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Would you do me a favor and point me to some (even one) article on this? I AM NOT trolling you, I sincerely want to learn more about this, as I have high BP View Quote View All Quotes View All Quotes Quoted:
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Since they began treating people in China. Some BP meds increase the number of receptor sites in the lungs that this virus attaches to. There several papers and articles about this on the web. Hypertension was #1 |
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So, to what do we attribute Germany's low mortality rate? Germany. Confirmed: 4,515 Deaths: 8 Recovered: 46 Active: 4,461 View Quote |
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Thanks, I had actually already read that one.... I was interested in the BP med "receptor" thing View Quote View All Quotes View All Quotes Quoted:
Thanks, I had actually already read that one.... I was interested in the BP med "receptor" thing Scientists Seek Answers to Hypertension–COVID-19 Link Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center. BOSTON — In the world of Ralph Baric, PhD, not much is a coincidence. So he perked up when he saw that SARS-CoV-2, the virus that causes COVID-19 illness, enters the lungs through ACE2 receptors, and that people with hypertension have worse outcomes than those with any other underlying condition. "I've thought it needed to be explored in more detail for quite a while," said Baric, a professor of epidemiology, microbiology, and immunology at the UNC Gillings School of Global Public Health in Chapel Hill, North Carolina, who has been studying coronavirus outbreaks for decades. Baric isn't alone. As the National Institutes of Health and private companies scramble to test existing and novel treatments for COVID-19, researchers and doctors are trying to determine whether the spike in serious COVID-19 illness in those with baseline hypertension is a coincidence of age and general ill health, or if it speaks to the role ACE2 receptors play in both hypertension and COVID-19 infection. And if there is an association, they want to know whether ACE inhibitors help or hurt people at highest risk for severe COVID-19 disease. "It's really important to say that these are all theoretical musings" right now, said Chris Longenecker, MD, from Case Western Reserve University School of Medicine in Cleveland, who watched Baric's presentation at the virtual Conference on Retroviruses and Opportunistic Infections (CROI) 2020, which is now online. "There is no evidence that I'm aware of that they have clinical benefits at this time," Longenecker told Medscape Medical News. During the same session, Zunyou Wu, MD, PhD, chief epidemiologist at the Chinese Center for Disease Control and Prevention, presented data showing that more than 40% of people with severe infection had baseline hypertension. Among those with severe illness, the next most common comorbidity was diabetes, at about half that rate. Similar data have been described elsewhere, as reported by Medscape Medical News. SARS-CoV-2 and ACE2 It turns out that SARS-CoV-2 was nearly tailor made for the human body. Although it seems to have emerged from bats or species that bats feed on, current thinking is that there are a number of these "SARS-like" viruses already in bat communities that use ACE2 receptors to invade cells. The receptors exist in multiple species, and in humans they dot the hearts and lungs. In addition, they play a role in the development of hypertension and diabetes, and are present in greater numbers in people with cardiovascular disease. Usually, even if a virus exists in bats, it takes several rounds of mutations before it moves from the original host species to another species and then to humans. And it can also take some time for a virus to go from a relatively benign infection to something that becomes epidemic. But Baric and other researchers who have been sequencing existing bat coronaviruses now believe that bat populations are "seeded with preprogrammed viruses that have been designed to use multiple bat ACE2 receptors. By random chance, some of those can actually directly use humans or a secondary reservoir host," he said. In other words, the viruses can jump the line and go directly from a bat-only virus to a human virus. "And in some cases, these viruses may be capable of programming directly to the epidemic range," Baric explained. The fact that SARS-CoV-2 targets ACE2 receptors could be significant, Baric said. For instance, ACE2 is on a sex-linked chromosome, meaning that women express the receptor at higher levels than men. But according to Wu's data, men have worse COVID-19 outcomes than women. And then there's the issue of ACE inhibitors. Reinin–angiotensin–aldosterone system inhibitors, which include ACE inhibitors, cause an increase in the expression of ACE2 receptors, according to a recent comment in Nature Reviews Cardiology. "The safety and potential effects of antihypertension therapy with ACE inhibitors or angiotensin-receptor blockers in patients with COVID-19 should be carefully considered," write the Chinese researchers. "Whether patients with COVID-19 and hypertension who are taking an ACE inhibitor or angiotensin-receptor blocker should switch to another antihypertensive drug remains controversial, and further evidence is required." This increased expression of ACE2 receptors was discussed in a recent BMJ letter, in which Swiss researchers point out that "we need rapid epidemiological and preclinical studies to clarify this relationship." If there is an association between ACE inhibitors and the virus, "we might be able to reduce the risk of fatal COVID-19 courses in many patients by temporarily replacing these drugs," they write. However, ACE2 has been shown to play a protective role in influenza-induced acute respiratory distress syndrome and, with age, ACE2 expression drops, said Baric, who agrees that more research is needed. "There is probably some direct relationship to the level of ACE2 expression and disease severity," he said. "And it probably plays some role in the age-related" severity trends we've seen in COVID-19. Small-molecule drugs designed to bind to ACE2 and prevent infection by SARS-CoV-2 were assessed in a 2013 study. "It's a very good idea to go back and re-explore the use of these drugs, both in vitro and in improved animal models," Baric said. Unanswered Questions For the CROI audience, the issue of hypertension and COVID-19 raised more questions than