4 ms·

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. "Th

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.

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.