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Thread: Covid 19: adjuvant approaches etc,

  1. #1
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    Covid 19: adjuvant approaches etc,

    These are my thoughts, RE, possible approaches to dealing with the serious, albeit rare, complications of this virus

    NOTE: I’m not a medical doctor and I don’t play one on TV but I am capable of supplying information of potential value they may not be aware of, and they can parse out what’s worth trying.

    Two: this does not represent medical advice, and under no circumstances should anyone use the information that follows in place of medical advice and treatment from a qualified medical professional as it applies to the Covid-19 virus. What follows may be highly useful as adjuvant or complementary approaches to treatment of the most serious complications of Covid-19 along with traditional therapies in extremis medical situations due to complications from Covid-19. I fully admit the data is thin as it applies to what follows and this virus, but it follows the “first do no harm” mantra:


    Read article HERE
    Last edited by WillBrink; 03-29-20 at 12:32.
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    Not mentioned in my article above, and interesting paper on the potential benefits of Melatonin as adjuvant treatment

    COVID-19: Melatonin as a potential adjuvant treatment


    Abstract

    This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology.

    This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens.

    Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients. Additional experiments and clinical studies are required to confirm this speculation.

    Full paper:

    https://www.sciencedirect.com/scienc...24320520303313
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    Thought this was interesting and of possible value:

    Former CDC Chief Dr. Tom Frieden: Coronavirus infection risk may be reduced by Vitamin D

    "Vitamin D supplementation reduces the risk of respiratory infection, regulates cytokine production and can limit the risk of other viruses such as influenza. A respiratory infection can result in cytokine storms – a vicious cycle in which our inflammatory cells damage organs throughout the body – which increase mortality for those with COVID-19. Adequate Vitamin D may potentially provide some modest protection for vulnerable populations.

    This is especially important for people who are Vitamin D deficient – and, surprisingly, that might include more than 40 percent of US adults. People who live in the northern part of the U.S. are at greater risk of deficiency.

    There is evidence of seasonality in some respiratory illnesses, including influenza and tuberculosis. A leading hypothesis is that seasonality is due to the reduction in Vitamin D because of decreased exposure to sunlight in winter months. There is no seasonality of influenza or tuberculosis in some tropical climates (such as south India), where weather – and sunlight exposure – remains more constant throughout the year."

    Cont:

    https://www.foxnews.com/opinion/form...with-vitamin-d
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    An interesting addition:

    FRIDAY, March 27, 2020 (HealthDay News) -- The administration of vitamin C shortens the length of mechanical ventilation in critically ill patients, according to a review recently published in the Journal of Intensive Care.

    Harri Hemilä, M.D., Ph.D., from the University of Helsinki, and Elizabeth Chalker, from the University of Sydney, conducted a systematic literature search to identify controlled trials that analyzed the effect of vitamin C on ventilation time among patients in the intensive care unit.

    Based on eight studies (685 patients) included in the meta-analysis, the researchers found that vitamin C shortened the length of mechanical ventilation on average by 14 percent. Significant heterogeneity in the effect of vitamin C existed between the trials, which was fully explained by the ventilation time in the untreated control group. For patients with the longest ventilation, corresponding to the most severely ill patients, vitamin C was most beneficial. Among 471 patients (in five trials) requiring ventilation for more than 10 hours, a dosage of 1 to 6 g/day of vitamin C shortened ventilation time on average by 25 percent.

    Source:

    Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis

    Abstract
    Background

    Our recent meta-analysis indicated that vitamin C may shorten the length of ICU stay and the duration of mechanical ventilation. Here we analyze modification of the vitamin C effect on ventilation time, by the control group ventilation time (which we used as a proxy for severity of disease in the patients of each trial).
    Methods

    We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials and reference lists of relevant publications. We included controlled trials in which the administration of vitamin C was the only difference between the study groups. We did not limit our search to randomized trials and did not require placebo control. We included all doses and all durations of vitamin C administration. One author extracted study characteristics and outcomes from the trial reports and entered the data in a spreadsheet. Both authors checked the data entered against the original reports. We used meta-regression to examine whether the vitamin C effect on ventilation time depends on the duration of ventilation in the control group.
    Results

    We identified nine potentially eligible trials, eight of which were included in the meta-analysis. We pooled the results of the eight trials, including 685 patients in total, and found that vitamin C shortened the length of mechanical ventilation on average by 14% (P = 0.00001). However, there was significant heterogeneity in the effect of vitamin C between the trials. Heterogeneity was fully explained by the ventilation time in the untreated control group. Vitamin C was most beneficial for patients with the longest ventilation, corresponding to the most severely ill patients. In five trials including 471 patients requiring ventilation for over 10 h, a dosage of 1–6 g/day of vitamin C shortened ventilation time on average by 25% (P < 0.0001).
    Conclusions

    We found strong evidence that vitamin C shortens the duration of mechanical ventilation, but the magnitude of the effect seems to depend on the duration of ventilation in the untreated control group. The level of baseline illness severity should be considered in further research. Different doses should be compared directly in future trials.

    https://jintensivecare.biomedcentral...560-020-0432-y
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    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

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    The side effects of melatonin, dizziness and nausea are fairly severe in a large portion of those who use it, even with 2.5mg the nausea experienced is dreadful. Just a precaution to those who may wish to use it prophylactically.
    Last edited by Evel Baldgui; 03-30-20 at 21:09.

