Maybe
Maybe not
Maybe some right.
I think this virus is still an enigma as to what all it does and what the various correlations actually mean - and what is causation versus correlation.
One of the more interesting ones I’ve read lately is that those who suffer from anosmia are not the ones that get critically ill - why? And what is the correlation with blood type and what does it mean?
If it wasn’t killing people it would be fascinating.
@Cerridwyn Yeah I would agree. With everything you said. And of course the title says “may be”. Definitely a lot not known and certainly as we learn more things will change.
Be interesting to know which version of the covid-19 they looked at - European version or Chinese version - are there illness differences between the two versions of the virus?
Also it would be interesting to see if different blood types affect the production of neutrophil extracellular traps (NET’s - they fight pathogens amongst other things). That could be one mechanism for that correlational finding (see below). I know I have read that people with type A, B and AB blood types are more likely to suffer from blood clots… but that doesn’t explain why B would be excluded in that earlier correlational study about blood type and covid-19.
One study found that people initial high levels of NETs (at covid-19 diagnosis) are more likely to suffer respiratory failure. If respiratory failure is due to micro blood clots as mentioned in that article this makes sense. NET’s cause blood vessel “stickiness” and hypothesized to cause blood clots (see below).
NETs are found in all the places of the body mentioned that covid-19 can damage. NETs are produced when there is inflammation (produced by neutrophils - for those that don’t know that is a component of the white cells that fight, amongst other things, viruses - and meant to fight pathogens) and so it would make sense that the more inflammation, the more NETs are produced. Earlier studies have found the level of inflammation (correlational though like much early research) has been implicated as well in covid-19.
And another speculation is that NETs contribute to the creation of blood clots which would be consistent with the original article with respect to micro blood clots in the lungs that then prevent O2 exchange, damage other organs, etc. (https://www.jci.org/articles/view/84538)
I was originally looking into this more because those of us with follicular non-hodkin’s (and DLBCL, probably more but these are the only two studied so far) lymphoma have higher NET levels anyway, that when they are higher outcomes are worse for those cancers (eg treatment failure)… Thus it would be even more dangerous for folks with nhl (and autoimmune diseases as those folks often have higher levels of NETs) to get covid-19 as the outcomes could be worse(using deductive logic - all of which would need to be tested).
That got me wondering IF people under active treatment for nhl and taking rituxan (depletes neutrophils as B cell lymphoma is a cancer of neutrophils), thus have a neutrophil count in the toilet would make fewer NETs. And then on the one hand be more susceptible to getting/being unable to successfully fight off viruses due to fewer neutrophils (they, amongst other things fight viruses), be less to suffer respiratory failure if they do get it due to fewer NETs. Of course that is a lot of “what if’s”. I plan to ask my oncologist exactly that when I see him in 2 weeks.
If a lower neutrophil count reduces the amount of NETs produced then would treating covid-19 with rituxan (or its second generation equivalent) could then doing that reduce the odds of respiratory failure and clots? Of course rituxan also decreases the ability to fight viruses so the down side might be bigger than the up side.
Lots and lots of what if’s… Interesting to speculate about though and thinking how the pieces might fit together. Wish I could test some of this as the pieces seem to all explain a piece of the pie so to speak.
those who suffer from anosmia are not the ones that get critically ill - why?
Since that is from (presumably so far) damaged nerves and if the blood clot hypothesis for this disease is correct, then actually that would make sense (well presuming that is more or less the nervous system is the only place attacked and not everywhere in one’s body that is vulnerable).
@Kidsandliz
Yes and no
It would potentially presuppose that the virus infects whichever cells it infects in one person and maybe something else in another.
Again Novel in so many ways.
@Cerridwyn And that (novel) of course is what makes this puzzle so interesting as people are having to think about this disease in such different ways with respect to mechanism, etc.
I just finished a long article summarizing the creation of/effects of NETs with different medical conditions (https://www.frontiersin.org/articles/10.3389/fimmu.2017.00081/full). What was interesting is that in many of the conditions that are shown to increase the risk for folks if they get covid-19 are also conditions where folks tend to have higher NET production.
The article says that with rheumatoid arthritis (RA) they easily produce high NETs. One treatment for RA is rituxan. I haven’t looked yet but I wonder if one reason why that helps is that is reduces the neutrophil count thus the ability to produce as high a level of NETs since it is the neurtrophils that produce them.
