SARS-CoV2 treatment

Covid-19 discussion, bring your own statistics
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shpalman
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Re: SARS-CoV2 treatment

Post by shpalman » Mon Apr 06, 2020 11:41 pm

molto tricky

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Re: SARS-CoV2 treatment

Post by Matatouille » Tue Apr 07, 2020 7:47 am

shpalman wrote:
Mon Apr 06, 2020 11:41 pm
ChubbyEmu on hydroxychloroquine
That was good, but (unless I missed it) he didn't list the most glaring fault in the study of this stuff IMO: Patients in the control arm were counted as dropouts if they died. Death seems to be a pretty relevant thing to measure, not remove from your results.

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Re: SARS-CoV2 treatment

Post by raven » Tue Apr 07, 2020 1:06 pm

shpalman wrote:
Mon Apr 06, 2020 11:41 pm
ChubbyEmu on hydroxychloroquine
Cheers for that, very informative.

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Re: SARS-CoV2 treatment

Post by basementer » Sat Apr 11, 2020 3:01 am

Matatouille wrote:
Tue Apr 07, 2020 7:47 am
shpalman wrote:
Mon Apr 06, 2020 11:41 pm
ChubbyEmu on hydroxychloroquine
That was good, but (unless I missed it) he didn't list the most glaring fault in the study of this stuff IMO: Patients in the control arm were counted as dropouts if they died. Death seems to be a pretty relevant thing to measure, not remove from your results.
He covers that in another video - https://www.youtube.com/watch?v=smI60BngTns
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Re: SARS-CoV2 treatment

Post by shpalman » Sat Apr 11, 2020 9:49 am

basementer wrote:
Sat Apr 11, 2020 3:01 am
Matatouille wrote:
Tue Apr 07, 2020 7:47 am
shpalman wrote:
Mon Apr 06, 2020 11:41 pm
ChubbyEmu on hydroxychloroquine
That was good, but (unless I missed it) he didn't list the most glaring fault in the study of this stuff IMO: Patients in the control arm were counted as dropouts if they died. Death seems to be a pretty relevant thing to measure, not remove from your results.
He covers that in another video - https://www.youtube.com/watch?v=smI60BngTns
Thanks for that - I hadn't seen it because it was on a different channel.
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Re: SARS-CoV2 treatment

Post by sTeamTraen » Sun Apr 12, 2020 12:27 am

Someone is trying to convince me of the merits of ozone as a treatment. "Apparently" it worked well in Italy. I found this paper. Thoughts? (Googling for "ozone therapy" brings up a large amount of woo.)
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Re: SARS-CoV2 treatment

Post by shpalman » Sun Apr 12, 2020 6:14 am

sTeamTraen wrote:
Sun Apr 12, 2020 12:27 am
Someone is trying to convince me of the merits of ozone as a treatment. "Apparently" it worked well in Italy. I found this paper. Thoughts? (Googling for "ozone therapy" brings up a large amount of woo.)
I hadn't heard of it. They really seem to think they have a hammer and that everything is a nail.
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Re: SARS-CoV2 treatment

Post by jdc » Sun Apr 12, 2020 9:53 pm

Boustrophedon wrote:
Sat Apr 04, 2020 5:01 pm
It would be interesting if both BCG and Thalidomide are effective against leprosy: One wonders what biochemistry is shared by SARS-CoV-2 and Mycobacterium leprae?
Dunno about thalidomide (isn't that for treating symptoms rather than preventing infection?) but from my reading of the Bloomberg piece BCG has a general effect which would apply to unrelated infections and there doesn't need to be any similarity in biochemistry for this.
“It can boost the immune system so that it defends better against a whole range of different infections, a whole range of different viruses and bacteria in a lot more generalized way,”
probably by enhancing the body’s innate immune system -- specifically white blood cells that target non-specific pathogens before an antibody response has kicked in
I found this WHO report: https://www.who.int/immunization/sage/m ... online.pdf which distinguishes between the specific effect of BCG in protecting against leprosy and the non-specific effects which protect against any old infection.
BCG vaccination has been reported to have non-specific (‘heterologous’) effects (NSE), which, like the
specific effects of BCG, may differ between genotypes and manufacturers.51,83,84,85 The implications of these
effects, and the settings and circumstances in which they are clinically important need to be more clearly
defined.86,87,88,89,90 The NSE of BCG should not be confused with the specific and cross-protective effects of
BCG vaccination against M. leprae, M. ulcerans and other non-tuberculous mycobacteria
.
NSE of BCG vaccination:
A recent systematic review by Higgins et al166 concluded that BCG vaccination was associated with a
reduction in all-cause mortality of approximately 50%. Because TB is an infrequent cause of death in infants
and young children, this reduction is unlikely to be entirely due to fewer deaths from the disease. It is
postulated that, in high mortality settings, BCG’s immunomodulatory effects reduce all-cause mortality by
also preventing infections other than TB.93

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Re: SARS-CoV2 treatment

Post by shpalman » Mon Apr 13, 2020 9:44 am

There's probably a reason that there are only Italian results for this: a vet at the University of Camerino thinks that since feline enteric coronavirus is bad, it might be worth trying L-Asparaginase because something something glycosylation.