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    Quote Originally Posted by Evel Baldgui View Post
    The side effects of melatonin, dizziness and nausea are fairly severe in a large portion of those who use it, even with 2.5mg the nausea experienced is dreadful. Just a precaution to those who may wish to use it prophylactically.
    In my 20+ years in the biz, I have not met a single person who experienced such side effects, I and know some using very high doses. However, that is a side effect listed in the lit, so noted.
    Last edited by WillBrink; 04-06-20 at 08:05.
    - Will

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    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

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    Will discuss via pm.

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    Covid-19 and Vitamin D Information

    Dr Gareth Davies (PhD), Dr Joanna Byers (MBChB), Dr Attila R Garami (MD, PhD)

    Author Bios

    This document is for medical professionals only.

    Note: this is not (yet) a published, peer-reviewed article. We will reformat soon and publish as a preprint but links to all research in this document can be checked in advance of publication.

    Call for data: we ask ICUs to test serum levels, add D3 to treatment plans,
    measure outcomes and report. Early clinical evidence will support clinical trial applications.
    Please Test, Treat, Measure, Report.

    A 2-page summary of this report can be found here: bit.ly/VitDCovid19SummaryShort
    Posters for GPs and ICUs: bit.ly/VitDCovid19Posters

    Evidence strongly suggests Vitamin D supplements could be effective in preventing Covid-19, and play a key role in treating patients if added to existing treatment plans, especially if this is done early in the disease progression.

    Cont:

    https://docs.google.com/document/d/1...0Y/mobilebasic
    - Will

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    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

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    NAC is discussed in my OP article, but via IV admin, but Nebulized NAC is FDA approved for some lung conditions. A Dr. Quay, is studying a combination of Nebulized H-NAC and Heparin, in an attempt to prevent people from having to be Mechanical Ventilated:

    New COVID-19 HOPE Clinical Trial Recommendations Introduced Today May Reduce or Eliminate Mechanical Ventilation for Coronavirus Patients

    Published: Mar 30, 2020

    Crucial life-saving initiative led by Dr. Steven Quay for clinical trials on the safety and efficacy of a combination of FDA-approved drugs (nebulized Heparin-N-acetylcysteine in COVID-19 Patients by Evaluation of pulmonary function (HOPE))

    SEATTLE (GLOBE NEWSWIRE) -- Physician-scientist and inventor Dr. Steven Quay, MD, PhD, is announcing a new combination treatment with the potential to improve pulmonary function and reduce or eliminate mechanical ventilation in patients with the coronavirus infection. The treatment uses two drugs previously approved by the FDA for other conditions: nebulized (inhaled as a fine mist) heparin combined with N-acetylcysteine (NAC), termed “H-NAC." Dr. Quay is making this new clinical trial protocol (called the COVID-19 HOPE Trial) available for use by the worldwide medical community. Starting today, doctors around the world are invited to directly download the protocol free of charge at www.DrQuay.com.

    “Given the rapid growth in the number of new COVID-19 cases worldwide, and especially in the U.S., I made the decision to make the HOPE Trial documents immediately available,” said Steven Quay, M.D., Ph.D. “From my experience having invented seven FDA-approved pharmaceuticals over my career, it is my reasoned opinion that this has a high likelihood of success and should be quick to test given that these drugs are widely available. Nebulized H-NAC could become a valuable new tool for frontline COVID-19 treatment, as it should reduce or eliminate the need for a mechanical ventilator.”

    Cont:

    https://www.biospace.com/article/rel...irus-patients/
    Last edited by WillBrink; 04-06-20 at 09:21.
    - Will

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    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

  10. #10
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    Important for those on the front lines, please read and assess, share if valuable.

    NOTE: some of the recs found below share similarities with my OP article and what's been posted in this thread:

    "Mechanical Ventilation may be doing harm. We need to think of alternative treatment strategies."

    Developed and updated by Paul Marik, MD, Chief of Pulmonary and Critical Care Medicine Eastern Virginia Medical School, Norfolk, VA

    Full doc:

    https://www.evms.edu/media/evms_publ...9_Protocol.pdf
    - Will

    General Performance/Fitness Advice for all

    www.BrinkZone.com


    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

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