Forum Topic

Of interest, blood thinners and Covid-19A treatment?Wed 06/05/2020 21:23Study finds blood thinners may help patients with severe Covid-19 infectionsFrom CNN's Maggie FoxBlood thinning drugs may help save some patients worst affected by coronavirus, doctors reported Wednesday.Their findings could point a way to help the virus-related issue of blood clots throughout the body. The team at Mount Sinai Hospital says it is now running experiments to see which anticoagulants may work best, and at which doses.     “Our findings suggest that systemic anticoagulants may be associated with improved outcomes among patients hospitalized with Covid-19,” they wrote in their report, published in the Journal of the American College of Cardiology.Dr. Valentin Fuster, director of Mount Sinai Heart and physician-in-chief of the Mount Sinai Hospital, and colleagues looked at more than 2,700 patients treated at Mount Sinai in New York City, which has been hit hard by coronavirus. Starting in March, some patients were given anti-clotting drugs based on bedside decisions made by doctors.The team started taking a systematic look at whether the drugs made a difference. They did, especially for patients who were put on ventilators to help them breathe.They found 29% of patients on ventilators who were given blood thinners died, compared to 63% of patients on ventilators who were not given blood thinners.    “The patients who received anticoagulants did better than those who didn’t,” Fuster told CNN.The findings are not clear-cut enough yet to make solid recommendations. The team noted that patients who were already severely ill were more likely to be given the blood thinners.The researchers did not find that the patients who got blood thinners were significantly more likely to have bleeding problems – one of the risks of the drugs.https://edition.cnn.com/world/live-news/coronavirus-pandemic-05-06-20-intl/index.html

Mark Julian Raymond ● 1817d

Things do not look good for hydroxychloroquine, a hugher proportion of people seem to be dying when taking it than not taking itStudy finds no benefit, higher death rate in patients taking hydroxychloroquine for Covid-19By Elizabeth Cohen and Dr. Minali Nigam, CNN.https://edition.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.htmlUpdated 0146 GMT (0946 HKT) April 22, 202(CNN)Coronavirus patients taking hydroxychloroquine, a treatment touted by President Trump, were no less likely to need mechanical ventilation and had higher deaths rates compared to those who did not take the drug, according to a study of hundreds of patients at US Veterans Health Administration medical centers.The study, which reviewed veterans' medical charts, was posted Tuesday on medrxiv.org, a pre-print server, meaning it was not peer reviewed or published in a medical journal. The research was funded by the National Institutes of Health and the University of Virginia.French study finds hydroxychloroquine doesn't help patients with coronavirusFrench study finds hydroxychloroquine doesn't help patients with coronavirusIn the study of 368 patients, 97 patients who took hydroxychloroquine had a 27.8% death rate. The 158 patients who did not take the drug had an 11.4% death rate."An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs," wrote the authors, who work at the Columbia VA Health Care System in South Carolina, the University of South Carolina and the University of Virginia.Researchers also looked at whether taking hydroxychloroquine or a combination of hydroxychloroquine and the antibiotic azithromycin, had an effect on whether a patient needed to go on a ventilator.4 ways Trump was wrong about hydroxychloroquine studies"In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19," the authors wrote.There are currently no products approved by the US Food and Drug Administration to prevent or treat Covid-19, although research is underway on many drugs.Hydroxychloroquine has been used for decades to treat patients with diseases such as malaria, lupus and rheumatoid arthritis. Trump has touted the drug as a "game changer" for Covid-19 and said hydroxychloroquine shows "tremendous promise."Physicians have warned that while Trump is enthusiastic about the drug, it still needs to be studied to see if it works and if it's safe.In another recent study, researchers in France examined medical records for 181 Covid-19 patients who had pneumonia and required supplemental oxygen. About half had taken hydroxychloroquine within 48 hours of being admitted to the hospital, and the other half had not.It found there was no statistically significant difference in the death rates of the two groups, or their chances of being admitted to the intensive care unit. However, it found eight patients who took the drug developed abnormal heart rhythms and had to stop taking it. This research also has not yet been peer-reviewed or published in a medical journal.