Again that makes me wonder if we could figure out how to reduce NET production without reducing it so low that people then can’t mount enough of an immune response if that might increase the odds of people not getting as severe a case, thus fewer dying. Wouldn’t be treating the virus per say, rather decreasing the toxic over response of the body to the infection. Until a treatment drug would be found that could be useful. It also looks like some other body chemicals are involved in producing NETs so blocking that could work too (well presuming they weren’t critical for something else).
Of course what is interesting and what turns out to be true in the end could well be different things…
@Cerridwyn Here’s something the New York Times published today about the blood type issue: “Another head-scratcher is why blood type might play a role in a Covid-19 infection. One idea is that the location on the genome where blood type is determined also contains a stretch of DNA that can trigger strong immune responses. It’s possible that genetic variations may lead to an overreaction in the immune system, causing extensive inflammation and lung damage.”
@Kidsandliz
there was also a very sad one a couple of days ago about data integrity and some concern that an organization that assembles data used by researchers, including some published in very reputable peer-reviewed medical journals, has possibly been either unethically manipulated all the way to downright falsified.
so many unknowns
there was also a good article in the Atlantic about what another journalist called post-COVID syndrome.
@Cerridwyn I hope those who have done data manipulation or falsification lose their jobs and get blackballed in their profession!!! And if they have medical degrees stripped of their license. That is beyond unethical not to mention potentially deadly. Back when I had breast cancer for the first time the entire University of Oklahoma’s breast cancer center faculty were fired due to data falsification. At the time I was beyond pissed that I had to travel out of state for decent care. The up side is that I figured since I had to travel I’d go to MD Anderson Cancer Center. In retrospect that was a major plus, especially since I’ve had more cancers.
I’ve read snippits about here and there about long recoveries past the acute state of the disease. I’ll have to hunt that article down.
Then there’s the uncertainty in the antibody test (aka the “serological” test) at around 50%. Basically, it is useless for a mythical “immunity passsport” before we find a vaccine two years from now. Part of the problem - we aren’t testing enough people to get a better read on the detection rates and figure out transmission/community spread vectors, and we also don’t test enough to figure out the false positives and develop a better test. The worst of both, and then there’s the confusion between tests that detect virus loads and those that detect antibodies and mixing up the testing volume, rate, and worst of all, the results.
It’s a hot mess - that is either on purpose or incompetence on the part of this administration, on orders from the top, while the Senate does nothing but support and perpetuate the obstruction.
@mike808 This article though wasn’t about antibody tests (although I agree with you about what you are saying with respect to tests, vaccinations, etc.), rather it was looking at the mechanisms for how covid-19 actually makes people sick, how it affects the body and damages it…
Certainly the more researchers know about the virus and how it operates, the higher the odds treatments can be found, tests to identify who has had it and measure how long antibodies last with respect to potential immunity, etc. and with finding an effective, safe vaccination.
@mike808
I think a lot of the problem is that (unfortunately)
most people don’t understand the difference and
most journalists fall in those same categories.
Gone are the days when information had to be vetted better before it made a splash in the paper or on the news (or worse– on a clickbait site or facebook/twitter/instagram etc. )
The sad truth is that this is a novel coronavirus, and contrary to popular belief (fueled by years of movie watching, binge watching Jack Ryan or 24, etc), it takes a while to unravel the mystery.
And of course in trying to unravel it we start with correlations, move on to more targeted approaches to studying it, things first thought to be “true” may be later found out to be wrong… Science takes time, peer review for publishing articles takes time. Starting with something not seen before takes even more time. Even with a lot of good minds working on it. Overall science is not a fast process.
There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that my ignorance is just as good as your knowledge.
— Isaac Asimov
@mike808
and…
there are multiple antibody tests. Some test for the current active antibodies point of care, with a finger prick. There are not so many false positives as false negatives from what I have heard first hand from lab scientists. They are more useful for helping to confirm a potential clinical diagnosis. If you are asymptomatic and negative, it is really not a way to say you are not carrying it.
