4 ms·

Not only viral pneumonia though. According to a professor, specializing in pandemics, I heard interviewed while the outbreak was still focused mainly in Wuhan,

by etiam 7y ago

Not only viral pneumonia though. According to a professor, specializing in pandemics, I heard interviewed while the outbreak was still focused mainly in Wuhan, many ultimately get killed off by bacterial secondary infection. Encouraging in some ways, under the horrifying circumstances, with the catch that in many parts of the world that secondary infection will be caused by multiple resistance bacteria. I'd say this pandemic is going to be by far the biggest single consequence post to date for the antibiotic resistance problem, despite being driven by a pathogen that was never sensitive to the antibiotics.

grabbalacious 7y ago
Yes, and isn't this cause for some optimism since many people have now received vaccines such as Prevnar-13 and Pneumovax-23?
- wbl 7y ago
  The CDC still isn't recommending them for all adults. At this point I probably won't go to the doctor's office due to transmission risks.
nostrademons 7y ago
I heard (from a doctor who just received an e-mail summarizing clinical results from Wuhan and Seattle) that actually the primary killer is cardiac arrest. "This virus is way smarter than I'd imagined. Apparently people don't mostly die of respiratory failure, but of cardiac arrest. Doctors have noted that right as patients begin to recover from their ARDS (severe respiraotry failure requiring intubation), they suddenly develop acute heart failure (dilated cardiomyopathy with EF going from normal to <10% acutely, for the doctors on here) and go into VF/VT or asystole." The mechanism for that is unknown, but apparently the virus is attacking the heart directly.
- thinkingemote 7y ago
  I heard that the virus isn't attacking the lungs or the heart, rather it's the immune systems response after the main infection has done it's business? Probably makes it more bizarre.
  - nostrademons 7y ago
    That's the "cytokine storm" theory, right? I've heard that but also heard conflicting and inconclusive evidence about it. Some evidence against it is that lymphopenia (abnormally low white blood cell count) is seen in 83% of patients and that patients with lymphopenia have significantly worse prognosis as far as death rates are concerned; this would seem to indicate that it's not the immune system doing the damage. It doesn't conclusively rule it out - you can develop cytokine storms with a depressed immune system, and Spanish Flu was another disease that also caused both lymphopenia and cytokine storms - but it does waggle its eyes suggestively in favor of looking for other causes.
    - thinkingemote 7y ago
      Thanks!
  - LifeLiverTransp 7y ago
    Large scale tissue damage (to the lungs) can lead to a change in blood chemistry that disrupts the hearts rythm. Remember doctor houses infarcted muscle leading to cardic arrest? Among porteins and shredded cell dna-rna, potasium is disloged from dead tissue, and weakens/disables the powerplants in muscles. The effect may be hidden beneath the general achiness of a viral malaise. https://www.webmd.com/digestive-disorders/hypokalemia#1 https://www.webmd.com/digestive-disorders/hypokalemia#1
- wahern 7y ago
  Cardiac arrest was also reported for SARS (SARS-CoV-1): https://www.ncbi.nlm.nih.gov/pubmed/14633442 https://www.ncbi.nlm.nih.gov/pubmed/14633442 So much is still unknown about SARS and MERS that I wouldn't hold my breath waiting for credible answers regarding SARS-CoV-2/COVID-19. And MERS is still circulating (see https://www.who.int/emergencies/mers-cov/en/ https://www.who.int/emergencies/mers-cov/en/), so it's not like nobody is interested.

by etiam 7y ago

grabbalacious 7y ago

Yes, and isn't this cause for some optimism since many people have now received vaccines such as Prevnar-13 and Pneumovax-23?

wbl 7y ago
The CDC still isn't recommending them for all adults. At this point I probably won't go to the doctor's office due to transmission risks.

nostrademons 7y ago

I heard (from a doctor who just received an e-mail summarizing clinical results from Wuhan and Seattle) that actually the primary killer is cardiac arrest. "This virus is way smarter than I'd imagined. Apparently people don't mostly die of respiratory failure, but of cardiac arrest. Doctors have noted that right as patients begin to recover from their ARDS (severe respiraotry failure requiring intubation), they suddenly develop acute heart failure (dilated cardiomyopathy with EF going from normal to <10% acutely, for the doctors on here) and go into VF/VT or asystole." The mechanism for that is unknown, but apparently the virus is attacking the heart directly.

thinkingemote 7y ago
I heard that the virus isn't attacking the lungs or the heart, rather it's the immune systems response after the main infection has done it's business? Probably makes it more bizarre.
- nostrademons 7y ago
  That's the "cytokine storm" theory, right? I've heard that but also heard conflicting and inconclusive evidence about it. Some evidence against it is that lymphopenia (abnormally low white blood cell count) is seen in 83% of patients and that patients with lymphopenia have significantly worse prognosis as far as death rates are concerned; this would seem to indicate that it's not the immune system doing the damage. It doesn't conclusively rule it out - you can develop cytokine storms with a depressed immune system, and Spanish Flu was another disease that also caused both lymphopenia and cytokine storms - but it does waggle its eyes suggestively in favor of looking for other causes.
  - thinkingemote 7y ago
    Thanks!
- LifeLiverTransp 7y ago
  Large scale tissue damage (to the lungs) can lead to a change in blood chemistry that disrupts the hearts rythm. Remember doctor houses infarcted muscle leading to cardic arrest? Among porteins and shredded cell dna-rna, potasium is disloged from dead tissue, and weakens/disables the powerplants in muscles. The effect may be hidden beneath the general achiness of a viral malaise. https://www.webmd.com/digestive-disorders/hypokalemia#1 https://www.webmd.com/digestive-disorders/hypokalemia#1
wahern 7y ago
Cardiac arrest was also reported for SARS (SARS-CoV-1): https://www.ncbi.nlm.nih.gov/pubmed/14633442 https://www.ncbi.nlm.nih.gov/pubmed/14633442 So much is still unknown about SARS and MERS that I wouldn't hold my breath waiting for credible answers regarding SARS-CoV-2/COVID-19. And MERS is still circulating (see https://www.who.int/emergencies/mers-cov/en/ https://www.who.int/emergencies/mers-cov/en/), so it's not like nobody is interested.