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🦘Cacatman's Personal Coronavirus COVID-19 Update Thread
- Thread starter cacatman
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Air Purifiers Can be Helpful in Closed Environments
Air Cleaners, HVAC Filters, and Coronavirus (COVID-19) | US EPA
EPA recommends precautions to reduce the potential airborne transmission of the virus, such as ventilation and air filtration as a part of a larger strategy that includes minimizing close contact, surface cleaning, handwashing, and other precautions.www.epa.gov
Should You Buy an Air Purifier for Covid-19?
They can help, but there are some things you need to know
elemental.medium.com
Interesting Finding Cleveland Clinic - Health Care Workers Less Likely to be Hospitalised with COVID-19 than the General Public
While healthcare workers faced similar odds of testing positive for COVID-19 as non-healthcare workers, those considered to be patient-facing healthcare workers were more likely than non-healthcare workers to test positive for the virus. COVID-19 symptoms were somewhat similar in both cohorts and included cough, fatigue, diarrhea, loss of appetite and vomiting; however, a lower proportion of healthcare workers developed fever or shortness of breath.
Healthcare workers were less likely than the general population to be hospitalized with COVID-19 infection, perhaps because healthcare workers tended to be healthier. A lower proportion of healthcare workers had co-morbidities, including chronic obstructive pulmonary disease, diabetes, coronary artery disease, heart failure, cancer or immunosuppressive disease. Healthcare workers also had a higher median income and were more likely to be nonsmokers, which may have contributed to their outcomes.
Impact of the COVID-19 pandemic on healthcare workers risk of infection and outcomes in a large, integrated health system - PMC
Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial. Utilizing a health system COVID-19 research registry, we assessed HCW risk for COVID-19 infection, hospitalization and intensive care unit (ICU) admission. ...
www.ncbi.nlm.nih.gov
Health Care Workers 7 times more likely to get COVID-19
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The authors report thrombotic complication rates of 2.6% in noncritically ill hospitalized patients with COVID-19 and 35.3% in critically ill patients from a recent US registry study.
Autopsy findings of microthrombi in multiple organ systems, including the lungs, heart, and kidneys, suggest that thrombosis may contribute to multisystem organ dysfunction in severe COVID-19, they note. Although the pathophysiology is not fully defined, prothrombotic abnormalities have been identified in patients with COVID-19, including elevated levels of D-dimer, fibrinogen, and factor VIII, they add.
"There is quite a difference between the two sets of guidelines, which can be a point of confusion," he added.
Table. Current Guideline Recommendations for Venous Thromboembolism Prevention in Hospitalized Patients With Coronavirus Disease 2019 Patient/Setting ACCP Guidelines ISTH Guidelines Critically ill, hospitalized Prophylactic low-dose LMWH Prophylactic-dose LMWH; half-therapeutic-dose LMWH considered if patient is high risk Non-critically ill, hospitalized Prophylactic-dose LMWH or fondaparinux Prophylactic-dose LMWH After discharge Extended prophylaxis not recommended LMWH/DOAC for up to 30 days considered if high thrombosis risk and low bleeding risk Nonhospitalized Routine prophylaxis not recommended Routine prophylaxis not recommended Abbreviations: DOAC, direct oral anticoagulant; LMWH, low molecular weight heparin
Piazza notes that at his center every hospitalized COVID patient who does not have a contraindication to anticoagulation receives a standard prophylactic dose of a once-daily low molecular weight heparin (eg, enoxaparin 40 mg). A once-daily product is used to minimize infection risk to staff.
src=soc_tw_201202_mscpedt_news_mdscp_thrombosis&faf=1
Diagnosis, Management, and Pathophysiology of Arterial and Venous Thrombosis in COVID-19
This JAMA Insights review summarizes the pathophysiology underlying the thrombotic diathesis characteristic of acute SARS-CoV-2 infection and current recommendations for the prevention, diagnosis, and management of the most common thrombotic complications in COVID-19, including acute myocardial...