answers. After the session, Keri Althoff, PhD, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, asked, by tweet, the number of smokers in the population Wu reported on, and the number of patients taking antihypertensive medication, but has not yet heard back from Wu, she told Medscape Medical News. Longenecker said he is tempted to take a step back from the dynamics of ACE2 receptors and ACE inhibitors, and wonders whether the relation between hypertension and worse COVID-19 outcomes might simply be over-represented in older people. "Older people have higher rates of hypertension, higher rates of cardiovascular disease," he told Medscape Medical News. "That may be an explanation. It may have nothing to do with the angiotensin receptor. Either way, these are things worth exploring." Epidemiology of COVID-19 Now and in the Future So far, SARS-CoV-2 has spread farther and faster than SARS, and it has different clinical characteristics. For instance, Wu showed that, unlike the original SARS outbreak in the early 2000s, when viral shedding began days after symptoms emerged, viral shedding of SARS-CoV-2 can start 24 to 48 hours before symptoms appear. "For SARS patients, wearing a mask is good enough to stop transmission," Wu explained. "For COVID-19, both patients and healthy people need to wear masks to stop transmission." The virus is also less deadly than SARS, said John Brooks, MD, from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC), during his presentation. Still, given current data and depending on how well the United States does in testing and treating people with the virus, the likely death rate from COVID-19 will be between 0.5% and 3.5%, according to the CDC. "COVID-19 could be 5 to 35 times more deadly than seasonal influenza," Brooks said. On Wednesday, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told a Congressional hearing that he expects COVID-19 to be 10 times as deadly as the flu. Conference on Retroviruses and Opportunistic Infections (CROI) 2020. Presented March 10, 2020. Follow Medscape on Facebook, Twitter, Instagram, and YouTube |
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I know 70 year olds that are probably healthier than 30 year olds. Also add that only the really sick are going to a hospital. Probably thousands of people kind of sick, moderately sick that will just stay home and ride it out. View Quote Benefits for such a use are: Highly contagious. Lives outside the host for days. Hosts can carry without signs for more than 7 days so remote destinations can be infected. Seems to have almost no impact on most young and healthy people. Has a high death rate for compromised individuals. When the healthcare system is overwhelmed and there is no professional care I am sure this rate increases. It has mutated at least once, or two different versions were released. If this were an engineered virus that was accidentally or intentionally released, we have no way to know if there are other similar version in a countries arsenal waiting for release. |
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No idea about infection rates and metrics from one country to the next.
Having visited Paris twice however I do know that chain smoking is the norm, and the air quality has the ambiance of hot garbage burning inside of a structure fire. Picture a dumpster shared by an Applebee's and a construction site being on fire. Imagine it being fueled with rotten food, OSB scrap, and dirty diapers. That's what Paris smells like, and that can't be healthy. |
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Quoted: In today's world it is impossible to stop the spread. But we can slow it down with preventive measures so supplies and medical facilities can keep up with it. With respirator treatment the most severely affected stand a good chance to survive. But if facilities are hammered with instant overflow then many won't get the full treatment. View Quote The greatest danger comes from overwhelming our healthcare system. |
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The next 2 weeks will be very interesting here in the US. I work in healthcare. Not looking forward to it but am ready for the ride.
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Thanks very much! But, I cant read the article without being a member or registering... ugh! View Quote View All Quotes View All Quotes Quoted:
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I know 70 year olds that are probably healthier than 30 year olds. Also add that only the really sick are going to a hospital. Probably thousands of people kind of sick, moderately sick that will just stay home and ride it out. View Quote It’s a meaningless metric. Triage has been proven for population health care, not for individual health care. |
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AIDS, immune compromised, cystic fibrosis, asthmatics, etc, many subgroups this could be hitting hard. Kharn View Quote View All Quotes View All Quotes |
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Worth noting Italy recovered is outpacing dead. No one cares about that though.
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Worth noting Italy recovered is outpacing dead. No one cares about that though. View Quote South Korea's been there for a day or two, but now Italy? Even Italy with its issues? ETA: the "half" number in france is ~150. Again I'm going to go out on a limb here and suggest the other half aren't. Would be very interesting to find out of those first 150, what the story is. |
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I was curious about the US recovery rate a few days ago. The confirmed count went from like 600 to 1300...and the recovered count stayed at 8. Made me curious why that was. Now our confirmed infected count is at 2,572 and out recovered count is at 12. Still wondering.... View Quote View All Quotes View All Quotes Quoted:
Quoted: Recent infections, this thing kills slow. 8 dead, 46 recovered isn't exactly painting a rosy picture The confirmed count went from like 600 to 1300...and the recovered count stayed at 8. Made me curious why that was. Now our confirmed infected count is at 2,572 and out recovered count is at 12. Still wondering.... We don’t even know yet, what type of immunity the recovered may have. To me, that the biggest unanswered question. |
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I bought a maneki-neko from the chinese dollar store at the flea market today, so I think I'll be safe now with my extra good luck.
