New aspects to COVID-19 are reported almost daily

It is hard to keep up. It is hard to get a comprehensive picture.

Medicine is an empirical science. It is based on findings. My theory is that it makes such enormous progress (compared to other sciences) because every doctor tests hypotheses every day. The patient reports this and the doc finds things like that and if that’s the case, it should get better if X. She does X and waits. Not the expected result? Back to the drawing board!

One can speculate a lot about the novel coronavirus but what really counts are findings and results. We can compare it with other sicknesses. Insight into how the virus works are important for finding cures and preventing.

Some excellent reporting and some more gave me lots of information.

No patient will have all symptoms.

My father, who was a pulmonologist, used to quip: Patients haven’t read the books so they don’t know what symptoms to display.

Patients’ Complaints

These patient complaints have come forth:
Out of breath. (Keep an open mind why.)
Dry cough.
Fever. In many infections.
Very tired. No energy. Also in the Flu.
No smell, no taste. Also in Influenza and the common cold.
Dermatological symptoms such as pseudo-frostbite, hives and persistent, sometimes painful redness.
Neurological problems, including depression, confusion, stroke and seizures, tingling or numbness in the extremities.
Symptoms of a serious heart attack, but without any blocked arteries.
A strange, “buzzing” or “fizzing” sensation throughout the body.
Deep muscle pains.
Painful skin as if sunburned. Like with Shingles?

Physicians’ Findings

This, physicians found:
Ground-glass-like lung images.
Mini-hemorrhages in the brain.
Low blood-oxygen levels.
High blood-ferritin levels (damage of red blood or liver cells).
High blood-ALT levels (a liver enzyme indicating liver damage).
Patients look like having altitude sickness (low oxygen).
Damages to the kidneys, heart, liver, colon (some seems permanent).
Testicular damage and male infertility.

Brain Storming

There is a specific protein in human cell walls that the COVID-19 virus uses to enter them. This protein is found in the cell walls lining blood vessels and also in certain cells in the lungs, kidneys, testicles. (COVID-19 is twice as deadly for men — is there a relation?)

The cells lining blood vessels becoming infected could explain (in some patients) why oxygen in the lungs may have difficulty getting into the bloodstream. And a lack of oxygen damages heart and kidney cells first.

Damaged blood vessel walls make the blood form blood cloths that block blood flow which may hurt the brain, heart, lungs, and kidneys first.

It’s hard to find enough ventilators for every critical COVID-19 patient. But maybe ‘thinning’ (stopping it from making cloths) their blood could help. However, that increases the risk of strokes from bleeding inside the skull.

But there is more. That specific protein in cell walls is used by interferon, a molecule the body makes to fight off viral infections. It’s still unclear how this competition plays out in COVID-19. Add to this the finding that this coronavirus may attack the immune system (T-cells) like the AIDS-virus.

Ventilator pressure damages the lungs and thus can’t be applied indefinitely. Maybe an alternative could be to drown the whole body in oxygen by putting the whole patient in a hyperbaric tank?

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One more thing. It’s not always clear how a microbe will slightly stroke one person and hammer down another. Sometimes baseless theories abound.

This happened with tuberculoses. Hypotheses varied from ‘constitutional weakness’ to ‘life in unhealthy city air.’ The arrival of working antibiotics made this all disappear. What determined the gravity of the illness was the viral load the patient had received. I was thinking if this could be the case with COVID-19 too. Some (young) medical personal have been hit so hard. A Yeshivah or Synagogue head shakes everyone’s hand so can be expected to have gotten a greater viral load too, which could be a risk factor.

There are frequent reports of who are more at risk from this infection. The newest one is: people who are overweight. There are some unconfirmed findings that smokers are more at risk for the infection turning deadly.

One study found that people from areas with more air pollution have statistically a greater chance to die from this coronavirus. That doesn’t mean that the pollution was a risk factor. It could very well be that Afro-Americans and the poor live more in such areas and they are more at risk.

Defeating COVID-19

The number of different types of therapies being developed is enormous:
Vaccine. Prevention is the best cure.
Passive immunization with serum antibodies from recovered patients.
Drugs that stimulate the immune system.
Drugs that make the body recognize the virus better.
Drugs that block components of the virus from being vital.
Drugs that block the virus from replicating.
Drugs to stop the virus from using the host cells for replication.
Drugs to fight the various bad symptoms the infection gives.

There are worries that getting over the infection might not be for good. That the virus might still be hiding and can reappear. At the moment, there is no way of knowing if this is true or that these are the results of people who seemed over it but were actually still sick with it (false-negative).

Early worries that this virus likely very easily can mutate seem confirmed now. Just like its sister, the flu virus. This may enable it to escape antibodies from previous infections. This virus is nothing to sneeze at.

In any case, the longer we succeed in not getting this virus, the greater the chance that it will never threaten us because: the epidemic would be over, we would be vaccinated or we then have drugs to stop it from harming us.