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

Snow Leopard said:
Remdesivir is ineffective at reducing viral load (once already infected) or reducing mortality in COVID patients.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

Do not believe the hype from the USA.
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The hype seems to be spreading..

Lovande resultat för coronamedicin i stor studie

https://www.svt.se/nyheter/vetenskap/lovande-resultat-for-coronamedicin
"Promising results for corona medicine in large study
UPDATED MAY 1, 2020
PUBLISHED APRIL 30, 2020
The US Health Authority, NIH, has released preliminary results of a research study with a drug for the coronavirus.

More than 1,000 patients with covid-19 were included in the study, all patients suffering from symptoms caused by the new coronavirus SARS COV-2.

The trial started on February 21, and shows that patients treated with the drug remdesivir recovered faster from the disease than a control group that did not receive the medication.

On average, those who received remedies were discharged from the hospital and were able to return to normal life after 11 days. It took 15 days for the patients in the control group. In the remedial group, eight percent of patients died, in the control group, mortality was 11.6 percent.

Contradictory results
But the benefits of remdesivir have also been questioned. On Wednesday, a Chinese study was published in The Lancet magazine with a completely different result.

The Chinese researchers found no evidence that the drug neither accelerates recovery nor reduces mortality. However, they point out that further research is needed because the study was discontinued as it had problems recruiting test subjects, which resulted in only 200 people being studied.

Although other studies have not been able to show as positive effects as the American study, Anders Sönnerborg, professor of clinical virology at the Karolinska Institute, is hopeful:

- If the results hold when we get all the data, then these are positive signals. Four days of shorter treatment may not sound like much, but it would mean a lot to the healthcare system, he says.

"Should be inserted earlier"
So far, the US health authorities have not told in detail which patients have received remedies, but Anders Sönnerborg assumes that these are the most severely ill in covid-19.

- In that case, this means that one could probably have an even better effect if the treatment could be put in earlier, he says.

If the scientific study published in May shows that the results hold, Anders Sönnerborg expects that the state authorities in the US can approve remedies for the treatment of covid-19 fairly quickly.

May come in June
- I think it is realistic that it may be out on the market already towards the end of June, he says.

Around the world, several major trials with remedies are currently underway. Anders Sönnerborg is leading the Swedish research in the field, and is uncertain about what will happen to it in the future.

If the US study keeps what it promises - and the drug really has a clear effect - it may be difficult to justify research excusing this drug from some of the patients for scientific reasons.

The new study is still not reviewed and published in a scientific journal, one expected later in May."
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'Happy hypoxia': unusual coronavirus effect baffles doctors
Some patients who appear not in distress are found to have dangerously low oxygen levels

It is a mystery that has left doctors questioning the basic tenets of biology: Covid-19 patients who are talking and apparently not in distress, but who have oxygen levels low enough to typically cause unconsciousness or even death.

The phenomenon, known by some as “happy hypoxia” (some prefer the term “silent”) is raising questions about exactly how the virus attacks the lungs and whether there could be more effective ways of treating such patients.
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Dagens Nyheter:Rehabiliteringen av covid 19-patienter stor utmaning för vården
https://www.dn.se/nyheter/sverige/r...C_J6mYbFLWC-vCCFWYkyRXVentR13OoqcCEuW_1Kdozvo

"Rehabilitation of covid 19 patients is a major challenge for healthcare
Healthcare is mobilized to help patients struggling for life in the acute stage of covid 19.

"But even now we must also take care of those who have been discharged and have received extensive damage from the infection," says Kristian Borg, a professor of rehabilitation."

English Google translation :
https://translate.googleusercontent...arden/&usg=ALkJrhjlJ3eqFLIpDI5M5SaUR0rza75cVg
 
The secondary consequences are where the real human and socio-politico-economic damage and cost will be, which is why we have to do everything possible to stop people getting infected in the first place.

Allowing natural herd immunity to develop via exposure and infection was always an insane idea.
 
