{"id":177,"date":"2020-05-09T09:58:04","date_gmt":"2020-05-09T16:58:04","guid":{"rendered":"https:\/\/reallycorrect.com\/ReallyCorrectWp1\/?page_id=177"},"modified":"2021-04-10T10:41:20","modified_gmt":"2021-04-10T17:41:20","slug":"covid19-sars-cov-2-and-treatment","status":"publish","type":"page","link":"https:\/\/reallycorrect.com\/ReallyCorrectWp1\/covid19-sars-cov-2-and-treatment\/","title":{"rendered":"COVID-19, SARS-CoV-2, and Severe-Case Treatment"},"content":{"rendered":"\n
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COVID-19 is presenting as many diseases. Acute Respiratory Distress Syndrome and the treatment for ARDS is likely NOT the correct treatment. There is a hemoglobin attack and oxygen deprivation component that is possibly more important to understand and treat than any associated pneumonia related components. The information below comes from various medical professionals who are trying desperately to identify good solutions. Currently it appears that steroids are proving very helpful as noted in the first several links below. Also see COVID-19 Therapeutics<\/a> and Hospitalized Patient Physical Therapy<\/a>.<\/strong><\/p>\n\n\n\n

Is short half-life Budesonide, Ciclesonide, and similar Inhaled Corticosteroids (ICS) an optimal treatment in some cases? Do they help increase pulse-oximeter measured blood oxygen saturation levels? Should it be administered on a calendar or physiologic event basis?

Could a rapid acting short-half-life steroid eliminate need for oxygen supplement long enough to begin [monoclonal \/ polyclonal] antibody (Regeneron) therapy?<\/p>\n\n\n

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Corticosteroid inhalers used by asthma patients may help treat COVID-19, researchers to begin human clinical trials – Health News , Firstpost<\/div>
The ultimate goal of the trial is to analyse if the Budesonide inhaler can be used as a low-cost and easily available early intervention therapy for COVID-19 patients to reduce the risks of severe respiratory illness.<\/div><\/div><\/div>\n\n\n


Budesonide Reduces Urgent Care And Hospitalization By 91 Percent<\/a><\/h3>\n\n\n\n

“The primary outcome<\/strong> was defined as COVID-19-related urgent care visits, including emergency department assessment or hospitalisation<\/strong>.”.
“In the per-protocol analysis, the primary outcome occurred in ten (14%) participants in the usual care group and one (1%) participant in budesonide group (difference in proportions 0\u00b7131, 95% CI 0\u00b7043\u20130\u00b7218; p=0\u00b7004), indicating a relative risk reduction of 91% for budesonide<\/strong>.”
“This effect, with a relative reduction of 91% of clinical deterioration is equivalent to the efficacy seen after the use of COVID-19 vaccine<\/strong>“<\/p>\n\n\n

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Inhaled budesonide in the treatment of early COVID-19 (STOIC): a phase 2, open-label, randomised controlled trial<\/div>
Early administration of inhaled budesonide reduced the likelihood of needing urgent
\nmedical care and reduced time to recovery after early COVID-19.<\/div><\/div><\/div>\n\n
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Inhaled budesonide in the treatment of early COVID-19 illness: a randomised controlled trial<\/div>
Background Multiple early hospital cohorts of coronavirus disease 2019 (COVID-19) showed that patients with chronic respiratory disease were significantly under-represented. We hypothesised that the widespread use of inhaled glucocorticoids was responsible for this finding and tested if inhaled gluc\u2026<\/div><\/div><\/div>\n\n
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Inhaled corticosteroids: A rapid review of the evidence for treatment or prevention of COVID-19 – The Centre for Evidence-Based Medicine<\/div>
Laura C Armitage and Rachel Brettell On behalf of the Oxford COVID-19 Evidence Service Team Centre for Evidence-Based Medicine,<\/div><\/div><\/div>\n\n
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Therapeutic potential of ciclesonide inhalation for COVID-19 pneumonia: Report of three cases<\/div>
No specific and effective anti-viral treatment has been approved for COVID-19 so far. Systemic corticosteroid has been sometimes administered to severe infectious diseases combined with the specific treatment. However, as lack of the specific anti-SARS-CoV-2 …<\/div><\/div><\/div>\n\n
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Local doctor believes he has found \u2018silver bullet\u2019 for COVID-19<\/div>
\u201cWhat I\u2019m using is Budesonide, it\u2019s an inhaled steroid that doesn\u2019t have the side effects of total body steroids but it has the benefits.\u201d<\/div><\/div><\/div>\n\n\n

