Covid 19 Sci/med discussions only

**WillBrink** · 04-15-20, 10:33

Other thread is closed, this one intended strictly discussion and dissemination of sci/med info for med pros and or those involved/interested, and might also pass info along. This thread is for medical info of value only:

What continues to rise to the top is that what they see is not classic ARDs, and intubation may cause more harm than good in some patients. There may be two distinct phenotypes that dictate different approaches. Please view this vid, and following vid linked. Doc posted below that has similar details and a recommended protocol.

Kyle-Sidell, ER and Critical Care MD working in NYC on the front lines:

Great interview with Dr Kyle-Sidell via Web MD with specific details:

"Do COVID-19 Vent Protocols Need a Second Look?"

https://www.youtube.com/watch?v=Elgct0nOcKY

Best document I have seen to date that it's not classic ARDS for many and recommended treatment protocol: EVMS CRITICAL CARECOVID-19 MANAGEMENT PROTOCOL by Paul Marik, MD Chief of Pulmonary and Critical Care Medicine Eastern Virginia Medical School. Med pros need to read this and pass it around!

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

My model and suggestions for adjuvant treatment of serious complications:

https://brinkzone.com/life-saving-st...complications/

**scooter22** · 04-15-20, 10:36

I think the most important update is how we treat the H vs L phenotyopes:

https://www.esicm.org/wp-content/upl...thor-proof.pdf

**WillBrink** · 04-15-20, 11:06

Originally Posted by scooter22

I think the most important update is how we treat the H vs L phenotyopes:

https://www.esicm.org/wp-content/upl...thor-proof.pdf

Good read. Outside my lane but I'd only add that note transitioning from type L to type H appears to have inflammation (cytokine storm?), and that aspect needs to be addressed asap in the type L person to prevent their transition to type H, and where perhaps a serious treatment gap exists and opportunity lost.

That's my non medical opinion. These are my thoughts on cytokine storm and inflammation due to possible massive release of iron ions and other factors:

https://brinkzone.com/life-saving-st...complications/

**WillBrink** · 07-10-20, 15:38

Originally Posted by WillBrink

Good read. Outside my lane but I'd only add that note transitioning from type L to type H appears to have inflammation (cytokine storm?), and that aspect needs to be addressed asap in the type L person to prevent their transition to type H, and where perhaps a serious treatment gap exists and opportunity lost.

That's my non medical opinion. These are my thoughts on cytokine storm and inflammation due to possible massive release of iron ions and other factors:

https://brinkzone.com/life-saving-st...complications/

Just updated the above article.

**ABNAK** · 04-15-20, 13:35

Originally Posted by scooter22

I think the most important update is how we treat the H vs L phenotyopes:

https://www.esicm.org/wp-content/upl...thor-proof.pdf

And does one confer immunity to the other? For that matter, since COVID-19 is relatively new do we really know about long-term immunity? I keep hearing (paraphrasing here) that once you get it and survive you're GTG. That may not be the case, especially for the longer term when it could appear next year or for several years.

**WillBrink** · 04-15-20, 14:31

Originally Posted by ABNAK

And does one confer immunity to the other? For that matter, since COVID-19 is relatively new do we really know about long-term immunity? I keep hearing (paraphrasing here) that once you get it and survive you're GTG. That may not be the case, especially for the longer term when it could appear next year or for several years.

We also keep hearing consistently or some getting re infected, but what % and how reliable that is, is unclear.

https://www.reuters.com/article/us-c...-idUSKCN20M124

**ABNAK** · 04-15-20, 14:38

Originally Posted by WillBrink

We also keep hearing consistently or some getting re infected, but what % and how reliable that is, is unclear.

https://www.reuters.com/article/us-c...-idUSKCN20M124

From that article:

"The virus also could be “biphasic”, meaning it lies dormant before creating new symptoms."

Lovely.....

**WillBrink** · 04-15-20, 14:48

Originally Posted by ABNAK

From that article:

"The virus also could be “biphasic”, meaning it lies dormant before creating new symptoms."

Lovely.....

It's the gift that keeps on giving. Let's hope that's not the case.

**ABNAK** · 04-15-20, 13:42

Originally Posted by scooter22

I think the most important update is how we treat the H vs L phenotyopes:

https://www.esicm.org/wp-content/upl...thor-proof.pdf

From the article you linked:

"These severely hypoxemic patients despite sharing a single
etiology (SARS-CoV-2) may present quite differently from one another: normally breathing (“silent”
hypoxemia) or remarkably dyspneic; quite responsive to nitric oxide or not; deeply hypocapnic or
normo/ hypercapnic; and either responsive to prone position or not. Therefore, the same disease
actually presents itself with impressive non-uniformity."

Kind of scary how it manifests itself at this stage, not to mention the weird symptoms that can indicate COVID-19 infection that normally wouldn't be associated with a predominantly respiratory illness. Like nailing jello to the wall.