The biology of coronavirus COVID-19 - including research and treatments

Trish said:
The Guardian newspaper, UK:
https://www.theguardian.com/world/2020/jun/23/covid-19-vaccine-may-not-work-for-at-risk-older-people-say-scientists?utm_term=RWRpdG9yaWFsX0d1YXJkaWFuVG9kYXlVS19XZWVrZGF5cy0yMDA2MjQ=&utm_source=esp&utm_medium=Email&CMP=GTUK_email&utm_campaign=GuardianTodayUK
Covid-19 vaccine may not work for at-risk older people, say scientists
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Ugh, the nasal flu vaccine is trash. It's not approved for use in Australia for good reason!
The rest of the article is not totally coherent, mentioning non specific "baseline inflammation" without explanation.

The claims that the vaccine won't work for the older population is still pure speculation at this point. Strong immune responses to the virus (which is necessary for the claim of greater inflammation) itself suggest that the generalised efficacy of vaccines to SARS-2 isn't going to be particularly unique.

What they're really hinting is that they want the vaccine to be universal (mandatory) for children.
 
Snow Leopard said:
The rest of the article is not totally coherent, mentioning non specific "baseline inflammation" without explanation.

The claims that the vaccine won't work for the older population is still pure speculation at this point.
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I agree I think this is just Arne Akbar bidding for money for his research programme into immune system ageing. A sideshow.
 
So if our immune system as ancient and decrepit people is so crap, why do they insist on offering us flu vaccine every year? OK, I get that flu isn't Covid, and maybe the Covid vaccine will act differently to flu vaccine, but article seems to be arguing that it's pointless giving any oldies any vaccine? Because our immune systems are useless because we're ancient and decrepit.
 
FT
Human genetics provides clues about mysteries of coronavirus

DNA differences suggest why some people suffer much more severely from disease than others.

Scientists have identified a new set of 68 genes associated with a high risk of developing severe Covid-19 as geneticists seek to understand why people vary so much in their susceptibility to the illness. The preprint paper released on Thursday by analytics company PrecisionLife, which used data from UK Biobank, adds to a growing number of genetic clues about vulnerability to the virus. The phenomenon of some people suffering grave illness while others are infected without symptoms despite being in similar environments has caused widespread puzzlement. Twelve of the 68 genes identified by Oxford-based PrecisionLife are involved in the heart and blood circulation, including the regulation of calcium levels. This tallies with the observation that the cardiovascular system often undergoes severe stress in patients hospitalised with Covid-19. Last week an international academic team found two areas of human DNA that differed significantly between 1,600 patients in Spain and Italy who suffered Covid-19 respiratory failure and people who bore no signs of disease.
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full article
https://www.ft.com/content/50006fa2-f99c-4da8-b817-abb2379565ce
 
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Rapid roll out of SARS-CoV-2 antibody testing—a concern
BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2420 (Published 24 June 2020)Cite this as: BMJ 2020;369:m2420
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  1. Monique Andersson, consultant in infection1,
  2. Nicola Low, professor of epidemiology and public health and director of research2,
  3. Neil French, head of the department of clinical infection microbiology and immunology, chair of infectious diseases and global health, and honorary consultant infectious diseases3,
  4. Trisha Greenhalgh, professor of primary care health sciences4,
  5. Katie Jeffery, consultant in infection5,
  6. Andrew Brent, consultant in infection and medicine5,
  7. Jonathan Ball, professor of molecular virology and director of Centre for Global Virus Research6,
  8. Allyson Pollock, professor of public health7,
  9. David McCoy, professor of global public health8,
  10. Miren Iturriza-Gomara, director9,
  11. Iain Buchan, executive dean10,
  12. Helen Salisbury, honorary senior clinical lecturer4,
  13. Deenan Pillay, pro vice provost (international), professor of virology11,
  14. Will Irving, professor and honorary consultant in virology12
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We are writing to express concerns over aspects of the establishment of SARS-CoV-2 antibody testing in England. NHS England and NHS Improvement wrote to NHS trusts and pathology networks on 25 May 2020, asking them to offer antibody testing at short notice and ramp up capacity to thousands of samples a day.12

We have three concerns about the request. Firstly, there is no specific clinical indication for the test on an individual basis. Secondly, the performance of these assays has not yet been assessed to the standard typically required of a novel test. And thirdly, the resource implications are not considered.

We support the rapid provision of diagnostic tests for individual and public health and recognise the need to deliver at pace. It is essential, however, that quality systems, which have evolved over many years and are the foundation for delivering the right result of the right test to the right person at the right time, are not circumvented.
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https://www.bmj.com/content/369/bmj.m2420
 
I spoke to a person from outside my family circle about coronavirus and she mentioned suffering from fatigue after buying groceries, and having different symptoms appear randomly on different days. She did not have a known coronavirus infection but it sounded a lot like a very mild form of the post-covid syndrome.

