SIAP: Covid-19 and Dexamethasone
Had not seen this posted, but Dexamethasone may be the first truly great news about a viable treatment for the most critically ill Covid-19 patients (i.e. those on ventilators or received oxygen support). To quote the article: "It cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth." I did a search and ironically, the drug was mentioned in late March as something that should NOT be used in treatments by a poster, highlighting the uncertainty in all this.
https://www.bbc.com/news/health-53061281
It's a cheap, widely available drug that's been around for 60+ years. In other articles, not the attached, I have read it is being used widely in a few major US hospital systems, with others now following suit based on these recent developments.
OT: what does SIAP stand for? I've seen it around, but no idea and google hasn't been helpful.
Sorry if already posted, I believe
LOL google very literally puts a BANNER at the top if you search "what does SIAP mean".
But he got an answer in literally one minute here, without having to visit another website so he laughs last.
I googled "SIAP" and "SIAP site:mgoblog.com," forgive me for not using google how it's supposed to be used and not doing the 80 year old grandpa move of asking Google questions when it's a search engine.
The 80-year-old grandpa method (phrasing the search as "what does siap mean") gets you better results than just searching for "siap" instead.
The Grandpa method gets me the meaning with the first result. The other method gets you the UN Statistical Institute for Asia and the Pacific as the first hit and frankly none of the results on the first page are applicable.
Mgoblog got you the result right away.
Disclaimer: thanks to machine learning and targeted advertising and all that, your search results may be different.
Yeah, but what do the Lycos search results tell you?
I am a traditionalist--I use Gopher for all my Internet searching needs!
Works for BPONE too.
Suck Igor's Adaptable Penis
They are also having success with low dose radiation.
Researchers at Emory University Hospital, led by Dr. Mohammad Khan, Associate Professor of Radiation Oncology, treated five COVID-19 patients with severe pneumonia who were requiring supplemental oxygen and whose health was visibly deteriorating. Their mean age was 90 with a range from 64 to 94, four were female, four were African-American, and one was Caucasian.
These patients were given a single low-dose of radiation (1.5 Gy) to both lungs, delivered by a front and back beam configuration. Patients were in an out of the Radiotherapy Department in 10 to 15 minutes.
Within 24 hours, four of the patients showed rapid improvement in oxygenation and mental status (more awake, alert and talkative) and were being discharged from the hospital 12 days later. Blood tests and repeated imaging of the lungs confirmed that the radiation was safe and effective, and did not cause adverse effects - no acute skin, pulmonary, gastrointestinal or genitourinary toxicities.
So, they shined sunlight *into* the body?
I know that you are trying to be clever, but the technology, Healight, is well on its way to being available. It was announced four days before Trump mentioned it. It is not clear if he was referencing this particular company or just generally speculating on the possibility. I read about it in the WSJ, but I believe the article is paywalled.
Well Trump wasn't referencing anything because he was just being a silly goose and "sarcastic"
Eh, it was absolutely clear he was not referencing that particular company. He described his thought process as if he was inventing it. So he was either a.)waxing poetically about something he clearly knows nothing about or b.)doing a horrible job of representing the achievements of a legitimate company. This convo shouldn't go off in a political direction. If you read his quotes apolitically, those are the only two ways his statements could be interpreted.
Here are some of the relevant quotes, emphasis mine:
“Supposing we hit the body with a tremendous — whether it’s ultraviolet or just very powerful light,” Mr. Trump said. “And I think you said that hasn’t been checked, but we’re going to test it?” “And then I said, supposing you brought the light inside the body, either through the skin or some other way.”
Sometimes, it's better to be lucky than good.
“Chance favors only the prepared mind”
-Louis Pasteur
Whether or not the president posses such a thing as a “prepared mind” when it comes to the complex matters of medicine and public health is probably outside the scope of this blog.
Okay, how about "Even a broken clock is right twice a day?"
This is not success. This is a near meaningless pilot study.
-ER NYC doctor
Originally it was stated that it wasn’t going to be used because they weren’t sure if lung function or the immune system was what needed to be the focus of the treatment. The fear was that while aiding the immune system this drug could attack the lung too much. Seems now that they feel the immune system needs to be the focus.
Small clarification... Dex would have no potential role in attacking the lungs. While steroids have a bunch of other issues (hypertension, steroid induced diabetes, fluid retention, mood lability, etc...) they don't harm the lungs. They're going to act as an immunosuppressant, so they don't "aid" the immune system in the sense they bolster the defenses. Quite the opposite, they tell the immune system to chill out. To your latter point, that's spot on, it does seem that the exaggerated immune response is what gets folks in the most trouble and steroids are excellent at tamping down that process.
The exaggerated immune response is essentially what is being seen with MIS-C (multisystem inflammatory syndrome in children) which is a syndrome seen in pediatric patients who were previously infected with COVID-19. Even the criteria for the disease requires more than 2 systems involved with increased inflammatory markers
Good summation. I had not heard that there was a concern about Dexamethasone or other steroids attacking the lungs. Seems spurious to me as steroids are frequently given for lung infections or issues, bronchitis, for example.
I haven't tracked treatments for covid a whole lot because it's not my field, but it surprised me that steroids were not a first line medication for a hyper inflammatory response.
Great news if it works in larger-scale testing.