Then there are those that test for exposure. they are fewer and farther between and when done with the finger prick, not very accurate. There was one, by Roche I think, but don’t quote me, that required actually phlebotomy and a tube of blood and that was pretty highly accurate when ran on people had a confirmed positive history. It is the type that is needed for exposure prevalence. It is of course, more expensive to run, but a few University labs have done so in smallish scales, and that is giving an exposure rate very different from an infection rate. it has to be positive for you to participate in a convalescent serum trial donation.
Biggest issue is that the general population doesn’t distinguish the different types of tests reveal different information and that some states lumped it all together to changes their infections / death statistics - or pure ignorance or both.
As a nation, the US loves science - if and only if it gives the results someone wants - not if it doesn’t.
On journalistic integrity is as much of an oxymoron as military intelligence is said to be. Didn’t used to be but it has become this. That and so called social media.
As a nation, the US loves science - if and only if it gives the results someone wants - not if it doesn’t.
And on a cancer list (when arguing with someone why they believed the science behind sentinel node biopsies - take out just the ones draining the tumor vs take out all the nodes but not the science about chemo) I said once, in frustration with those who believe snake oil testimonials over chemo research “science, like gravity, works all the time, not just when you want it to”.
Of course mistakes are made when doing science, hypotheses (Ho) that we initially fail to reject may end up being rejected later when we know more and can do a better study, etc. (technically you don’t prove" things, you are looking at a specific Ho and either rejected or you fail to reject; fail to reject is not the same as confirm as you may have missed variables, screwed up, etc. and so may reject it later with a better study).
@Cerridwyn@Kidsandliz
Now you’re talking “theories”, like Evolution and a spherical earth that, get a load of this nonsense , isn’t the center of the heavens as God intended is to be. What’s next? Women choosing when or if they’re ready to produce an heir for you? Bollocks! A pox on them librals destroying 'Murica.
Maybe
Maybe not
Maybe some right.
I think this virus is still an enigma as to what all it does and what the various correlations actually mean - and what is causation versus correlation.
One of the more interesting ones I’ve read lately is that those who suffer from anosmia are not the ones that get critically ill - why? And what is the correlation with blood type and what does it mean?
If it wasn’t killing people it would be fascinating.
/giphy spock fascinating
@Cerridwyn Yeah I would agree. With everything you said. And of course the title says “may be”. Definitely a lot not known and certainly as we learn more things will change.
Be interesting to know which version of the covid-19 they looked at - European version or Chinese version - are there illness differences between the two versions of the virus?
Also it would be interesting to see if different blood types affect the production of neutrophil extracellular traps (NET’s - they fight pathogens amongst other things). That could be one mechanism for that correlational finding (see below). I know I have read that people with type A, B and AB blood types are more likely to suffer from blood clots… but that doesn’t explain why B would be excluded in that earlier correlational study about blood type and covid-19.
One study found that people initial high levels of NETs (at covid-19 diagnosis) are more likely to suffer respiratory failure. If respiratory failure is due to micro blood clots as mentioned in that article this makes sense. NET’s cause blood vessel “stickiness” and hypothesized to cause blood clots (see below).
NETs are found in all the places of the body mentioned that covid-19 can damage. NETs are produced when there is inflammation (produced by neutrophils - for those that don’t know that is a component of the white cells that fight, amongst other things, viruses - and meant to fight pathogens) and so it would make sense that the more inflammation, the more NETs are produced. Earlier studies have found the level of inflammation (correlational though like much early research) has been implicated as well in covid-19.
The other thing NETs do is “cause blood vessels to become sticky” (https://www.the-scientist.com/features/why-immune-cells-extrude-webs-of-dna-and-protein-66459). Now that would be consistent with the blood hypothesis of the article I originally posted and would be consistent with why people with a higher level of NETs are more likely to suffer respiratory failure…
And another speculation is that NETs contribute to the creation of blood clots which would be consistent with the original article with respect to micro blood clots in the lungs that then prevent O2 exchange, damage other organs, etc. (https://www.jci.org/articles/view/84538)
I was originally looking into this more because those of us with follicular non-hodkin’s (and DLBCL, probably more but these are the only two studied so far) lymphoma have higher NET levels anyway, that when they are higher outcomes are worse for those cancers (eg treatment failure)… Thus it would be even more dangerous for folks with nhl (and autoimmune diseases as those folks often have higher levels of NETs) to get covid-19 as the outcomes could be worse(using deductive logic - all of which would need to be tested).