I also learned that the butcher where I often buy meat had proper covid-19 and has been left with a lot of joint pain.

This seems to align with my suspicion that in my family we already had coronavirus exposure and just had fairly mild symptoms. For those that don't know, I live in Lombardy.
 
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I'm not exactly sure where to put this but this should do.


Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30287-X/fulltext
Concerns regarding potential neurological complications of COVID-19 are being increasingly reported, primarily in small series. Larger studies have been limited by both geography and specialty. Comprehensive characterisation of clinical syndromes is crucial to allow rational selection and evaluation of potential therapies. The aim of this study was to investigate the breadth of complications of COVID-19 across the UK that affected the brain.
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Complete clinical datasets were available for 125 (82%) of 153 patients. 77 (62%) of 125 patients presented with a cerebrovascular event, of whom 57 (74%) had an ischaemic stroke, nine (12%) an intracerebral haemorrhage, and one (1%) CNS vasculitis. 39 (31%) of 125 patients presented with altered mental status, comprising nine (23%) patients with unspecified encephalopathy and seven (18%) patients with encephalitis. The remaining 23 (59%) patients with altered mental status fulfilled the clinical case definitions for psychiatric diagnoses as classified by the notifying psychiatrist or neuropsychiatrist, and 21 (92%) of these were new diagnoses. Ten (43%) of 23 patients with neuropsychiatric disorders had new-onset psychosis, six (26%) had a neurocognitive (dementia-like) syndrome, and four (17%) had an affective disorder. 18 (49%) of 37 patients with altered mental status were younger than 60 years and 19 (51%) were older than 60 years, whereas 13 (18%) of 74 patients with cerebrovascular events were younger than 60 years versus 61 (82%) patients older than 60 years.
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It's a long paper but it is frankly adding a lot of weight to the possibility that a significant % of what we consider psychiatric diseases may be pathogenic in origin. At least if a virus can have the same outcome, it's a distinction without a difference.

This is in an elderly population, median age 71, so it's not clear if this is particular or a general pattern, or even if it's specific to some of the organ damage like blood clots. Given how prevalent cardiovascular disease is, maybe there's a connection to psychiatric symptoms.
 
Basically I suspect that coronavirus is causing a lot of nonsevere symptoms in a lot more people than is currently believed because the existing diagnostic tests are inadequate.

This suspicion is based in part on what people in my area are telling me about their health, and the example of people with covid toes testing negative on blood tests yet having coronavirus in their "covid toes".

This could be an opportunity to make some very significant progress in understanding the actual causes of a lot of health problems, but I fear that the usual psychobabble may prevent that.

The psychogenic theorists are going to go wild seeing all these symptomatic but coronavirus negative people.

There is still hope that it will be just too obvious that the virus is somehow causing these problems that people might overcome the psychogenic dogma and become curious.
 
strategist said:
This suspicion is based in part on what people in my area are telling me about their health, and the example of people with covid toes testing negative on blood tests yet having coronavirus in their "covid toes".

This could be an opportunity to make some very significant progress in understanding the actual causes of a lot of health problems, but I fear that the usual psychobabble may prevent that.
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Of course they're already blaming covid toes on "inactivity" and "lifestyle changes".
 
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Art Vandelay said:
Of course they're already blaming covid toes on "inactivity" and "lifestyle changes".
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I can't take that level of dumb. I expect better from a group of teenagers doing a school project. This is easily falsifiable, even more so considering the latest beauty from the RCGP about "lifestyle" choices, including being sedentary, that imply this should be common among a population of sedentary people. The excuses are so pathetic. "Walking barefoot" in your house? WTH?

Everything to avoid blaming a pathogen. It's pathological at this point. The BPS religion has fried their brains. This is madness.
 
Karolinska Institutet, Sweden: "Immunity to COVID-19 is probably higher than tests have shown"
Article said:
New research from Karolinska Institutet and Karolinska University Hospital shows that many people with mild or asymptomatic COVID-19 demonstrate so-called T-cell-mediated immunity to the new coronavirus, even if they have not tested positively for antibodies. According to the researchers, this means that public immunity is probably higher than antibody tests suggest. The article will soon be freely available on the bioRxiv server and has been submitted for publication in a scientific journal.

