3 ms·

To connects the dots, pathological cytokine release syndrome is highly likely to be causing the (extremely rare) instances of stroke in non-elderly COVID-19 pat

To connects the dots, pathological cytokine release syndrome is highly likely to be causing the (extremely rare) instances of stroke in non-elderly COVID-19 patients, organ damage, etc. I get incredibly annoyed when people act like (a) these strokes / organ damage are happening in significant quantities and (b) that it’s unique to SARS-2

dreamcompiler 6y ago
Are you saying cytokine storms are the only mechanism causing thrombosis in COVID-19? I was under the impression that SARS-2 itself also had the ability to cause clots. Is that incorrect?
acqq 6y ago
> extremely rare Is it? From all lab confirmed cases in USA until end of May, almost every 200th in age group 20-29 was admitted to ICU. Almost every 100th in age group 30-39. (1) Admitted to ICU means "probably considered intubation (or received it immediately)" Which is very, very unpleasant thing: https://en.wikipedia.org/wiki/Tracheal_intubation https://en.wikipedia.org/wiki/Tracheal_intubation Is that "extremely rare" to you? (In the USA there are 7.2% inhabitants aged 20-29, 6.7% aged 30-39. Even if the number of "unconfirmed but infected" is 10 times higher, that still gives around 24000 people in the USA aged 20-39 needing ICU, or 8 times more than died on 9/11. And those are just provably "non-elderly". All those 40 and older would need even much more ICU beds. I hope it's obvious that if there are not enough ICU beds much more people would die.) 1) It can be calculated from https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm For 20-29 182469 confirmed, 864 ICU, for 30-39 214849 confirmed, 1879 ICU. (Additionally, males were admitted to ICU almost twice as much as females)
- gridlockd 6y ago
  The comment said "(extremely rare) instances of stroke", not ICU admissions.
  - acqq 6y ago
    This is a thread about dexamethasone, not "strokes", and we also know that from 8 patients that are intubated the treatment with dexamethasone saves one, compared to those intubated never treated with dexamethasone. We also know that dexamethasone is at best not helping if given outside of ICU. Once again, dexamethasone has to be given to 8 intubated people to save one, and that's considered the drug with the most visible effect in fighting Covid-19 up to now -- i.e. the most successful drug up to now! You can imagine how little effect other drugs produced in the verified trials. In that context, talking about ICU and intubated is exactly on topic, hand-waving "strokes" isn't. Moreover, the comment actually said "strokes / organ damage" not "strokes." Nevertheless, the main effect of dexamethasone is on the intubated patients.
    - gridlockd 6y ago
      Regardless of what the thread is or isn't about, the comment you quoted made specific claims: - Strokes (and organ damage) are the result of cytokine storms - Strokes (and organ damage) in COVID-19 are "extremely rare" That may be true or untrue, but you are not responding to those claims, you are responding to something else. I'm not even sure what that is, because nobody actually wrote it down.
      - acqq 6y ago
        The comment tried by introducing "strokes" to distract from the topic: dexamethasone which helps intubated patients. Insisting on that non-topic here just doesn't improve the discussion. Discussing "strokes" by "non-elderly" as the special case of all intubated patients as somehow relevant for dexamethasone isn't supported by any research, as far as I know. And I claim that the number of patients that could be saved using dexamethasone even in the age groups 20-39, if they get infected, is nothing "extremely rare" among "non-elderly": only before end of May, surely more than 100 US patients aged 20-39 could have been saved. If "non-elderly" means "still working" the number is even much higher.
        gridlockd 6y ago
koheripbal 6y ago
I thought the clotting caused by SARS-CoV-2 was thought to be the cause of strokes. ...as well as other thrombosis late stage patients are getting. ...at least that's what the clinical updated from the NYC doctors group is reporting on TWIV podcast each week.

dreamcompiler 6y ago

Are you saying cytokine storms are the only mechanism causing thrombosis in COVID-19? I was under the impression that SARS-2 itself also had the ability to cause clots. Is that incorrect?

acqq 6y ago

> extremely rare Is it? From all lab confirmed cases in USA until end of May, almost every 200th in age group 20-29 was admitted to ICU. Almost every 100th in age group 30-39. (1) Admitted to ICU means "probably considered intubation (or received it immediately)" Which is very, very unpleasant thing: https://en.wikipedia.org/wiki/Tracheal_intubation https://en.wikipedia.org/wiki/Tracheal_intubation Is that "extremely rare" to you? (In the USA there are 7.2% inhabitants aged 20-29, 6.7% aged 30-39. Even if the number of "unconfirmed but infected" is 10 times higher, that still gives around 24000 people in the USA aged 20-39 needing ICU, or 8 times more than died on 9/11. And those are just provably "non-elderly". All those 40 and older would need even much more ICU beds. I hope it's obvious that if there are not enough ICU beds much more people would die.) 1) It can be calculated from https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm For 20-29 182469 confirmed, 864 ICU, for 30-39 214849 confirmed, 1879 ICU. (Additionally, males were admitted to ICU almost twice as much as females)

gridlockd 6y ago
The comment said "(extremely rare) instances of stroke", not ICU admissions.
- acqq 6y ago
  This is a thread about dexamethasone, not "strokes", and we also know that from 8 patients that are intubated the treatment with dexamethasone saves one, compared to those intubated never treated with dexamethasone. We also know that dexamethasone is at best not helping if given outside of ICU. Once again, dexamethasone has to be given to 8 intubated people to save one, and that's considered the drug with the most visible effect in fighting Covid-19 up to now -- i.e. the most successful drug up to now! You can imagine how little effect other drugs produced in the verified trials. In that context, talking about ICU and intubated is exactly on topic, hand-waving "strokes" isn't. Moreover, the comment actually said "strokes / organ damage" not "strokes." Nevertheless, the main effect of dexamethasone is on the intubated patients.
  - gridlockd 6y ago
    Regardless of what the thread is or isn't about, the comment you quoted made specific claims: - Strokes (and organ damage) are the result of cytokine storms - Strokes (and organ damage) in COVID-19 are "extremely rare" That may be true or untrue, but you are not responding to those claims, you are responding to something else. I'm not even sure what that is, because nobody actually wrote it down.
    - acqq 6y ago
      The comment tried by introducing "strokes" to distract from the topic: dexamethasone which helps intubated patients. Insisting on that non-topic here just doesn't improve the discussion. Discussing "strokes" by "non-elderly" as the special case of all intubated patients as somehow relevant for dexamethasone isn't supported by any research, as far as I know. And I claim that the number of patients that could be saved using dexamethasone even in the age groups 20-39, if they get infected, is nothing "extremely rare" among "non-elderly": only before end of May, surely more than 100 US patients aged 20-39 could have been saved. If "non-elderly" means "still working" the number is even much higher.
      - gridlockd 6y ago

koheripbal 6y ago

I thought the clotting caused by SARS-CoV-2 was thought to be the cause of strokes. ...as well as other thrombosis late stage patients are getting. ...at least that's what the clinical updated from the NYC doctors group is reporting on TWIV podcast each week.