Preprint
A SARS-CoV-2 protein interaction map reveals targets for drug repurposing

Abstract
The novel coronavirus SARS-CoV-2, the causative agent of COVID-19 respiratory disease, has infected over 2.3 million people, killed over 160,000, and caused worldwide social and economic disruption1,2. There are currently no antiviral drugs with proven clinical efficacy, nor are there vaccines for its prevention, and these efforts are hampered by limited knowledge of the molecular details of SARS-CoV-2 infection.

To address this, we cloned, tagged and expressed 26 of the 29 SARS-CoV-2 proteins in human cells and identified the human proteins physically associated with each using affinity-purification mass spectrometry (AP-MS), identifying 332 high-confidence SARS-CoV-2-human protein-protein interactions (PPIs). Among these, we identify 66 druggable human proteins or host factors targeted by 69 compounds (29 FDA-approved drugs, 12 drugs in clinical trials, and 28 preclinical compounds).

Screening a subset of these in multiple viral assays identified two sets of pharmacological agents that displayed antiviral activity: inhibitors of mRNA translation and predicted regulators of the Sigma1 and Sigma2 receptors. Further studies of these host factor targeting agents, including their combination with drugs that directly target viral enzymes, could lead to a therapeutic regimen to treat COVID-19.
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https://www.nature.com/articles/s41586-020-2286-9
 
was just thinking that if CRP testing in GPs had become standard practice (eg http://www.pulsetoday.co.uk/clinica...-to-help-cut-antibiotics-use/20037084.article) it might have helped to identify a lot of people with SARS-Cov2 earlier.........

(On tv last night there was someone who had CV and was being discharged from hospital, who said her GP prescribed antibiotics and corticosteroids when she first became symptomatic a month or so ago).
 
Sean said:
The secondary consequences are where the real human and socio-politico-economic damage and cost will be, which is why we have to do everything possible to stop people getting infected in the first place.

Allowing natural herd immunity to develop via exposure and infection was always an insane idea.
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I couldn't agree more.

Opinion piece in Dagens Nyheter:
https://www.dn.se/ledare/erik-helmerson-notan-for-rehab-blir-dyr-i-bade-pengar-och-lidande/

"Erik Helmerson: The bill for rehab becomes expensive in both money and suffering
Many covid patients will need long and resource-intensive rehabilitation. It can have effects on healthcare that we have talked about far too little."
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"We can expect complex rehabilitation needs and the need for long-term efforts by specialized rehabilitation teams," writes a large number of well-qualified doctors in the Medical Journal ."
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"On Thursday, five researchers published a very interesting text on DN Debate on two choices in the fight against corona: the "braking strategy", which has been Sweden's choice, and "the hammer and the dance" respectively. The latter involves severe restrictions to stifle the spread of the infection, followed by punctual action against new outbreaks, until a vaccine is available. The former risks leading to more ill people - and thus more requiring intensive care and rehabilitation."
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" And yes, the success of disease control is determined not only by how many people die, but also by how large the other effects are on the entire society. The cost of rehab, measured in terms of both money and suffering, must fit into that equation."
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https://translate.googleusercontent...dande/&usg=ALkJrhhLT3MDmAMRArcn3u-Ig63-JaTPDQ
 
A human monoclonal antibody blocking SARS-CoV-2 infection

Abstract
The emergence of the novel human coronavirus SARS-CoV-2 in Wuhan, China has caused a worldwide epidemic of respiratory disease (COVID-19). Vaccines and targeted therapeutics for treatment of this disease are currently lacking. Here we report a human monoclonal antibody that neutralizes SARS-CoV-2 (and SARS-CoV) in cell culture. This cross-neutralizing antibody targets a communal epitope on these viruses and may offer potential for prevention and treatment of COVID-19."

https://www.nature.com/articles/s41467-020-16256-y
 
Anna H said:
I couldn't agree more.

Opinion piece in Dagens Nyheter:
https://www.dn.se/ledare/erik-helmerson-notan-for-rehab-blir-dyr-i-bade-pengar-och-lidande/









https://translate.googleusercontent...dande/&usg=ALkJrhhLT3MDmAMRArcn3u-Ig63-JaTPDQ
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And yes, the success of disease control is determined not only by how many people die, but also by how large the other effects are on the entire society
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If only that were true. It really should. The reality instead is mostly "out of sight, out of mind (and nevermind the complaints)".
 
rvallee said:
If only that were true. It really should. The reality instead is mostly "out of sight, out of mind (and nevermind the complaints)".
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Yes, the reality is very saddening and short-sighted:(.
There doesn't seem to have been any long term analysis made before implementing this strategy except for the effects a lockdown would have on the economic system (but is there ever in politics?)