“T cells are a type of white blood cells that are specialised in recognising virus-infected cells, and are an essential part of the immune system,” says Marcus Buggert, assistant professor at the Center for Infectious Medicine, Karolinska Institutet, and one of the paper’s main authors. “Advanced analyses have now enabled us to map in detail the T-cell response during and after a COVID-19 infection. Our results indicate that roughly twice as many people have developed T-cell immunity compared with those who we can detect antibodies in.”

In the present study, the researchers performed immunological analyses of samples from over 200 people, many of whom had mild or no symptoms of COVID-19 [...]
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https://news.ki.se/immunity-to-covid-19-is-probably-higher-than-tests-have-shown
 
mango said:
Karolinska Institutet, Sweden: "Immunity to COVID-19 is probably higher than tests have shown"


https://news.ki.se/immunity-to-covid-19-is-probably-higher-than-tests-have-shown
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I wouldn't personally put any weight on this finding.T cell responses are notoriously difficult to interpret. Antibody responses are 100 times more reliable across the board. Antibody tests are the gold standard. There seem to be a proportion of scientists motivated to show that things are not as bad as is thought.

The one disease where T cell responses are the standard is TB and in that case they show previous exposure but do not show immunity.People with positive T cell tests are given treatment on the assumption that they cannot get rid of the bacteria themselves.
 
It's a massive understatement to say that this virus is freakin weird. This will be paywalled but you should be able to read it in incognito mode if it's blocked.

Coronavirus autopsies: A story of 38 brains, 87 lungs and 42 hearts

https://www.washingtonpost.com/health/2020/07/01/coronavirus-autopsies-findings/
Among the most important findings, consistent across several studies, is confirmation the virus appears to attack the lungs the most ferociously. They also found the pathogen in parts of the brain, kidneys, liver, gastrointestinal tract and spleen and in the endothelial cells that line blood vessels, as some had previously suspected. Researchers also found widespread clotting in many organs.
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Given widespread reports about neurological symptoms related to the coronavirus, Fowkes said, she expected to find virus or inflammation — or both — in the brain. But there was very little. When it comes to the heart, many physicians warned for months about a cardiac complication they suspected was myocarditis, an inflammation or hardening of the heart muscle walls — but autopsy investigators were stunned that they could find no evidence of the condition.
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Most recently, a study out last month in the Lancet’s eClinicalMedicine, found abnormal clotting in the heart, kidney and liver, as well as the lungs of seven patients, leading the authors to suggest this may be a major cause of the multiple-organ failure in covid-19 patients.
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owkes, from Mount Sinai, and her colleague, Clare Bryce, whose work on 25 hearts has been published online but not yet peer reviewed, said they saw some “very mild” inflammation of the surface of the heart but nothing that looked like myocarditis.
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Of all the coronavirus’s manifestations, its impact on the brain has been among the most vexing. Patients have reported a host of neurological impairments, including reduced ability to smell or taste, altered mental status, stroke, seizures — even delirium.
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In June, researchers in France reported that 84 percent of patients in intensive care had neurological problems, and a third were confused or disoriented at discharge. Also this month, those in the United Kingdom found that 57 of 125 coronavirus patients with a new neurological or psychiatric diagnosis had experienced a stroke due to a blood clot in the brain, and 39 had an altered mental state.
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He found snippets of virus in only some areas, and it was unclear whether they were dead remnants or active virus when the patient died. There were only small pockets of inflammation. But there were large swaths of damage due to oxygen deprivation. Whether the deceased were longtime intensive care patients or people who died suddenly, Solomon said, the pattern was eerily similar.
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Merged thread

Radio progs on Covid tonight (2nd July 2020)

There are 2 BBC World Service programmes on Covid tonight, one at 22.00 and one at 22.30, but you can listen to them now.

The first one looks at the origin, bringing up the possibility that it escaped from a laboratory: https://www.bbc.co.uk/programmes/w3csz6l7

The second one looks at loss of taste and smell: https://www.bbc.co.uk/programmes/w3cszjq1
 
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rvallee said:
It's a massive understatement to say that this virus is freakin weird. This will be paywalled but you should be able to read it in incognito mode if it's blocked.

Coronavirus autopsies: A story of 38 brains, 87 lungs and 42 hearts

https://www.washingtonpost.com/health/2020/07/01/coronavirus-autopsies-findings/
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We already suspected much of this from SARS-1 (consequences of ACE-2 being targeted), but I guess some people want to rediscover the wheel. Also, the problem isn't merely clotting, but rather the difficulty the body has in clearing those clots, hence blood thinners aren't necessarily going to solve the problem. Also, brain related infections (and clotting) are rare for COVID patients, but when you have over 300,000 cases, a few are bound to show up! Damage due to oxygen deprivation is not unusual in those who have died of severe respiratory infections.
 
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