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Showing posts from April, 2020

An Antiviral drug shows benefit: Story behind the story

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Most of us watched the news of Dr. Anthony Fauci on April 29, 2020 announcing positive results of the clinical trial of the antiviral drug remdesivir. This positive news was like a ray of bright sunshine suddenly peeking through the dark clouds that had hung over the nation for last two months. It looks like that we have a winner. As good a news as this is, it is still preliminary and not the magic bullet that we are hoping for. So, I spent hours this morning digging through the sources and here is the story behind the story. The Story: The National Institute of Allergy and Infectious Diseases (NIAID, a division of the NIH, USA) sponsored clinical trial shows remdesivir accelerates recovery from advanced COVID-19. The NIH News Release April 29. 2020.   Story behind the story: The NIAID had launched a multicenter clinical trial of the drug remdesivir in February 2020 in 100 testing sites globally. The drug, given intravenously, was to be tested in hospitalized...

Liver, Kidney, Brain and Other Organ damage in COVID-19

As of today, USA has over 1 million positive cases, that is 1/3 rd of the total 3 million cases reported worldwide. The rise in the number of cases has also brought about a surge in COVID-19 related medical literature. The shared experience of the worldwide medical community has started to be published in the medical journals. What we are learning is that whereas respiratory system takes the brunt of the viral attack, the other organs of the body are not immune. Before reviewing the impact of COVID-19 on other organs of the body, one must recognize that the data being published has been put together in a haste. Most of the published articles include the clinical information that we know so far. This includes data on presenting symptoms, what organs were affected, the laboratory test abnormalities, and the x-rays and CT scans findings.   Since China is ahead of others, most case reports are coming from there. Many are anecdotal and small case studies. These are often from sin...

Do Masks stop the Coronavirus?

Let us admit: Masks are going to be the new normal. Whether we like it or not, it will become part of our dress for the foreseeable future as we start to return to schools, offices and factories. There are as many questions about masks as the variety of masks out there. There are DIY masks made at home, the one sewn by grandmas, made with 3-D printers, bandannas, surgical masks, the N95, the ones worn by the construction workers, and many more that I cannot even enumerate.   Which one’s work and for what? Do they protect or not? Protect us or the others around us? One thing is clear, any type of mouth and nose covering when in public, is essential. “Normally, you think about wearing a mask to protect yourself,” said Mike Bell, deputy director of the Division of Healthcare Quality Promotion at the U.S. Centers for Disease Control and Prevention. “That’s not what this is about. It’s about not spraying respiratory secretions and spit into the air around you” he said, as he s...

The Science Behind Antibodies to Coronavirus

Students, employees, and workers are getting cabin fever during the prolonged lock down and are eager to return to normalcy or the new normal. The authorities are torn between safeguarding the public health vs. allowing resumption of routine social and business activities. So when will it be safe to return to work or school? There is no one answer because each situation and circumstance will be different. One general answer is: When we will have herd immunity. To achieve that goal, we will need to test a lot of people, millions of people. That is easy said, but difficult to do. A key component of herd immunity is to know how many have developed antibodies to the virus and therefore have some level of protection against being re-infected. If we think of the virus as a “body” or a foreign entity that attacks us, then the “antibody” is the substance that is produced to repel and prevent the infection from taking hold. The “antibodies” produced by our immune system ar...

What are Vaccines and How Will they Work Against Coronavirus

What are Vaccines and How Will they Work against the Coronavirus. Vaccines are most often used to prevent infectious diseases, although they have also been used to treat certain illnesses including cancer.  Most vaccines are given as “shots” while some such as the polio vaccine are given as drops, to be taken by mouth. The classic example is the Polio vaccine that is used to prevent Poliomyelitis, a paralyzing disease of the nervous system. To understand how vaccines work, one needs a basic understanding of the immune system. Almost all living organisms are endowed with an immune system that protects them from foreign invaders such as bacteria and viruses. Even tiny bacteria can become infected with viruses.  When a germ enters our body, it is recognized as “foreign” by the immune system and efforts are mounted to get rid of this invader. Drug manufacturers use this property to develop vaccines. There are many ways by which the tell-tale information of ...

