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Coronavirus Treatment : Can an Hydroxychloriquine plus Zinc Work?
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<blockquote data-quote="Nelson Vergel" data-source="post: 174402" data-attributes="member: 3"><p>From Harvard School of Medicine</p><p></p><p><strong>BASIC VIROLOGY, IMMUNOLOGY, AND PATHOGENESIS:</strong></p><p></p><ul> <li data-xf-list-type="ul">SARS-CoV-2 is a new virus belonging to the Coronavirus family, which includes less pathogenic strains responsible for the common cold, as well as the viruses responsible for SARS and MERS. It is genetically related to the coronavirus responsible for the SARS outbreak in 2003; the closest identified relative was isolated from bats.</li> </ul><p></p><ul> <li data-xf-list-type="ul">SARS-CoV-2 is spread primarily via droplet, though it can be aerosolized and can persist on plastic and stainless steel surfaces for up to 72 hours. Disinfectants with commercial concentrations of EtOH or H2O2 are effective.</li> </ul><p></p><ul> <li data-xf-list-type="ul">Microscopically, the virus is a ssRNA+ enveloped virus with a helical capsid, coated with S protein ‘studs,’ which facilitate receptor binding and membrane fusion. S protein binds to the ACE2 receptor of type 2 pneumocytes.</li> </ul><p></p><ul> <li data-xf-list-type="ul">People with severe COVID-19 have a cytokine storm and increased neutrophil migration to the lungs. Protection against reinfection is unclear; CD4+ Th1 and CD8+ cells both are part of the immune response to the virus.</li> </ul><p></p><ul> <li data-xf-list-type="ul">Lymphopenia is seen in COVID-19, presumably due to bone marrow suppression by the antiviral response.</li> </ul><p></p><p><strong>CLINICAL PRESENTATION OF COVID-19</strong></p><p></p><ul> <li data-xf-list-type="ul">Common symptoms: cough, fever, and fatigue; however, sputum, shortness of breath, myalgias, sore throat, headache, nasal congestion, and nausea/vomiting/diarrhea have also been reported.</li> </ul><p></p><ul> <li data-xf-list-type="ul">The elderly and those with comorbid conditions (most clearly cardiovascular disease, respiratory conditions, and cancer) are at higher risk for a more severe disease course and death. </li> </ul><p></p><ul> <li data-xf-list-type="ul">RT-PCR on respiratory samples is the current gold standard. Serologic antibody tests are undergoing FDA approval. </li> </ul><p></p><ul> <li data-xf-list-type="ul">Common lab findings: ↓lymphocytes, ↓platelets, ↑CRP. Higher inflammatory markers seen in more severe disease.</li> </ul><p></p><ul> <li data-xf-list-type="ul">Common chest CT findings: bilateral ground glass opacities, consolidations, and “crazy paving” patterns.</li> </ul><p></p><p><strong>TREATMENT OF COVID-19</strong></p><p></p><ul> <li data-xf-list-type="ul">Clinical outcomes include mild disease, pneumonia, severe pneumonia, ARDS, and septic shock.</li> </ul><p></p><ul> <li data-xf-list-type="ul">Case fatality rate estimated to be ~2%, but many cases likely remain undiagnosed.</li> </ul><p></p><ul> <li data-xf-list-type="ul">Triage: Mild symptoms - ~14-day home quarantine. Only admit if there is significant risk of decompensation. Moderate to severe symptoms - admit to the hospital in an airborne isolation room. ICU level care necessary for advanced ventilatory support or support for 2+ organ systems.</li> </ul><p></p><ul> <li data-xf-list-type="ul">Standard supportive measures: isolation, conservative fluid management; Possible supportive measures if comorbid conditions: empiric antibiotics, oseltamivir, bronchodilators; Advanced supportive measures: ventilatory support.</li> </ul><p></p><p><strong>INVESTIGATIONAL THERAPIES AND VACCINE DEVELOPMENT</strong></p><p></p><ul> <li data-xf-list-type="ul">There are currently no FDA-approved treatments directed against COVID-19 at this time (3/18/20). A variety of therapies are under investigation, however. These include repurposing of antivirals (remdesivir, lopinavir/ritonavir), antimalarials (chloroquine/hydroxychloroquine), and immunosuppressive medications (tocilizumab), or transfusing antibodies against SARS-CoV-2 analogs/SARS-CoV.