To be fair there wasn't much knowledge about the dramatic consequences for many of the survivors at the beginning of the pandemic, but now that we know better, shouldn't we do better?
 
Evidence that SARS-CoV-2 has been around longer than assumed.

https://www.france24.com/en/20200505-france-s-first-known-covid-19-case-was-in-december

Personally I am wondering if a nasty cold I had at the beginning of December, which had all the same symptoms, including dry cough and losing taste and smell which I actually wrote in my diary, was in fact Covid 19. I will try to get a post infection test when it becomes available.
 
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Jaybee00 said:
Humoral immune response and prolonged PCR positivity in a cohort of 1343 SARS-CoV 2 patients in the New York City region
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Notably the study revealed that 99% of patients seroconverted, a number of people are being falsely diagnosed with COVID19 (they probably have other viral infections), and the usual accuracy limitations of the tests.

The fact that viral fragments continue to be detected is not atypical of viruses and suggests prolonged low level infection for some time. (note that the authors don't suggest that individuals are infectious after the patients feel like they have recovered)

The last few nasty viruses I had, hit me for several waves over a period of 6 weeks so it doesn't surprise me personally (never felt completely well).
 
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Scientists say a now-dominant strain of the coronavirus appears to be more contagious than original

Scientists have identified a new strain of the coronavirus that has become dominant worldwide and appears to be more contagious than the versions that spread in the early days of the COVID-19 pandemic, according to a new study led by scientists at Los Alamos National Laboratory.

The new strain appeared in February in Europe, migrated quickly to the East Coast of the United States and has been the dominant strain across the world since mid-March, the scientists wrote.

In addition to spreading faster, it may make people vulnerable to a second infection after a first bout with the disease, the report warned...
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Particularly interesting given earlier discussions on this thread and others about the virus mutating. Scary.
 
Pre-print, but interesting.

SARS-Cov2 enables anaerobic bacteria (Prevotella, et al) to colonize the lungs disrupting homeostasis - symptoms (ARDS, septic shock, blood clots, arterial stroke) finds resonance, with key differences, in the ‘forgotten disease’ Lemierre Syndrome, caused by anaerobic bacteria enabled by Epstein Barr Virus
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https://osf.io/usztn/

Metagenomic studies of Covid19 patient sequencing data from different countries (China, Brazil, Peru, Cambodia) shows a pattern that SARS-Cov2 enables anaerobic bacteria (eg Prevotella, Veil- lonella, Capnocytophaga, Fusobacterium, Oribacterium and Bacteroides) colonize the lungs, disrupting the homeostasis found in healthy controls. These bacteria are implicated in cytokine storm, cause ground glass opacity in lungs and are associated with cardiac injury - all symptoms associated with Covid19. Many studies also show several bacterial infection markers - like Procalcitonin, C-reactive protein (CRP) and ferritin - being significantly high. This is also confirmed here in the lung sample from a 74 year old deceased patient, showing high levels of IFITM3, ferritin and S100 calcium binding protein. Anaer- obic bacteria causing initial symptoms like persistent fever, chills, pain and later symptoms like ARDS, blood clots, arterial stroke and septic shock finds resonance in a ”forgotten disease” - Lemierre syndrome (LS). Very interestingly, LS is enabled by Epstein Barr Virus - possibly by ‘a transient depression of T cell immunity’, and the complex interaction can ‘cause diagnostic uncertainty’. However, there are key differences - for example origin of LS is the jugular vein while Covid19 starts in the lungs (and this difference should result in Covid19 to be easier to treat). Co-infection of EBV and SARS-Cov2 leads to greater symptoms (fever, higher CRP) in a study of 67 patients. Enhanced pathogen testing kits, which include searching for these bacteria, could confirm this disruption in Covid19, and thus anaerobic-specific antibiotics could significantly help in therapy.
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