The protocol also includes chloroquine, because of course it does, and heparin.

All that's happened is that it's been patented, because you can patent any old sh.t in the US.
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Re: SARS-CoV2 treatment

Post by tom p » Fri Apr 17, 2020 12:03 pm

This isn't really about a treatment (it's about chloroquine, which unless you're a French fraudster (and yes, what he did is tantamount to fraud, so dodgy was his data & the fact that he knew exactly what he was doing), an orange moron or a Polish friend of the orange moron, isn't a cure), but I'm sure it will brighten up everyone's day to learn that there is a chloquine-containing drug in Bangladesh called "Clit".
I expect it will stimulate the patient so they'll have it licked in no time.

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Re: SARS-CoV2 treatment

Post by Gfamily » Fri Apr 17, 2020 12:28 pm

tom p wrote:
Fri Apr 17, 2020 12:03 pm
This isn't really about a treatment (it's about chloroquine, which unless you're a French fraudster (and yes, what he did is tantamount to fraud, so dodgy was his data & the fact that he knew exactly what he was doing), an orange moron or a Polish friend of the orange moron, isn't a cure), but I'm sure it will brighten up everyone's day to learn that there is a chloquine-containing drug in Bangladesh called "Clit".
I expect it will stimulate the patient so they'll have it licked in no time.
If you can find it.
My avatar was a scientific result that was later found to be 'mistaken' - I rarely claim to be 100% correct
ETA 5/8/20: I've been advised that the result was correct, it was the initial interpretation that needed to be withdrawn
Meta? I'd say so!

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Re: SARS-CoV2 treatment

Post by shpalman » Sat Apr 18, 2020 8:02 am

https://twitter.com/DrChrisMoulton/stat ... 65377?s=19
Ventilating patients with Covid-19 seems to drive the infection deeper into the lungs and doesn’t save many lives. We urgently need the results of the PRCTs of ventilation versus non-invasive oxygen therapy in patients with this poorly understood infection.
Somebody in a reply linked to https://warwick.ac.uk/fac/sci/med/resea ... covery-rs/
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Re: SARS-CoV2 treatment

Post by Brightonian » Thu Apr 23, 2020 12:20 pm

Ventilators can do more harm than good, it says here: https://www.statnews.com/2020/04/21/cor ... ntilators/

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Re: SARS-CoV2 treatment

Post by FlammableFlower » Fri Apr 24, 2020 5:21 pm

mAbs (monoclonal antibodies) are stupidly expensive and very difficult to develop. One of the hardest things is production on any kind of scale.

Thalidomide is a really interesting example of a (many) repurposed drug. It's teratogenic effects come from its anti-angiogenesis effects which have now been utilised to arrest cancer growth.

All this throwing the kitchen sink at covid is interesting for me - we have a third year literature essay where each academic sets a title that the students then pick and mine is on drug repurposing. It means I might get some different reports in future...

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Re: SARS-CoV2 treatment

Post by AMS » Fri Apr 24, 2020 6:12 pm

FlammableFlower wrote:
Fri Apr 24, 2020 5:21 pm
mAbs (monoclonal antibodies) are stupidly expensive and very difficult to develop. One of the hardest things is production on any kind of scale.
Is that still the case? There are some pretty big bioreactors out there now (15,000 L or more).

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Re: SARS-CoV2 treatment

Post by FlammableFlower » Fri Apr 24, 2020 8:17 pm

It's a good point. To be honest, it's a while since I've properly looked. I would have thought though that that scale would be for a mature, developed product.

Although... this is a situation where you have one hell of a market if you can develop it. It'll need to through several levels of scale.

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Re: SARS-CoV2 treatment

Post by shpalman » Mon Apr 27, 2020 9:07 pm

molto tricky

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Re: SARS-CoV2 treatment

Post by sTeamTraen » Sat May 02, 2020 11:13 am

MMR vaccine may prevent, or mitigate effects of, SARS-CoV-2.

I guess this would explain why most children seem to cope with the disease pretty well (but I haven't read the full article, and it seems that precisely this observation is what led the authors to investigate this idea).

It's always been a bit ironic that the solution to this crisis will require the anti-vaxx loons to get vaccinated, but it would be absolutely f.cking hilarious if it was MMR.
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Re: SARS-CoV2 treatment

Post by raven » Sat May 02, 2020 4:33 pm

It would be hilarious.

More seriously, it's safe, we have it on hand in quantity, we could start doing it tommorow, so there's some advantages.

But.

Is it likely that MMR would also protect from Covid-19? Would that be full protection or only partial?

We must already have pretty high levels of immunity to measles, mumps and rubella in the population. Certainly many of us oldies actually had them as children, so if immunity was protective against Covid-19 we'd be seeing it in those age groups too I'd have thought, not just the under 25s who've had MMR.