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since when did high blood pressure put someone in the higher risk bracket for covid19? View Quote |
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As if Americans are healthy. Many forget the average American is overweight, which would be considered an underlying condition. View Quote Seems like it is also true that the average American has never spent any time in France when you hear people saying things like, "French people all smoke, sit around and drink wine all day, and they're all pussies". The one thing the French do have in abundance is a laissez-faire attitude. But sounds like that is changing. A buddy in France just posted this on FB a few minutes ago: " The latest news today in France: All restaurants, cafes, bars, cinemas, and shops are hereby closed from midnight on. Groceries and pharmacies are excepted. It's about time...there's been a lot of "indifference" in this country lately." |
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THANK YOU VERY MUCH! Sometimes I just love the people on this forum, and this is one of those times!!!! :) View Quote View All Quotes View All Quotes Quoted:
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Quoted: Thanks. I’ll provide some updates throughout the week but hospital preparedness went from 0-100 mph the last few days. There was always preparedness but it’s ramping up BIG TIME. View Quote |
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So, to what do we attribute Germany's low mortality rate? Germany. Confirmed: 4,515 Deaths: 8 Recovered: 46 Active: 4,461 View Quote |
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Agreed. Seems like it is also true that the average American has never spent any time in France when you hear people saying things like, "French people all smoke, sit around and drink wine all day, and they're all pussies". View Quote View All Quotes View All Quotes Quoted:
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As if Americans are healthy. Many forget the average American is overweight, which would be considered an underlying condition. Seems like it is also true that the average American has never spent any time in France when you hear people saying things like, "French people all smoke, sit around and drink wine all day, and they're all pussies". That's almost double But it is a good point that America's got a bunch of overweight people. I know a lot of the rhodes scholars from the 1,200 page thread get triggered when people talk differences in population densities, habits, health, etc to try to figure this puzzle out, so prepare for the hatemail for volunteering that guys |
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the Germans are cheating. They are reporting two classes of death - Death directly caused by Covid, and death where covid was a factor. Other nations are combining the two. View Quote View All Quotes View All Quotes Quoted:
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So, to what do we attribute Germany's low mortality rate? Germany. Confirmed: 4,515 Deaths: 8 Recovered: 46 Active: 4,461 Their death was caused by heart attack, they had COVID though. They're in the COVID toll. |
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Why is it 4 times that of the flu? Is it because we only have enough test kits to test the most severely sick...bingo! I working on the front lines today. I am watching it unfold in front of me. NOBODY qualifies for a test. View Quote 4x the flu is wishful thinking. The fact that you're a healthcare worker and not taking this seriously is appalling. Though fortunately, I'm guessing you're pretty low on the totem pole. AEMT? |
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Quoted: Dr Fauci addressed this specifically and said that a person with high blood pressure that is well controlled by medication has mitigated the additional risk from coronavirus. In other words, if you are have blood pressure that is well controlled by medication you are not in a higher risk bracket. I was relieved to learn this as my dad takes meds for high blood pressure. View Quote Thanks! |
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Dr Fauci addressed this specifically and said that a person with high blood pressure that is well controlled by medication has mitigated the additional risk from coronavirus. In other words, if you are have blood pressure that is well controlled by medication you are not in a higher risk bracket. I was relieved to learn this as my dad takes meds for high blood pressure. View Quote View All Quotes View All Quotes Quoted:
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since when did high blood pressure put someone in the higher risk bracket for covid19? im otherwise healthy so who knows .. oh well |
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Dr Fauci addressed this specifically and said that a person with high blood pressure that is well controlled by medication has mitigated the additional risk from coronavirus. In other words, if you are have blood pressure that is well controlled by medication you are not in a higher risk bracket. I was relieved to learn this as my dad takes meds for high blood pressure. View Quote View All Quotes View All Quotes Quoted:
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since when did high blood pressure put someone in the higher risk bracket for covid19? |
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Quoted: I think I read something about beta blockers. If you're on lisinopril or maxide probably not an issue. View Quote |
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Quoted: Wait for real? We're there right now? South Korea's been there for a day or two, but now Italy? Even Italy with its issues? ETA: the "half" number in france is ~150. Again I'm going to go out on a limb here and suggest the other half aren't. Would be very interesting to find out of those first 150, what the story is. View Quote |
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Quoted: No it's not because of that. The CFR is currently 35x higher. 4x the flu is wishful thinking. The fact that you're a healthcare worker and not taking this seriously is appalling. Though fortunately, I'm guessing you're pretty low on the totem pole. AEMT? View Quote That tells me the CFR is at least half of what is currently being reported. We also don't really know how many people get the flu every year, we just estimate it and take a well educated guess. |
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