Mark Julian Raymond ● 1832d

One would like to believe what the Government says even if there are glaring holes, and there are. For example,  one area that raises questions is of the two metres for social distancing, is it actually enough?The South China Morning Post'Coronavirus can travel twice as far as official ‘safe distance’ and stay in air for 30 minutes, Chinese study finds'https://www.scmp.com/news/china/science/article/3074351/coronavirus-can-travel-twice-far-official-safe-distance-and-stayThe article from the South China Morning Post raise some interesting questions about which we have heard little in the UK media or from our Government, and begs the question is two metres enough for social distancing or is it a pseudo-scientific number arrived at by the behaviourists in the Downing Street nudge unit as what the population will tolerate, rather than the most effective physical distance? It is not so much a question of whether what we are being told is accurate, it is more a question of what we are not being told.It is not a young article, though the study referenced has elicited little response (9th March 2020) which I find rather intriguing.Coronavirus can travel twice as far as official ‘safe distance’ and stay in air for 30 minutes, Chinese study finds    Authorities advise people to stay 1-2 metres apart, but researchers found that a bus passenger infected fellow travellers sitting 4.5 metres away    The scientists behind the research said their investigation also highlighted the importance of wearing face masks because of the length of time it can lingerStephen Chen in BeijingPublished: 10:44pm, 9 Mar, 2020Updated: 4:15pm, 11 Mar, 2020The coronavirus that causes Covid-19 can linger in the air for at least 30 minutes and travel up to 4.5 metres – further than the “safe distance” advised by health authorities around the world, according to a study by a team of Chinese government epidemiologists.The researchers also found that it can last for days on a surface where respiratory droplets land, raising the risk of transmission if unsuspecting people touch it and then rub their face.The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper.These findings, from a group of official researchers from Hunan province investigating a cluster case, challenge the advice from health authorities around the world that people should remain apart at a “safe distance” of one to two metres (three to six and a half feet).Their work was based on a local outbreak case on January 22 during the peak Lunar New Year travel season. A passenger, known as “A”, boarded a fully booked long-distance coach and settled down on the second row from the back.The passenger already felt sick at that point but it was before China had declared the coronavirus outbreak a national crisis, so “A” did not wear a mask, nor did most of the other passengers or the driver on the 48-seat bus.Several passengers became infected during the four-hour bus journey.China requires closed circuit television cameras to be installed on all long-distance buses, which provided valuable footage for researchers to reconstruct the spread of the virus on the bus, whose windows were all closed.“It can be confirmed that in a closed environment with air-conditioning, the transmission distance of the new coronavirus will exceed the commonly recognised safe distance,” the researchers wrote in a paper published in peer-review journal Practical Preventive Medicine last Friday.The paper also highlighted the risk that the virus could remain afloat even after the carrier had left the bus.The scientists warned that the coronavirus could survive more than five days in human faeces or bodily fluids.They said the study proves the importance of washing hands and wearing face masks in public places because the virus can linger in the air attached to fine droplet particles.“Our advice is to wear a face mask all the way [through the bus ride],” they added.Hu Shixiong, the lead author of the study who works for the Hunan Provincial Centre for Diseases Control and Prevention, said the security camera footage showed patient “A” did not interact with others throughout the four-hour ride.But by the time the bus stopped at the next city, the virus had already jumped from the carrier to seven other passengers.These included not only people sitting relatively close to “patient zero”, but also a couple of victims six rows from him – roughly 4.5 metres away.They all later tested positive, including one passenger who displayed no symptoms of the disease.After these passengers left, another group got on the bus about 30 minutes later. One passenger sitting in the front row on the other side of the aisle also became infected.Hu said the patient, who was not wearing a mask, was likely to have inhaled aerosols, or tiny particles, breathed out by the infected passengers from the previous group.Aerosols are light-weighted particles that are formed from tiny droplets of bodily fluids.“The possible reason is that in a completely enclosed space, the airflow is mainly driven by the hot air generated by the air conditioning. The rise of the hot air can transport the virus-laden droplets to a greater distance,” said the paper.After getting off the shuttle bus, the initial carrier got on a minibus and travelled for another hour. The virus jumped to two other passengers, one of whom was also sitting 4.5 metres away from patient “A”.By the time the study was finished in mid February, patient “A” had infected at least 13 people.It is generally believed that the airborne transmission of Covid-19 is limited because the tiny droplets produced by patients will quickly sink to the ground.This belief has prompted the Chinese health authorities to suggest that people should stay a metre apart in public and the US Centres for Disease Control recommend a safe distance of six feet (about 1.8 metres).The researchers also found that none of those passengers in the two buses who wore face masks were infected.They said it vindicated the decision to ask people to wear a face mask in public.“When riding on more closed public transportation such as subways, cars, planes, etc, you should wear a mask all the time, and at the same time, minimise the contact between your hands and public areas, and avoid touching your face before cleaning,” they said.The researchers also suggested improving sanitation on public transport and adjusting the air conditioning to maximise the volume of fresh air supplied.Italy puts 16 million people in lockdown as coronavirus death toll spikes by over 100They also said interiors should cleaned and disinfected once or twice a day, especially after passengers arrive at the terminal.A doctor in Beijing involved in the diagnosis and treatment of Covid-19 patients said the study had left some questions unanswered.For instance, the passengers sitting immediately next to the carriers were not infected, though they were suffering the highest exposure to the disease-bearing aerosols.“Our knowledge about this virus’s transmission is still limited,” he said.

Mark Julian Raymond ● 1833d