That got me wondering IF people under active treatment for nhl and taking rituxan (depletes neutrophils as B cell lymphoma is a cancer of neutrophils), thus have a neutrophil count in the toilet would make fewer NETs. And then on the one hand be more susceptible to getting/being unable to successfully fight off viruses due to fewer neutrophils (they, amongst other things fight viruses), be less to suffer respiratory failure if they do get it due to fewer NETs. Of course that is a lot of “what if’s”. I plan to ask my oncologist exactly that when I see him in 2 weeks.
If a lower neutrophil count reduces the amount of NETs produced then would treating covid-19 with rituxan (or its second generation equivalent) could then doing that reduce the odds of respiratory failure and clots? Of course rituxan also decreases the ability to fight viruses so the down side might be bigger than the up side.
Lots and lots of what if’s… Interesting to speculate about though and thinking how the pieces might fit together. Wish I could test some of this as the pieces seem to all explain a piece of the pie so to speak.
@Cerridwyn
Since that is from (presumably so far) damaged nerves and if the blood clot hypothesis for this disease is correct, then actually that would make sense (well presuming that is more or less the nervous system is the only place attacked and not everywhere in one’s body that is vulnerable).
@Kidsandliz
Yes and no
It would potentially presuppose that the virus infects whichever cells it infects in one person and maybe something else in another.
Again Novel in so many ways.
@Cerridwyn And that (novel) of course is what makes this puzzle so interesting as people are having to think about this disease in such different ways with respect to mechanism, etc.
I just finished a long article summarizing the creation of/effects of NETs with different medical conditions (https://www.frontiersin.org/articles/10.3389/fimmu.2017.00081/full). What was interesting is that in many of the conditions that are shown to increase the risk for folks if they get covid-19 are also conditions where folks tend to have higher NET production.
The article says that with rheumatoid arthritis (RA) they easily produce high NETs. One treatment for RA is rituxan. I haven’t looked yet but I wonder if one reason why that helps is that is reduces the neutrophil count thus the ability to produce as high a level of NETs since it is the neurtrophils that produce them.
Again that makes me wonder if we could figure out how to reduce NET production without reducing it so low that people then can’t mount enough of an immune response if that might increase the odds of people not getting as severe a case, thus fewer dying. Wouldn’t be treating the virus per say, rather decreasing the toxic over response of the body to the infection. Until a treatment drug would be found that could be useful. It also looks like some other body chemicals are involved in producing NETs so blocking that could work too (well presuming they weren’t critical for something else).
Of course what is interesting and what turns out to be true in the end could well be different things…
@Cerridwyn Here’s something the New York Times published today about the blood type issue: “Another head-scratcher is why blood type might play a role in a Covid-19 infection. One idea is that the location on the genome where blood type is determined also contains a stretch of DNA that can trigger strong immune responses. It’s possible that genetic variations may lead to an overreaction in the immune system, causing extensive inflammation and lung damage.”
@Kidsandliz
there was also a very sad one a couple of days ago about data integrity and some concern that an organization that assembles data used by researchers, including some published in very reputable peer-reviewed medical journals, has possibly been either unethically manipulated all the way to downright falsified.
so many unknowns
there was also a good article in the Atlantic about what another journalist called post-COVID syndrome.
@Cerridwyn I hope those who have done data manipulation or falsification lose their jobs and get blackballed in their profession!!! And if they have medical degrees stripped of their license. That is beyond unethical not to mention potentially deadly. Back when I had breast cancer for the first time the entire University of Oklahoma’s breast cancer center faculty were fired due to data falsification. At the time I was beyond pissed that I had to travel out of state for decent care. The up side is that I figured since I had to travel I’d go to MD Anderson Cancer Center. In retrospect that was a major plus, especially since I’ve had more cancers.
I’ve read snippits about here and there about long recoveries past the acute state of the disease. I’ll have to hunt that article down.
Then there’s the uncertainty in the antibody test (aka the “serological” test) at around 50%. Basically, it is useless for a mythical “immunity passsport” before we find a vaccine two years from now. Part of the problem - we aren’t testing enough people to get a better read on the detection rates and figure out transmission/community spread vectors, and we also don’t test enough to figure out the false positives and develop a better test. The worst of both, and then there’s the confusion between tests that detect virus loads and those that detect antibodies and mixing up the testing volume, rate, and worst of all, the results.