jamanetwork.com
Thrombotic Complications of COVID-19: Principles for Treatment and Prevention
Expert insights and a thromboprophylaxis protocolconsultqd.clevelandclinic.org
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Why Children Have Lower Risk
Factors proposed to explain the difference in severity of COVID-19 in children and adults include those that put adults at higher risk and those that protect children. The former include: (1) age-related increase in endothelial damage and changes in clotting function; (2) higher density, increased affinity and different distribution of angiotensin converting enzyme 2 receptors and transmembrane serine protease 2; (3) pre-existing coronavirus antibodies (including antibody-dependent enhancement) and T cells; (4) immunosenescence and inflammaging, including the effects of chronic cytomegalovirus infection; (5) a higher prevalence of comorbidities associated with severe COVID-19 and (6) lower levels of vitamin D. Factors that might protect children include: (1) differences in innate and adaptive immunity; (2) more frequent recurrent and concurrent infections; (3) pre-existing immunity to coronaviruses; (4) differences in microbiota; (5) higher levels of melatonin; (6) protective off-target effects of live vaccines and (7) lower intensity of exposure to SARS-CoV-2.
AstraZeneca/Oxford vs Pfizer/Biontech vs Moderna Vaccine Information
AZ/Oxford Vaccine - uses a chimpanzee adenovirus (chimp adenovirus has been used so that the body doesn't create an immune response ie. unlikely to have been exposed to it before) to carry in DNA (which has the replicating instructions on the DNA deleted so that it can't be infectious). It is transcribed into RNA and then in the cytoplasm, is used as mRNA
Pfizer/Biontech & Moderna Vaccine - Uses a lipid bilayer (micelles) to inject mRNA into the cell to make the cell produce part of the spike protein (of the COVID-19 virus) via the cells own machinery (ribosomes).
Then the spike protein then causes the immunogenic response.
AZ/Oxford Vaccine - Trials - DNA virus platform trials in Brazil, UK (+USA). 9,000 enrolled in Brazil, 3,000 in UK. 2 vaccinations 1 month apart. In UK trial, 1/2 dose was given, followed by full dose accidentally. It checked for infections through multiple nasal swabbing. Brazilian study was 62% efficacy. But British was 90%. Some people were getting meningitis doses (not saline) so they got a more realistic placebo effect.
But Pfizer and Moderna vaccines were checked for clinical symptoms of disease that made people go to hospital, but it doesn't tell you if they prevent infections to other people.
AZ/Oxford needs to be stored from 2-8 degrees C/36-46 degrees F.
Moderna vaccine has to be stored at -20 degrees C/- 4 degrees F.
Pfizer - 70 degrees C/- 94 degrees F if stored for 6 months.
AZ has promised not to make profit from this vaccine ie USD$3-5 vs $20 for the others.
AZ will make 3 billion doses.
No serious side effects with AZ and no severe COVID-19 cases in vaccine group.
AstraZeneca press release | AZD1222 vaccine met primary efficacy endpoint in preventing COVID-19
AstraZeneca-Oxford Covid-19 Vaccine Up to 90% Effective in Late-Stage Trials (Wall Street Journal) | AstraZeneca-Oxford Covid-19 Vaccine Up to 90% Effective in Late-Stage Trials
Why the AstraZeneca-Oxford Covid-19 vaccine is different (Vox) | Why the AstraZeneca-Oxford Covid-19 vaccine is different
Why the Pfizer and BioNTech vaccine is a cause for optimism — and skepticism (Vox) | Why the Pfizer and BioNTech vaccine is a cause for optimism — and skepticism
AstraZeneca Registered Trial in US | Phase III Double-blind, Placebo-controlled Study of AZD1222 for the Prevention of COVID-19 in Adults - Full Text View - ClinicalTrials.gov
Pfizer claims its Covid-19 vaccine is 90 percent effective so far. Here’s what we actually know. (Vox) | Pfizer claims its Covid-19 vaccine is 90 percent effective so far. Here’s what we actually know.
