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Thread: Covid 19: adjuvant approaches etc,

  1. #21
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    Not A study, but very much in line with recs and suggestive data already posted. I think this a win for covid patients.

    New York hospitals treating coronavirus patients with vitamin C

    The regimen is based on experimental treatments administered to people with the coronavirus in Shanghai, China, Weber said.

    “The patients who received vitamin C did significantly better than those who did not get vitamin C,” he said.

    “It helps a tremendous amount, but it is not highlighted because it’s not a sexy drug.”

    A spokesman for Northwell — which operates 23 hospitals, including Lenox Hill Hospital on Manhattan’s Upper East Side — said vitamin C was being “widely used” as a coronavirus treatment throughout the system, but noted that medication protocols varied from patient to patient.

    “As the clinician decides,” spokesman Jason Molinet said.

    About 700 patients are being treated for coronavirus across the hospital network, Molinet said, but it’s unclear how many are getting the vitamin C treatment.

    Cont:

    https://nypost.com/2020/03/24/new-yo...ith-vitamin-c/
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  2. #22
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    This one is more an FYI. I tend to think the hyper immune aspect of Covid can be mitigated via various existing approaches discussed in this thread, but it will be interesting to see how this turns out:

    Gents, and interesting development that may be of interest happening in FL:

    ‘Amazing potential.’ UM doctor to start stem cell trial for coronavirus patients

    A team of doctors at the University of Miami won emergency federal approval to use stem cell therapy on patients suffering severe lung inflammation from COVID-19. The treatment will begin this week, starting with a dozen patients.

    The UM Miller School of Medicine doctors are proposing to block the inflammation using an intravenous infusion of stem cells from umbilical cords, building on promising but limited results from a 10-patient study in China. The Food and Drug Administration granted immediate authorization for the trial earlier this week.

    Dr. Camillo Ricordi, a UM professor and stem cell therapy researcher, said the cells derived from one umbilical cord, which are typically discarded after a woman gives birth, could generate enough stem cells to treat over 10,000 patients. Stem cells have the capability of becoming specialized cells that sometimes repair damage, and the type taken from umbilical cords — known as mesenchymal stem cells — are adaptable to a number of uses.

    Cont:

    https://www.miamiherald.com/news/hea...242008576.html
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  3. #23
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    And speaking of stem cells, there is something seemingly worth pursuing as apparently early results looked very promising and follow up study will happen:

    "The stem cells were produced by RESTEM, a leading-edge biotechnology company dedicated to the discovery and development of cell-based therapeutics. RESTEM’s cells are grown from umbilical cord tissue by a proprietary process and reduce inflammation, thereby allowing tissue regeneration and healing to occur.

    The patients who received the treatment were on ventilation support and showed reduction of their oxygen requirement from 100 percent to less than 50 percent within days of the infusion. This was accompanied by a significant reduction in levels of various key circulating inflammatory markers, meaning the harmful inflammation crippling the lungs of all three patients was not only arrested but reversed.

    “The remarkable ability for these cells to mitigate inflammatory processes holds great promise for COVID-19 patients as well as for people with many other illnesses,” said Dr. Koehne, deputy director and chief of blood & marrow transplant at Miami Cancer Institute, part of Baptist Health, and Principal Investigator for the study, which is currently undergoing review at the FDA. “These patients have improved their lung status much more quickly than patients treated with other experimental therapies.”

    Cont:

    https://baptisthealth.net/baptist-he...aptist-health/
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  4. #24
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    As some of you are aware, they're seeing a Kawasaki like response in children exposed to Covid and it's been fatal in some.

    And what gets the hyper inflammation ball rolling during the acute phase? Oxidative stress apparantly:

    Oxidative stress and Kawasaki disease: how is oxidative stress involved from the acute stage to the chronic stage?

    Rheumatology (Oxford). 2017 Jan;56(1):6-13. doi: 10.1093/rheumatology/kew044. Epub 2016 Apr 18.

    Abstract

    Inflammation and oxidative stress are closely related. Further, oxidative stress plays an important role in the pathology of inflammation-based Kawasaki disease. An excessive in vivo production of reactive oxygen species increases oxidative stress in the body, which triggers an endless vicious spiral of inflammation reactions and reactive oxygen metabolites. This presumably forms diffuse vasculitis in the acute phase. Acute inflammation and oxidative stress can be rapidly controlled by treatments; however, they may remain for a long time. This has recently been identified as a problem in the chronic phase of Kawasaki disease. Generally, the presence of vascular inflammation and oxidative stress impairs blood vessels, leading to the onset of atherosclerosis, which is a widely recognized risk. The current discussion focuses on whether the same is valid for blood vessels in the chronic phase of Kawasaki disease.

    Full paper:

    https://academic.oup.com/rheumatolog...56/1/6/2631538

    Interesting to note, IV Vite C showed real promise and is mentioned in the paper above:

    Clinical Investigation

    Evaluation by High-Resolution Ultrasonography of Endothelial Function in Brachial Artery After Kawasaki Disease and the Effects of Intravenous Administration of Vitamin C

    https://www.jstage.jst.go.jp/article...0_908/_article
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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.”