Steroids suppress the immune system in a lot of different ways and cause fluid retention - both are very undesirable in a case of a infection that often results in a pneumonia. However, once the benefit outweighs those risks (extreme inflammation of the lungs that prevents gas exchange even with ventilation), it's a very effective anti-inflammatory and could potentially save lives in the extreme cases. This isn't anything new though and it has been in the playbook since COVID started. As you said, they've been around for pretty much all of modern medicine. Cortisone was used in the late 40's. We have a lot of experience with using them and it's usually reserved for non-infectious inflammatory processes (autoimmune or asthma-type stuff) due to severe immunosuppression. It's even used explicitly to cause this in the case of organ transplantation to prevent rejection.
Of course, in the case of cytokine storm, suppressing the immune system could be a good thing and this is probably why we’re seeing these results. So it may cause us to rethink the aversion to corticosteroids in infections.
Edit:
Personally, I'm more of a tocilizumab kind of guy when it comes to cytokine storms. But steroids are cheaper, more readily available, and pretty safe. Wouldn't surprise me if "standard therapy" ended up including both treatments.
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30162-0/fulltext
This steroid is actually used by mountainclimbers who are suffering from altitude sickness becuase they are finding that COVID is not attacking the lungs but actually blood cells, specifically stripping red blood cells of nitrogen. Why is N important? Because it helps to exchange CO for O in the lungs. In essence, COVID is causing people to suffocate, much like they do from altitude sickness. Thus, it should be logical that a steroid that allows people to quickly from altitude sickness would assist in helping those who were struggling to breathe for lack of oxygen.
Know what else is good for altitude sickness?
Cocaine.
So I'm set.
This is not correct.
I've been prescribed prednisone for times when my immune system gets overly aggressive and I break out into a rash which basically nothing else can stop once it gets started. I've been wondering if the same type of steroid treatment would work for cases where the damage is coming from basically the bodies response to the virus which I believe is the main cause for death in coronavirus.
But like others no doubt heard early on they decided to not go that route and I can't remember why but like with my case the skin is just another organ so hopefully this helps. Prednisone and dexamethasone are both corticosteroids and both are cheap even without insurance.
Side note for a long time doctors thought that rashes I would get were the result of poison ivy or oak or something else and it wasn't until I saw a nurse practitioner in Northern Michigan on vacation one day that she listened and then correctly identified it as a result of stress. Since that time like 10 years ago I have only had the issue once more and now know that if my wrists start to itch I start to look for ways to reduce stress etc.
I've had to do the same. Prednisone is some very nasty shit.
I took it when I found out I was allergic to pencillin in my late 20's. I broke out in such intense hives, I couldn't sleep and the itch was so bad, I had to lay on a scratchy rug to scratch my back. My throat started to close up as well. The prednisone saved me. But yes, they don't like patients to take it more than they need to.
Ok, so just to be clear about these drugs, they are immuno suppressors. They suppress your immune system. Some of the most severe cases of covid-19 are when your own immune system over-reacts because it can't figure out the bug. So, these may be life saving drugs in these extreme cases, but ABSOLUTELY SHOULD NOT be taken if you only have mild symptoms or as a preventative. DO NOT TAKE IMMUNO-SUPPRESSORS UNLESS YOUR IMMUNE SYSTEM IS DESTROYING YOUR OWN BODY.
Yeah, if you hadn't said it I would have. The whole regime of Covid-19 treatment is a mix of accelerators and brakes, and this is the best widely available brake so far (the cheapest, at least). But you don't step on the brakes when you need the gas and vice versa, or bad things happen.
Cautiously optimistic. We’ve gone through a bundle of medications claiming to be the silver bullet, none of which have, as of yet, been proven to universally treat Covid specifically, but apparently symptoms related to it.
IE, anything to keep people alive is great news, but it seems none have been a one treatment fits all, hence none have passed clinical trials as THE standard recovery med.
Perhaps this needs to be the more realistic approach until if/when a universal vaccine arrives.
https://twitter.com/KavinderMd/status/1274772379894460427?s=19
"A not heavily reported on factor is we are much much better at treatment now than we were 3 months ago. The major clinical breakthrough was treating cover more as a vasculitis and not as a viral pneumonia as it was initially treated."
Some interesting and related notes from this doctor. I remember a while ago seeing that heart disease was actually the biggest risk factor, not smoking or lung disease.
I've read that statins may be effective in treating and/or may be a therapeutic because of the vascular inflammation. They're also readily available and cheap, though I don't think they've figured out how they might fit into the puzzle.
I give it roughly a week before the drug is pulled. The powers that be have obviously not killed enough people yet.
Is this sarcasm? You think that the United States government or some shadow organization is going to rid the world of a safe drug that's been around for 70yrs so that more people will die? GTFO with that nonsense. Seriously. That is a bad take and you should feel bad having typed it while thinking you were on a 4Chan board (unless you're being sarcastic, in which case, maybe be more clearly sarcastic)
It will however, ruin your chances to make the Olympics
My poop is a treatment. Thatsy why I pwped
It's no Hydroxychloroquine, that stuff was a game changer.
Well, we have 63 million doses on hand in case Malaria cones to Florida.
Dexamethasone is readily available, but over the past year we have been dealing with shortages of it, well before the pandemic.
Can't wait till China repays the world for this negligence versus the world propping up China.
Do you think they have the class to actually own up?
No fucking chance. More likely they start a new pandemic from their careless use of animal products to maintain an erection - than the world gets any retribution.
Leronlimab by Cytodyn (CYDY). Look it up and get in on the stock before it shoots up. Can shut down the cytokine cascase of Covid and also will be first line therapy for HIV.
Promising and many hospitals will likely give it to patients requiring suppl oxygen. But we really need a 2nd trial to confirm. I'll be the 2nd trial will have a smaller effect size (hopefully still positive though!).
Great.