“In conclusion, we report a case of severe COVID-19 pneumonia that was diagnosed correctly on the basis of typical chest CT findings and other clinical features, with a favorable outcome. Our findings suggest that ciclesonide inhalant may improve the respiratory status in severe COVID-19 pneumonia<\/a> and is worthy of further study in clinical trials” – Infection Prevention and Control Department Yokohama City University Hospital<\/p>\n\n\n

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Asthma inhalers being trialed for treatment of COVID-19<\/div>
Researchers from Queensland University of Technology and Oxford University are working in collaboration to begin human clinical trials of inhaled corticosteroids, commonly used for asthma patients, on patients with COVID-19. The researchers believe that this could be useful for patients with the nov\u2026<\/div><\/div><\/div>\n\n
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QUT and Oxford researchers collaborate on new COVID-19 asthma drug trial<\/div>
QUT researchers are collaborating with colleagues at the University of Oxford on a UK clinical trial to test common asthma inhalers as a treatment for COVID-19 infection.<\/div><\/div><\/div>\n\n
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Researchers to test asthma drug to treat Covid-19 – Korea Biomedical Review<\/div>
Local infectious disease specialists said they would evaluate the potential of a…<\/div><\/div><\/div>\n\n
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Covis Pharma B.V. Initiates Phase 3 Clinical Trial of Alvesco (Ciclesonide) Inhaler for the Treatment of COVID-19<\/div>
\/PRNewswire\/ — Covis Pharma B.V. today announced the initiation of a Phase 3 clinical study to assess the safety and efficacy of its asthma drug Alvesco…<\/div><\/div><\/div>\n\n
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Two Drugs Show Promise Against COVID-19<\/div>
Korean researchers have screened 48 FDA-approved drugs against SARS-CoV-2, and found that 2, which are already FDA-approved for other illnesses, seem promising. The FDA approval for other uses would greatly reduce the time needed to gain FDA approval of use in COVID-19.\u00a0The research is published in\u00a0\u2026<\/div><\/div><\/div>\n\n
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Nip it in the bud: New study will attack SARS-Cov2 where it multiplies | McGill University Health Centre<\/div>
RI-MUHC researchers initiate a clinical trial of ciclesonide to possibly prevent mild cases of COVID-19 from worsening<\/div><\/div><\/div>\n\n
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Therapeutic potential of ciclesonide inhalation for COVID-19 pneumonia: Report of three cases<\/div>
No specific and effective anti-viral treatment has been approved for COVID-19 so far. Systemic corticosteroid has been sometimes administered to severe infectious diseases combined with the specific treatment. However, as lack of the specific anti-SARS-CoV-2 …<\/div><\/div><\/div>\n\n
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The inhaled steroid ciclesonide blocks SARS-CoV-2 RNA replication by targeting the viral replication-transcription complex in cultured cells<\/div>
Here, we screened steroid compounds to obtain a drug expected to block host inflammatory responses and MERS-CoV replication. Ciclesonide, an inhaled corticosteroid, suppressed replication of MERS-CoV and other coronaviruses, including SARS-CoV-2, the cause of COVID-19, in cultured cells. The effecti\u2026<\/div><\/div><\/div>\n\n\n


Is the half-life of Methylprednisolone >18hrs? Is that excessive in some cases? Is a short half-life dose of Budesonide and pause an improved treatment in some cases?<\/p>\n\n\n

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Treatment Protocol \u2013 Frontline COVID-19 Critical Care Working Group<\/div>
We have tweaked the protocol based on the best emerging data; however our core philosophy and approach have not changed. Some have asked why our initial protocol included hydroxychloroquine, the anti-viral drug that was widely touted as a cure for the COVID-19 disease that is caused by the virus. \u2026<\/div><\/div><\/div>\n\n\n


Is 6mg\/day Dexamethasone the correct treatment? Is the half-life of Dexamethasone >36hrs? When administered daily, is the dose cumulative? Is that excessive in some cases? Were some studies that showed depleted immune titers at terminal related to long-half life steroid cumulative effects? Is a short half-life dose of Budesonide and pause an improved treatment in some cases? A possibly related study “27 COVID-19, 51 septic, 18 critically-ill non-septic (CINS)<\/a>” In the study, the 51+18 cohorts were screened to avoid “greater than or equivalent to 300 mgs\/day of hydrocortisone or other immunosuppressive medications” but the COVID-19 cohort was not screened, implying they could have been hit hard with steroids? No treatment info on the COVID-19 group. So how do we know they were not hit hard with steroid? COVID treatments of 6mg\/day dexamethasone is equivalent of 150mg hydrocortisone but longer half-life? >36hrs? So it would accumulate up over days? If that were the treatment (again – no way to know from this publication?) how would that end in 10 to 15 days? Is that too much steroid? Is a short hit and pause a better treatment? Or is this study correct and it’s not cytokine induced inflammation at all? Or ?? Study has patient data in important appendix link: https:\/\/insight.jci.org\/articles\/view\/140329\/sd\/1<\/a><\/p>\n\n\n