  5. #25
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    Good review paper to check out that further supports use of whey, NAC, and other compounds that support GSH production:

    Endogenous deficiency of glutathione as the most likely cause of serious manifestations and death in patients with the novel coronavirus infection (COVID-19): a hypothesis based on literature data and own observations

    Based on an exhaustive literature analysis and own observations, I proposed a hypothesis that glutathione deficiency is exactly the most plausible explanation for serious manifestation and death in COVID-19 infected patients. The major risk factors established for severe COVID-19 infection and relative glutathione deficiency found in COVID-19 infected patients with moderate-to-severe illness have converged me to two very important conclusions: (1) oxidative stress contributes to hyper-inflammation of the lung leading to adverse disease outcomes such as acute respiratory distress syndrome, multiorgan failure and death; (2) poor antioxidant defense due to endogenous glutathione deficiency as a result of decreased biosynthesis and/or increased depletion of GSH is the most probable cause of increased oxidative damage of the lung, regardless which of the factors aging, chronic disease comorbidity, smoking or some others were responsible for this deficit. The hypothesis provides novel insights into the etiology and mechanisms responsible for serious manifestations of COVID-19 infection and justifies promising opportunities for effective treatment and prevention of the illness through glutathione recovering with N-acetylcysteine and reduced glutathione.

    Paper:

    https://www.researchgate.net/publica...re_data_and_ow
    - Will

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  6. #26
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    An open label study in the works examining NAC and Covid:

    A Study of N-acetylcysteine in Patients With COVID-19 Infection

    Brief Summary:

    The study researchers think that a medication called N-acetylcysteine can help fight the COVID-19 virus by boosting a type of cell in your immune system that attacks infections. By helping your immune system fight the virus, the researchers think that the infection will get better, which could allow the patient to be moved out of the critical care unit or go off a ventilator, or prevent them from moving into a critical care unit or going on a ventilator.

    The US Food and Drug Administration (FDA) has approved N-acetylcysteine to treat the liver side effects resulting from an overdose of the anti-inflammatory medication Tylenol® (acetaminophen). N-acetylcysteine is also used to loosen the thick mucus in the lungs of people with cystic fibrosis or chronic obstructive pulmonary disease (COPD). This study is the first to test N-acetylcysteine in people with severe COVID-19 infections.

    https://clinicaltrials.gov/ct2/show/NCT04374461
    - 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.”

  7. #27
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    Excellent paper on glutathione (GSH) and its importance in Covid infections:

    Endogenous deficiency of glutathione as the most likely cause of serious manifestations and death in patients with the novel coronavirus infection (COVID-19): a hypothesis based on literature data and own observations

    Based on an exhaustive literature analysis and own observations, I proposed a hypothesis that glutathione deficiency is exactly the most plausible explanation for serious manifestation and death in COVID-19 infected patients. The major risk factors established for severe COVID-19 infection and relative glutathione deficiency found in COVID-19 infected patients with moderate-to-severe illness have converged me to two very important conclusions: (1) oxidative stress contributes to hyper-inflammation of the lung leading to adverse disease outcomes such as acute respiratory distress syndrome, multiorgan failure and death; (2) poor antioxidant defense due to endogenous glutathione deficiency as a result of decreased biosynthesis and/or increased depletion of GSH is the most probable cause of increased oxidative damage of the lung, regardless which of the factors aging, chronic disease comorbidity, smoking or some others were responsible for this deficit. The hypothesis provides novel insights into the etiology and mechanisms responsible for serious manifestations of COVID-19 infection and justifies promising opportunities for effective treatment and prevention of the illness through glutathione recovering with N-acetylcysteine and reduced glutathione.

    https://www.researchgate.net/publica...re_data_and_ow
    - 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.”

  8. #28
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    The Cleveland Clinic FL sponsoring a study looking at C/zinc and covid.

    Coronavirus 2019 (COVID-19)- Using Ascorbic Acid and Zinc Supplementation (COVIDAtoZ)

    We aim to see whether ascorbic acid and zinc gluconate which has limited side effect profile and is readily available over the counter can decrease the duration of symptoms seen in patients with new diagnosis of COVID-2019. A secondary purpose is to see whether Zinc and/or Ascorbic acid supplementation can prevent progression of the severe manifestations of the disease including development of dyspnea and acute respiratory distress syndrome which may require hospitalization, mechanical ventilation, and or lead to death.