My Immune System is Killing Me

Most living organisms have immune systems that help them stay alive and healthy. But there are times when the immune response overshoots the boundary and becomes dangerous and even lethal to “self “. We know this because during this pandemic, many people are dying not only because of weak immune system but due to overactive immune response. A physiological phenomenon called “cytokine storm” that was unknown 50-60 years ago, is now commonly talked about during the coronavirus pandemic. Before we talk about the abnormal, lets learn a little bit about the normal immune system. Immune system is both “innate” (that we are born with) and acquired (we develop it over our lifetime). It is also classified as cellular (where the main players are cells) and humoral (where the main actors are proteins called antibodies). Innate immune system recognizes tissues that are “self” and rejects or destroys those that are “foreign”. A good example is blood group. An individual who inheri...

Covid-19 Treatment Guidelines: Infectious Disease Society of America

Summary of COVID-19 Treatment Guidelines Infectious Diseases Society of America (ISDA) Guidelines on the Treatment and Management of Patients with COVID-19 in my words Published by IDSA , 4/11/2020 The following is my take on the treatment recommendations put out by the experts at the Infectious Diseases Society of America. The original article can be accessed here. Most people who become infected, suffer a mild illness consisting of sore throat, cough and fever. In some cases, the virus infects the lungs causing shortness of breath and pneumonia. For those who are advised hospitalization, the treatments may include intravenous fluids and control of the fever. In more severe cases, breathing support may be needed in the form of a ventilator. Since there is no established treatment for this novel virus, many treatments are being tested. The treatments (clinical trials) are available at most of the major hospitals and institutions.   The experts at the ISDA have th...

The ABC of Pandemic: Animals, Bats and Coronavirus

ABC: Animals, Bats and Corona Virus Lord Matt Ridley’s report in my words This much we know that an animal was the source of the SARS-CoV-2 virus (the current novel coronavirus). However, was it a bat or a pangolin (a scaly anteater) or perhaps both? It’s not clear. As I sat down to read the paper this past weekend, an article in the Wall Street Journal caught my eye. I thought to share it with my friends. So here it is a report by Lord Matt Ridl ey —in my words. But before I do that, let me share what I have learnt so far about bats. There are about 1,300 species of bats in the world. Some are tiny, as tiny as a bumble bee, while others such as fruit bats can weigh up to 4 pounds and flying foxes have a wingspan of 5 feet. Bats are mammals and can live up to 30 years. Some live solitary lives while others live in colonies of more than a million. Bats have been the source of most of the dangerous new diseases of the past two decades. The natural reservoir of rab...

Current Treatment Options for COVID-19 Illness

Possible Treatments for COVID-19 There are no proven methods to treat COVID-19, the illness caused by the novel (new) coronavirus. When the infection is mild, it causes sore throat, cough and low-grade fever.   It is often self-limited and does not require prescription medication. However various treatment options are being discussed in the media. Here is a summary of what was presented by the New York City Health and Hospitals Corporation, Office of Population Health on 4/5/2020. Some of the following drugs are FDA approved, others are not. Some of these drugs are very costly and like all drugs, have potential serious side effects. Although some side effects are universally known, they may vary in intensity based on the individual’s physiology, underlying diseases and health status. It is highly advised that none of these should be taken without being prescribed and without the supervision of a knowledgeable physician. Remdesivir This anti-viral drug has yet not be...

Letter to My Family during Covid-19 Pandemic

My Dear Family. Greetings First, I want you to know that as of today, we are well. No cough, no fever and no shortness of breath.   Tomorrow is another day, but so far so good. Thank you for your good wishes and prayers. Your telephone and video calls are greatly appreciated. They cheer us up. Today, I write to you about a subject that is not pleasant, so please forgive me if you do not like what I have to say. Today I am writing to you about death and dying. You do know that I am an optimist. So you must be wondering why I am I talking about death and dying. And you have guessed right. It is the coronavirus. No. I am not infected, or at least I don’t think that I am. Thank God, I have no symptoms.   But coronavirus has made me realize how fragile my life is and this little bug can turn it upside down so easily.   The virus has made me think if I am "ready"and "prepared". I don’t fear death, but I do worry if I am ready. Do I have financial, me...