It’s a hot mess - that is either on purpose or incompetence on the part of this administration, on orders from the top, while the Senate does nothing but support and perpetuate the obstruction.
@mike808 This article though wasn’t about antibody tests (although I agree with you about what you are saying with respect to tests, vaccinations, etc.), rather it was looking at the mechanisms for how covid-19 actually makes people sick, how it affects the body and damages it…
Certainly the more researchers know about the virus and how it operates, the higher the odds treatments can be found, tests to identify who has had it and measure how long antibodies last with respect to potential immunity, etc. and with finding an effective, safe vaccination.
@mike808
I think a lot of the problem is that (unfortunately)
Gone are the days when information had to be vetted better before it made a splash in the paper or on the news (or worse– on a clickbait site or facebook/twitter/instagram etc. )
The sad truth is that this is a novel coronavirus, and contrary to popular belief (fueled by years of movie watching, binge watching Jack Ryan or 24, etc), it takes a while to unravel the mystery.
@chienfou @mike808
And of course in trying to unravel it we start with correlations, move on to more targeted approaches to studying it, things first thought to be “true” may be later found out to be wrong… Science takes time, peer review for publishing articles takes time. Starting with something not seen before takes even more time. Even with a lot of good minds working on it. Overall science is not a fast process.
@chienfou @Kidsandliz
And then there’s this truism:
@mike808
and…
there are multiple antibody tests. Some test for the current active antibodies point of care, with a finger prick. There are not so many false positives as false negatives from what I have heard first hand from lab scientists. They are more useful for helping to confirm a potential clinical diagnosis. If you are asymptomatic and negative, it is really not a way to say you are not carrying it.
Then there are those that test for exposure. they are fewer and farther between and when done with the finger prick, not very accurate. There was one, by Roche I think, but don’t quote me, that required actually phlebotomy and a tube of blood and that was pretty highly accurate when ran on people had a confirmed positive history. It is the type that is needed for exposure prevalence. It is of course, more expensive to run, but a few University labs have done so in smallish scales, and that is giving an exposure rate very different from an infection rate. it has to be positive for you to participate in a convalescent serum trial donation.
Biggest issue is that the general population doesn’t distinguish the different types of tests reveal different information and that some states lumped it all together to changes their infections / death statistics - or pure ignorance or both.
As a nation, the US loves science - if and only if it gives the results someone wants - not if it doesn’t.
On journalistic integrity is as much of an oxymoron as military intelligence is said to be. Didn’t used to be but it has become this. That and so called social media.
@Cerridwyn @mike808
@Cerridwyn @mike808
And on a cancer list (when arguing with someone why they believed the science behind sentinel node biopsies - take out just the ones draining the tumor vs take out all the nodes but not the science about chemo) I said once, in frustration with those who believe snake oil testimonials over chemo research “science, like gravity, works all the time, not just when you want it to”.
Of course mistakes are made when doing science, hypotheses (Ho) that we initially fail to reject may end up being rejected later when we know more and can do a better study, etc. (technically you don’t prove" things, you are looking at a specific Ho and either rejected or you fail to reject; fail to reject is not the same as confirm as you may have missed variables, screwed up, etc. and so may reject it later with a better study).
@Cerridwyn @Kidsandliz
Now you’re talking “theories”, like Evolution and a spherical earth that, get a load of this nonsense , isn’t the center of the heavens as God intended is to be. What’s next? Women choosing when or if they’re ready to produce an heir for you? Bollocks! A pox on them librals destroying 'Murica.
@Cerridwyn @Kidsandliz @mike808 But do we really love science?
@blaineg @Kidsandliz @mike808
EXACTLY!
@Cerridwyn @Kidsandliz @mike808
I think some of the Thalidomide kids would disagree with you on that mike808
Thanks for the article; lots of info in it and the links it contains!
@phendrick You are welcome. I am glad there are some people on this who appreciate stuff like this at this level of detail.
by the way…
the illness is COVID 19,
the virus is SARS CoV 2
(sort of like AIDS is the disease, HIV the virus)
@chienfou I’ve been being careless in how I refer to it. Thanks for the reminder.
Great and useful information!