</li> </ul><p></p><ul> <li data-xf-list-type="ul">It is expected that COVID-19 vaccine development will take a minimum of one year.</li> </ul></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 174402, member: 3"] From Harvard School of Medicine [B]BASIC VIROLOGY, IMMUNOLOGY, AND PATHOGENESIS:[/B] [LIST] [*]SARS-CoV-2 is a new virus belonging to the Coronavirus family, which includes less pathogenic strains responsible for the common cold, as well as the viruses responsible for SARS and MERS. It is genetically related to the coronavirus responsible for the SARS outbreak in 2003; the closest identified relative was isolated from bats. [/LIST] [LIST] [*]SARS-CoV-2 is spread primarily via droplet, though it can be aerosolized and can persist on plastic and stainless steel surfaces for up to 72 hours. Disinfectants with commercial concentrations of EtOH or H2O2 are effective. [/LIST] [LIST] [*]Microscopically, the virus is a ssRNA+ enveloped virus with a helical capsid, coated with S protein ‘studs,’ which facilitate receptor binding and membrane fusion. S protein binds to the ACE2 receptor of type 2 pneumocytes. [/LIST] [LIST] [*]People with severe COVID-19 have a cytokine storm and increased neutrophil migration to the lungs. Protection against reinfection is unclear; CD4+ Th1 and CD8+ cells both are part of the immune response to the virus. [/LIST] [LIST] [*]Lymphopenia is seen in COVID-19, presumably due to bone marrow suppression by the antiviral response. [/LIST] [B]CLINICAL PRESENTATION OF COVID-19[/B] [LIST] [*]Common symptoms: cough, fever, and fatigue; however, sputum, shortness of breath, myalgias, sore throat, headache, nasal congestion, and nausea/vomiting/diarrhea have also been reported. [/LIST] [LIST] [*]The elderly and those with comorbid conditions (most clearly cardiovascular disease, respiratory conditions, and cancer) are at higher risk for a more severe disease course and death. [/LIST] [LIST] [*]RT-PCR on respiratory samples is the current gold standard. Serologic antibody tests are undergoing FDA approval. [/LIST] [LIST] [*]Common lab findings: ↓lymphocytes, ↓platelets, ↑CRP. Higher inflammatory markers seen in more severe disease. [/LIST] [LIST] [*]Common chest CT findings: bilateral ground glass opacities, consolidations, and “crazy paving” patterns. [/LIST] [B]TREATMENT OF COVID-19[/B] [LIST] [*]Clinical outcomes include mild disease, pneumonia, severe pneumonia, ARDS, and septic shock. [/LIST] [LIST] [*]Case fatality rate estimated to be ~2%, but many cases likely remain undiagnosed. [/LIST] [LIST] [*]Triage: Mild symptoms - ~14-day home quarantine. Only admit if there is significant risk of decompensation. Moderate to severe symptoms - admit to the hospital in an airborne isolation room. ICU level care necessary for advanced ventilatory support or support for 2+ organ systems. [/LIST] [LIST] [*]Standard supportive measures: isolation, conservative fluid management; Possible supportive measures if comorbid conditions: empiric antibiotics, oseltamivir, bronchodilators; Advanced supportive measures: ventilatory support. [/LIST] [B]INVESTIGATIONAL THERAPIES AND VACCINE DEVELOPMENT[/B] [LIST] [*]There are currently no FDA-approved treatments directed against COVID-19 at this time (3/18/20). A variety of therapies are under investigation, however. These include repurposing of antivirals (remdesivir, lopinavir/ritonavir), antimalarials (chloroquine/hydroxychloroquine), and immunosuppressive medications (tocilizumab), or transfusing antibodies against SARS-CoV-2 analogs/SARS-CoV. [/LIST] [LIST] [*]It is expected that COVID-19 vaccine development will take a minimum of one year. [/LIST] [/QUOTE]
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Coronavirus Treatment : Can an Hydroxychloriquine plus Zinc Work?
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