3 ms·

From what I understand, in the late stages of the disease, it's not necessarily the virus that's killing the patient. Often, the virus has been cleared and it's

From what I understand, in the late stages of the disease, it's not necessarily the virus that's killing the patient. Often, the virus has been cleared and it's the patient's own immune response that's doing the damage.

Mtinie 7y ago
This matches what I've read, too. It's less about the virus during the later stages and more about the infected person's immune system. If they've entered a state of amplified immune response, colloquially called a "cytokine storm," organs are damaged when their cells are mistakenly attacked. If you can moderate the immune system's reaction you can prevent significant damage. HCQ is useful for this type of immuno-suppression. Here's a pre-print of an article from a few years back which talks about HCQ and cytokine storms: Scott W. Canna, Edward M. Behrens. Making Sense of the Cytokine Storm: a conceptual framework for understanding, diagnosing and treating hemophagocytic syndromes. Pediatric Clinics of North America [Preprint]. April 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368378/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368378/ Published article link: https://dx.doi.org/10.1016%2Fj.pcl.2012.03.002 https://dx.doi.org/10.1016%2Fj.pcl.2012.03.002
- mundu_wa_hinya 7y ago
  The problem is that the immunosuppression by hcq takes a few weeks to kick in [1]. So it will not stop the Cytokine storm in time. tocilizumab seems to be a better option. 1. https://www.versusarthritis.org/about-arthritis/treatments/drugs/hydroxychloroquine/ https://www.versusarthritis.org/about-arthritis/treatments/d... 2. https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_In...
  - mariodiana 7y ago
    My understanding is that tocilizumab is roughly 100 times as expensive as hydroxychloroquine and has intensive storage requirements. I don't see how the drug scales.

Mtinie 7y ago

This matches what I've read, too. It's less about the virus during the later stages and more about the infected person's immune system. If they've entered a state of amplified immune response, colloquially called a "cytokine storm," organs are damaged when their cells are mistakenly attacked. If you can moderate the immune system's reaction you can prevent significant damage. HCQ is useful for this type of immuno-suppression. Here's a pre-print of an article from a few years back which talks about HCQ and cytokine storms: Scott W. Canna, Edward M. Behrens. Making Sense of the Cytokine Storm: a conceptual framework for understanding, diagnosing and treating hemophagocytic syndromes. Pediatric Clinics of North America [Preprint]. April 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368378/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368378/ Published article link: https://dx.doi.org/10.1016%2Fj.pcl.2012.03.002 https://dx.doi.org/10.1016%2Fj.pcl.2012.03.002

mundu_wa_hinya 7y ago
The problem is that the immunosuppression by hcq takes a few weeks to kick in [1]. So it will not stop the Cytokine storm in time. tocilizumab seems to be a better option. 1. https://www.versusarthritis.org/about-arthritis/treatments/drugs/hydroxychloroquine/ https://www.versusarthritis.org/about-arthritis/treatments/d... 2. https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_In...
- mariodiana 7y ago
  My understanding is that tocilizumab is roughly 100 times as expensive as hydroxychloroquine and has intensive storage requirements. I don't see how the drug scales.