interventional studies testing whether face masks and eye protection work in humans to protect against airborne viral particles. A critical issue with many such studies is that medical staff only use masks and/or eye protection at work, opening them to being infected outside of work. Found a small study [1] getting around this problem by exposing subjects (n = 28, avg age 30.5 years) to monodispersed live attenuated influenza vaccine particles by placing them in front of a vibrating-orifice aerosol generator for 20 minutes, subsequently testing for infection using RT-PCR and culture in nasal washes. Surgical mask: 3M 1818 | N95 mask: 3M 1860/1860S | Eye Protection: Z87 Uvex non-vented ----------------------------------------------- RESULTS ----------------------------------------------- No precautions: 4 out of 4 infected. Ocular exposure only: 4 out of 4 infected. Surgical mask only: 5 out of 5 infected. Surgical mask + eye protection: 5 out of 5 infected. N95 mask only: 3 out of 5 infected. N95 mask + eye protection: 1 out of 5 infected. 1. Bischoff WE, Reid T, Russell GB, Peters TR. Transocular entry of seasonal influenza-attenuated virus aerosols and the efficacy of n95 respirators, surgical masks, and eye protection in humans. J Infect Dis. 2011;204(2):193–199.