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COVID-19 – EMCrit Project<\/div>
CONTENTS Basic biology Infection control Transmission Personal protective equipment (PPE) Diagnosis Signs & symptoms Labs Imaging CXR & CT scan Lung ultrasonography General approach to imaging Bronchoscopy Diagnostic approach for admitted patients Treatment: General protocols ED patients getting adm\u2026<\/div><\/div><\/div>\n\n\n
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Coronavirus (COVID-19) Update: FDA Authorizes Monoclonal Antibodies for Treatment of COVID-19<\/div>
The FDA issued an EUA for two monoclonal antibodies to be administered together for treating mild to moderate COVID-19 in adults and pediatric patients.<\/div><\/div><\/div>\n\n\n


“We found that diabetes mellitus, body temperature \u2265 37.8\u00b0C, peripheral oxygen saturation < 92%, and CK-MB > 6.3 are independent predictors of severe disease in hospitalized COVID-19 patients. Appropriate assessment of prognostic factors and close monitoring to provide the necessary interventions at the appropriate time in high-risk patients may reduce the case fatality rate of COVID-19”<\/p>\n\n\n

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Prognostic Factors for Severe Coronavirus Disease 2019 in Daegu, Korea<\/div>
Jang JG, et al. J Korean Med Sci. 2020 Apr;35(23):e209. https:\/\/doi.org\/10.3346\/jkms.2020.35.e209<\/div><\/div><\/div>\n\n
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Detectable 2019-nCoV viral RNA in blood is a strong indicator for the further clinical severity<\/div>
The novel coronavirus (2019-nCoV) infection caused pneumonia. we retrospectively analyzed the virus presence in the pharyngeal swab, blood, and the anal swab detected by real-time PCR in the clinical lab. Unexpectedly, the 2109-nCoV RNA was readily detected …<\/div><\/div><\/div>\n\n
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A dynamic COVID-19 immune signature includes associations with poor prognosis<\/div>
A common immune signature in the blood of patients with COVID-19, who are otherwise clinically heterogeneous, sheds light into the pathogenesis and clinical progression of the disease.<\/div><\/div><\/div>\n\n
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COVID-19 Protocols<\/div>
Brigham and Women\u2019s Hospital COVID-19 Clinical Guidelines<\/div><\/div><\/div>\n\n
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Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome<\/div>
The kinin-kallikrein system is a crucial target for the treatment of COVID-19.<\/div><\/div><\/div>\n\n
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Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections<\/div>
A cohort of asymptomatic patients infected with SARS-CoV-2 had significantly lower levels of virus-specific IgG antibodies compared to a cohort of age- and sex-matched symptomatic infected patients.<\/div><\/div><\/div>\n\n
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60% Of People Naturally Resistant To SARS-COV2, New Study Reveals<\/div>
New research suggests majority of people may already have resistance based on previous infections…<\/div><\/div><\/div>\n\n\n

Do anti-coagulants help increase pulse-oximeter measured blood oxygen saturation levels?<\/p>\n\n\n

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COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up<\/div>
Coronavirus disease 2019 (COVID-19), a viral respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may predispose patients to thrombotic disease, both in the venous and arterial circulations, due to excessive …<\/div><\/div><\/div>\n\n
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COVID-19:Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism<\/div>
The novel coronavirus pneumonia (COVID-19) is an infectious acute respiratory caused by the novel coronavirus. The virus is a positive-strand RNA virus with high homology to bat coronavirus. In this study, conserved domain analysis, homology modeling, and molecular docking were used to compare the b\u2026<\/div><\/div><\/div>\n\n
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MUST READ! Research Reveals That COVID-19 Attacks Hemoglobin In Red Blood Cells, Rendering It Incapable Of Transporting Oxygen. Current Medical Protocols Could All Be Wrong! – Thailand Medical News<\/div>
COVID-19 Research: Findings from a new study released by Chinese researchers , Dr Wenzhong Liu from Sichuan University and Dr Hualan Li from Yibin University has revealed that the Sars-CoV-2 coronavirus attacks hemoglobin in the the red blood cells through a series of cellular actions, that ultimat\u2026<\/div><\/div><\/div>\n\n
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Mechanisms of hypoxemia<\/div>
Oxygen is an essential element for life and without oxygen humans can survive for few minutes only. There should be a balance between oxygen demand and delivery in order to maintain homeostasis within the body. The two main organ systems responsible for …<\/div><\/div><\/div>\n\n\n

This video, being a bit dated from Mar 31, 2020, provides important background information and is a call for action to reduce damage from improper ventilator use including that of over-pressure and premature use.<\/p>\n\n\n\n

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