Pfizer Vaccination Side Effects
With the Pfizer vaccine, the younger participants were, the more commonly they reported similar reactions: fatigue, headache, muscle pain, chills, joint pain, and fever. Among the small data set of 100 adolescents aged 12–15, for example, 14% experienced a fever after the first dose, and 20% experienced one after the second dose, compared to 1% and 11% in older adults (over age 55).
The most commonly reported adverse events with the Pfizer vaccine were headache (42% of participants with the first dose and 52% with the second) and fatigue (27% and 59%), which also occurred in the placebo group, though at lower rates. One common theme that occurred across all ages was a stronger reaction to the second Pfizer dose than the first.
AstraZeneca Vaccination Side Effects
The adverse reactions reported in the AstraZeneca vaccine trials are similar—fever, chills, fatigue, headache, muscle aches, nausea, joint pain, or generally feeling crummy—though complete phase 3 data are not available yet. One severe adverse event occurred in the AstraZeneca trial: a person developed transverse myelitis (an inflammation of the spinal cord) 2 weeks after getting the second dose, though researchers could not determine if it was related to the vaccine or not. The person recovered and remained in the trial. Not enough data from other vaccine candidates are available yet, but they’re likely to be similar unless an unexpected adverse event is found.
Moderna Vaccination Side Effects
Moderna did report numbers for severe adverse events: about 2% developed high fevers (102ºF–104ºF) and severe chills. Other severe Moderna vaccine reactions included severe fatigue (10% of participants), muscle pain (9%), joint pain (5%), and headache (5%). Likely a much higher percentage experienced mild or moderate versions of those side effects, but we won’t know until the company releases the full data.
Every Covid-19 Vaccine Question You’ll Ever Have, Answered
Clear guidance on everything you want to know about the vaccine (and then some)
elemental.medium.com
Pfizer/BioNTech reported their vaccine has 95% efficacy based on the 170 cases of Covid that occurred among their 38,000 trial participants. That means for every 100 people who get the vaccine, only five would likely develop Covid if exposed. The Moderna vaccine has 94% efficacy based on 196 cases among 30,000 participants, but it prevented 100% of severe Covid cases.Last edited:
Immunity - Convalescent Plasma Makes No Difference in Outcomes
FDA approved.
Large Trial from India
PLACID Multicentre Trial
464 patients and half got CP 200 ml twice 24 hours apart or placebo
P/F ratio - P (amount of O2)/F (amount of O2 that had to be given) ie. higher numbers meant you were less sick. Normal = 400-500. They admitted people 200-300.
End points for the study:-
1. P/F - 100 or
2. Death
Those who got CP had a 19% chance of hitting the end point.
Placebo arm had 18% chance.
ie. CP made NO difference to survival.
Causes clotting issues.
Monoclonal antibodies may provide the best of both worlds.
Are aborted foetuses used for vaccines? Are ‘aborted babies’ being used for a COVID-19 vaccine?
Convalescent plasma in the management of moderate covid-19 in adults in India: open-label phase II multicentre randomized controlled trial (BMJ) | https://www.bmj.com/content/bmj/371/bmj.m3939.full.pdf
Convalescent plasma is ineffective for covid-19 (BMJ) | https://www.bmj.com/content/bmj/371/bmj.m4072.full.pdfLast edited:
Effect of Face Masks on Gas Exchange in Healthy Persons and Patients with COPD
Used surgical (not n95) masks.
Severe COPD patients <FEV 1 N = 15 vs healthy house staff
Looked at Heartrate, ABG Pa02, PC02.
Healthy house staff - no difference at 5 & 30 mins
Severe COPD - After 6 min walk test - there was a drop in O2 sat and increased CO2, but they didn't do a test without the mask!!!
Could be anxiety or psychologically related re: discomfort with mask use.
https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.202007-812RL
