Covid 19: adjuvant approaches etc,

[WillBrink]

Updated 1/30/22: These are my thoughts, RE, possible approaches to dealing with the serious, albeit rare, complications of this virus.

Updates include:

Why do some people on "on paper" seem like they should not have any problems with covid and get very sick while someone who has various co morbidity does not? It's may be due to their ACE/ACE II ratios. Excellent paper on that topic is linked.

What causes "long covid"? Likely the same thing the causes the serious complications and damage in acute phase of exposure: ROS formation... New review paper linked.

That's just some of the updated topics and sources added to the article that people need to understand, that continues to be overlooked, some might even say actively ignored.

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

[WillBrink]

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

[WillBrink]

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

[WillBrink]

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

[Evel Baldgui]

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.

[WillBrink]

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.

[Arik]

Can anyone confirm this one way or another?

https://www.independentsentinel.com/...unnecessarily/

"The American Medical Association has officially rescinded a previous statement against the use of Hydroxychloroquine (HCQ) in the treatment of COVID-19 patients. Physicians can use it at their discretion.


In March, the AMA had issued a statement that was highly critical of HCQ in regards to its use as a proposed treatment by some physicians in the early stages of COVID-19.

The AMA discouraged doctors from ordering the medication in bulk for “off-label” use. They use it for illnesses like malaria and rheumatoid arthritis.

The AMA also claimed that there was no proof that it was effective in treating COVID. They added it could be harmful in some instances.

As it happens, on page 18 of a recent AMA memo, issued on October 30 (resolution 509, page 3), the organization officially reversed its stance on HCQ. Now, they say its potential for good currently may supersede the threat of any potentially harmful side effects"



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[WillBrink]

Can anyone confirm this one way or another?

https://www.independentsentinel.com/...unnecessarily/

"The American Medical Association has officially rescinded a previous statement against the use of Hydroxychloroquine (HCQ) in the treatment of COVID-19 patients. Physicians can use it at their discretion.


In March, the AMA had issued a statement that was highly critical of HCQ in regards to its use as a proposed treatment by some physicians in the early stages of COVID-19.

The AMA discouraged doctors from ordering the medication in bulk for “off-label” use. They use it for illnesses like malaria and rheumatoid arthritis.

The AMA also claimed that there was no proof that it was effective in treating COVID. They added it could be harmful in some instances.

As it happens, on page 18 of a recent AMA memo, issued on October 30 (resolution 509, page 3), the organization officially reversed its stance on HCQ. Now, they say its potential for good currently may supersede the threat of any potentially harmful side effects"

What I found:

https://factcheck.afp.com/us-medical...19-treatment-0

[WillBrink]

Double tap. But, some studies of possible interest:

Meltzer DO, et al. Association of vitamin D status and other clinical characteristics with COVID-19 test results. JAMA Network Open. 2020; doi:10.1001/jamanetworkopen.2020.19722.
Carpagnano GE, et al. Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. Journal of Endocrinological Investigation. 2020; doi:10.1007/s40618-020-01370-x.
Castillo ME, et al. Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study. The Journal of Steroid Biochemistry and Molecular Biology. 2020; doi:10.1016/j.jsbmb.2020.105751.
Bergman P. The link between vitamin D and COVID-19: Distinguishing facts from fiction. Journal of Internal Medicine. 2020; doi:10.1111/joim.13158.
Vitamin D. National Institutes of Health. https://www.covid19treatmentguidelin...apy/vitamin-d/. Accessed Sept. 9, 2022.

[Arik]

And yet crickets from the "follow the science" crowd

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