Although I suppose it depends on whether 'natural' immunity is as good as immunity after a vaccine. I thought it was. The immunity to mumps after MMR might possibly fade over time, or at least some of the cases at universities recently have been students who've had the vaccine. But I've never heard of anyone getting mumps after they've had it as a child.

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Re: SARS-CoV2 treatment

Post by jdc » Sat May 02, 2020 7:23 pm

raven wrote:
Sat May 02, 2020 4:33 pm
It would be hilarious.

More seriously, it's safe, we have it on hand in quantity, we could start doing it tommorow, so there's some advantages.

But.

Is it likely that MMR would also protect from Covid-19? Would that be full protection or only partial?

We must already have pretty high levels of immunity to measles, mumps and rubella in the population. Certainly many of us oldies actually had them as children, so if immunity was protective against Covid-19 we'd be seeing it in those age groups too I'd have thought, not just the under 25s who've had MMR.

Although I suppose it depends on whether 'natural' immunity is as good as immunity after a vaccine. I thought it was. The immunity to mumps after MMR might possibly fade over time, or at least some of the cases at universities recently have been students who've had the vaccine. But I've never heard of anyone getting mumps after they've had it as a child.
Not sure our levels of natural immunity would be that high. Measles is the most contagious of those three so we would have had higher levels of natural immunity against this, and notifications before 1968 were about 1-2% of the population. Ish. Dunno if every case would have been notified but I think that they were meant to be (and looking at the deaths they seem to be in the 1 per 2500-5000 notifications range for the 1950s and 60s). It might be a bit higher than 1-2% if not all cases were notified but I'd be surprised if it was even remotely close to the figures for vaccine coverage - especially once MMR was introduced.

afaik, natural immunity does tend to last longer than vaccine-induced but this is more pronounced with some vaccines than others (I think waning immunity was particularly a problem with the pertussis vaccine).

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Re: SARS-CoV2 treatment

Post by jdc » Sat May 02, 2020 7:31 pm

raven wrote:
Sat May 02, 2020 4:33 pm
Is it likely that MMR would also protect from Covid-19? Would that be full protection or only partial?
Looks to me like they're suggesting people who've had MMR might be less ill with Covid-19 rather than being fully protected.
we hypothesize that MMR could protect against poor outcome in COVID-19 infection. As an initial test of this hypothesis, we identified that 1) age groups that most likely lack of MMR vaccine-induced immunity had the poorest outcome in COVID-19, and 2) COVID-19 disease burden correlates with rubella antibody titres, potentially induced by SARS-CoV2 homologous sequences

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Re: SARS-CoV2 treatment

Post by jdc » Sat May 02, 2020 8:54 pm

I'm being thick here. It's ~1% per year isn't it.

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Re: SARS-CoV2 treatment

Post by JQH » Sat May 02, 2020 9:08 pm

jdc wrote:
Sat May 02, 2020 7:31 pm
raven wrote:
Sat May 02, 2020 4:33 pm
Is it likely that MMR would also protect from Covid-19? Would that be full protection or only partial?
Looks to me like they're suggesting people who've had MMR might be less ill with Covid-19 rather than being fully protected.
we hypothesize that MMR could protect against poor outcome in COVID-19 infection. As an initial test of this hypothesis, we identified that 1) age groups that most likely lack of MMR vaccine-induced immunity had the poorest outcome in COVID-19, and 2) COVID-19 disease burden correlates with rubella antibody titres, potentially induced by SARS-CoV2 homologous sequences
Those most likely to have not had the MMR are older and thus more likely to have additional health problems and therefore more likely to have a poorer covid19 outcome.
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Re: SARS-CoV2 treatment

Post by basementer » Sat May 02, 2020 10:57 pm

JQH wrote:
Sat May 02, 2020 9:08 pm
jdc wrote:
Sat May 02, 2020 7:31 pm
raven wrote:
Sat May 02, 2020 4:33 pm
Is it likely that MMR would also protect from Covid-19? Would that be full protection or only partial?
Looks to me like they're suggesting people who've had MMR might be less ill with Covid-19 rather than being fully protected.
we hypothesize that MMR could protect against poor outcome in COVID-19 infection. As an initial test of this hypothesis, we identified that 1) age groups that most likely lack of MMR vaccine-induced immunity had the poorest outcome in COVID-19, and 2) COVID-19 disease burden correlates with rubella antibody titres, potentially induced by SARS-CoV2 homologous sequences
Those most likely to have not had the MMR are older and thus more likely to have additional health problems and therefore more likely to have a poorer covid19 outcome.
Yes. They appear to be conjecturing vaccination status from age, when they really ought to be disentangling the two.
Money is just a substitute for luck anyway. - Tom Siddell

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Re: SARS-CoV2 treatment

Post by raven » Sat May 02, 2020 11:00 pm

jdc wrote:
Sat May 02, 2020 8:54 pm
It's ~1% per year isn't it.

I'd guess so. If lots of people have been exposed, it's only the youngest cohort & those who've missed it previously that are susceptible. And as measles has an Ro of 12-18 it would be really suprising if only 1% of the population had had it.

(Wikipedia has values for common infectious diseases here. They're all pretty high.)

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