    This is a single-center, prospective, randomized study which plans to enroll 520 patients with a principal diagnosis of COVID-2019, managed in an outpatient setting, who presented after being sent by a healthcare provider to get tested and receive a PCR (Polymerase Chain Reaction) -assay based confirmed diagnosis of the disease. All patients who agree to participate in the study will answer a baseline questionnaire about their symptoms at the time of inclusion. Patients will then be randomized to one of 4 study arms. Patients in Arm A (n=130) will receive vitamin C (to be taken divided over 2-3 times a day with meals), patients in Arm B (n=130) will receive zinc gluconate to be taken at bedtime, patients in Arm C (n=130) will receive both vitamin C (to be taken divided over 2-3 times a day with meals) and zinc gluconate (taken at bedtime). Patients in arms A, B and C will take study supplements daily for 10 days. Patients in Arm D (n=130) will not receive any of the study medications and continue on standard of care. Patients will then track their symptoms daily from day 0 to day 28 answering 4 basic questions on illness severity. They will stop filling out their daily questions once they reach 0 for all categories or they reach the end of the 28 day study period. Study team members will call patients at days 7, 14, 21, and 28 of the study period to assess need for hospitalization, ER visit, or additional medications prescribed by a healthcare provider, and any side effects from the supplements that the patient could have experienced.


    https://clinicaltrials.gov/ct2/show/study/NCT04342728
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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.”

  9. #29
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    Another paper finds a correlation between D status and severity of Covid:

    Strong Correlation Between Prevalence of Severe Vitamin D Deficiency and Population Mortality Rate from COVID-19 in Europe

    Background: SARS-CoV-2 virus causes a very wide range of COVID-19 disease severity in humans: from completely asymptomatic to fatal, and the reasons behind it are often not understood. There is some data that Vitamin D may have protective effect, so authors decided to analyze European country-wide data to determine if Vitamin D levels are associated with COVID-19 population death rate. Methods: To retrieve the Vitamin D levels data, authors analyzed the Vitamin D European population data compiled by 2019 ECTS Statement on Vitamin D Status published in the European Journal of Endocrinology. For the data set to used for analysis, only recently published data, that included general adult population of both genders ages 40-65 or wider, and must have included the prevalence of Vitamin D deficiency. Results: There were 10 countries data sets that fit the criteria and were analyzed. Severe Vitamin D deficiency was defined as 25(OH)D less than 25 nmol/L (10 ng/dL). Pearson correlation analysis between death rate per million from COVID-19 and prevalence of severe Vitamin D deficiency shows a strong correlation with r = 0.76, p = 0.01, indicating significant correlation. Correlation remained significant, even after adjusting for age structure of the population. Additionally, over time, correlation strengthened, and r coefficient asymptoticaly increased.

    Conclusions: Authors recommend universal screening for Vitamin D deficiency, and further investigation of Vitamin D supplementation in randomized control studies, which may lead to possible treatment or prevention of COVID-19.

    https://www.medrxiv.org/content/10.1....24.20138644v1
    - 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. #30
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    FYI, I have updated the article linked in the OP with new data etc. discusses NAC. An interesting case study:

    COVID-19 Patient with Multifocal Pneumonia and Respiratory Difficulty Resolved Quickly: Possible Antiviral and Anti-Inflammatory Benefits of Quercinex (Nebulized Quercetin-NAC) as Adjuvant
    Robert Schettig, Trevor Sears, Matthew Klein, Ruth Tan-Lim, Ronald Matthias Jr., Christopher Aussems, Michael Hummel, Rory Sears, Zachary Poteet, Daniel Warren, John Oertle, Dino Prato

    Abstract: Background: SARS-CoV-2 (COVID-19) is a viral pandemic with no current vaccine or effective treatment. Hydroxychloroquine and azithromycin are not without cardiovascular risk or complications, and these treatments can fail to aid in full recovery from COVID-19. As new treatments become approved for the pandemic, an inexpensive, non-toxic, and safe adjunctive therapy is needed.

    Case Presentation: A 59-year-old male presented with respiratory symptoms. Chest X-ray revealed classic indications of COVID-19 pneumonia. A PCR nasopharyngeal swab test confirmed a COVID-19 infection and hospital doctors prescribed Rocephin, azithromycin, and hydroxychloroquine. The patient was then prescribed Quercinex, a nebulized formula of quercetin-(cyclodextrin) (20 mg/mL) and N-acetylcysteine (100 mg/mL) three times daily for 14 days by physicians at Envita Medical Center for continued COVID-19 respiratory symptoms. Following 30 minutes after each nebulization treatment, the patient experienced immediate deep breathing relief that lasted for multiple hours. Within the following 48 hours after the first treatment, respiratory symptoms continued to diminish and resolve quickly.

    Finally, post-treatment follow-up chest X-rays revealed no pulmonary fibrosis (scarring) and clear lung fields. Conclusion: The Quercinex formula appeared to greatly alleviate the unresolved respiratory symptoms rapidly. Several mechanisms of the formula, namely antiviral and anti-inflammatory action, with direct administration via nebulizer to the deep lung tissue, could potentially explain the fast and complete recovery. We recommend that the Quercinex formula be considered for further clinical study as an adjuvant or on its own for COVID-19 and possibly other viral pulmonary conditions.

    Cont:

    https://m.scirp.org/papers/101227?fb...RHSwvs1lhS0FhQ
    - Will

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    LE/Mil specific info:

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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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