fishweewee

New coronavirus - it's pretty bad.

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Interesting article in recent Lancet.

 

The virus "greatly resembles SARS."

 

Cytokine release and pneumonia is the major killer.  


The virus is making your immune system your enemy.  


Interestingly, they're saying steroids (the usual Tx for CRS) should be used sparingly.

 

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

 

Prof Chaolin Huang, MD * Yeming Wang, MD * Prof Xingwang Li, MD * Prof Lili Ren, PhD * Prof Jianping Zhao, MD * Yi Hu, MD * et al.

Published:January 24, 2020

 

*snip*

 

We report here a cohort of 41 patients with laboratory-confirmed 2019-nCoV infection. Patients had serious, sometimes fatal, pneumonia and were admitted to the designated hospital in Wuhan, China, by Jan 2, 2020. Clinical presentations greatly resemble SARS-CoV. Patients with severe illness developed ARDS and required ICU admission and oxygen therapy. The time between hospital admission and ARDS was as short as 2 days. At this stage, the mortality rate is high for 2019-nCoV, because six (15%) of 41 patients in this cohort died.

 

The number of deaths is rising quickly...

 

The pathophysiology of unusually high pathogenicity for SARS-CoV or MERS-CoV has not been completely understood. Early studies have shown that increased amounts of proinflammatory cytokines in serum (eg, IL1B, IL6, IL12, IFNγ, IP10, and MCP1) were associated with pulmonary inflammation and extensive lung damage in SARS patients.22 

 

MERS-CoV infection was also reported to induce increased concentrations of proinflammatory cytokines (IFNγ, TNFα, IL15, and IL17).23 We noted that patients infected with 2019-nCoV also had high amounts of IL1B, IFNγ, IP10, and MCP1, probably leading to activated T-helper-1 (Th1) cell responses. Moreover, patients requiring ICU admission had higher concentrations of GCSF, IP10, MCP1, MIP1A, and TNFα than did those not requiring ICU admission, suggesting that the cytokine storm was associated with disease severity...

 

A biotech co put out a press release putting this into perspective (this hit my newsfeed, I am a biotech stock analyst but not

 

CytoSorb, the Wuhan Coronavirus, and Cytokine Storm

 

MONMOUTH JUNCTION, N.J., Jan. 28, 2020 /PRNewswire/ -- CytoSorbents Corporation (NASDAQ: CTSO), a critical care immunotherapy leader with more than 80,000 global treatments of its CytoSorb® blood purification technology to treat deadly inflammation in critically-ill and cardiac surgery patients around the world, highlights the recent publication in The Lancet entitled, "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China."  The article notes the correlation of high levels of circulating inflammatory cytokines, or "cytokine storm," with severity of illness in patients infected with the Wuhan coronavirus (2019-nCoV).  These data provide the rationale to potentially use CytoSorb, the first specifically-approved extracorporeal cytokine adsorber in the European Union, in this setting.  CytoSorb is distributed in 58 countries worldwide, and is available in Hong Kong, Vietnam, Malaysia, France, and Australia where patients infected with the virus have been reported.

 

In this publication, Huang, et al. describe the characteristics and clinical course of hospitalized patients infected with the Wuhan coronavirus who did, or did not, require treatment in the intensive care unit (ICU).  Those that were admitted to the ICU, particularly those with severe disease, exhibited significantly higher levels of inflammatory cytokines compared to those that did not.  This "cytokine storm" can trigger a viral sepsis in coronavirus infection, where viral replication and excessive, uncontrolled systemic inflammation can lead to pneumonitis, acute respiratory distress syndrome, respiratory failure, shock, organ failure, secondary bacterial pneumonia, and potentially death.  This same correlation between cytokine storm and severity of illness was observed previously in both SARS and MERS patients.

 

Dr. Phillip Chan, MD, PhD, Chief Executive Officer of CytoSorbents stated, "CytoSorb has been used to control deadly inflammation in tens of thousands of treatments in patients with either bacterial or viral sepsis.  Although CytoSorb has not yet been specifically used to treat patients infected with this newly emergent coronavirus, we believe it can play an important role, with or without anti-viral therapies, in the treatment of this highly inflammatory illness."

 

The Wuhan coronavirus has a relatively asymptomatic incubation period for up to 14 days, often marked only by dry cough and fatigue, when the afflicted can transmit the virus to others, followed by fever and the development of viral pneumonia.  The spread of the coronavirus has also been facilitated by international travel.

 

Researchers in Hong Kong have warned that the number of people infected by the Wuhan coronavirus (2019-nCoV) could be 30 times more than the reported 4,500 cases that have killed 106 people already, with now 5 confirmed cases and more than 100 suspected cases in the U.S. The contagiousness, lack of specific treatments or vaccines, and feared mortality has created a health scare in China and in many countries around the world similar to the 2002-2003 SARS (Severe Acute Respiratory Syndrome) coronavirus outbreak in China that infected 8,098 people and killed 774 (or 1 in 10 died), and the 2012 MERS (Middle East Respiratory Syndrome) coronavirus contagion with 2,494 confirmed cases and 858 deaths to date (approximately 1 in 3 died).


Stay safe.

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So, as you all suspected, the Chinese government downplayed the number of infections and fatalities even as the chi-coms quarantined a city larger than NYC.

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I read a report that it has a lower fatality rate than SARS but the number of infections could push the total death toll much higher than SARS.

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Not to belittle this . . . but the 2002-03 SARS killed 8100 people . . . 2012 MERS killed 860 people . . . assuming an astronomical death toll of 1mm from this new coronaviris, that's .0125% of the world population of 8 billion.

 

In the more likely case, 20,000 die from this virus . . . that's .00025% of world population.  Not to be cliche, but being hit and killed by lightening is more likely.

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Posted (edited) · Report post

5 mins ago, Mike said:

I read a report that it has a lower fatality rate than SARS but the number of infections could push the total death toll much higher than SARS.

that's what was initially reported.  not sure about that now - in the lancet cohort of n=41 pts, 15% of them died.  that's a higher rate than sars (10%).

 

the interesting thing is, there were only 8,500 cases of SARS in 2002-2003.

 

this is gonna blow that out of the water.

 

the lancet article said a large percentage of the infected pts (n=41) needed a ventilator.  if you run out of hospital beds, that's a problem.

Edited by fishweewee

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Just now, cartopper said:

Not to belittle this . . . but the 2002-03 SARS killed 8100 people . . . 2012 MERS killed 860 people . . . assuming an astronomical death toll of 1mm from this new coronaviris, that's .0125% of the world population of 8 billion.

 

In the more likely case, 20,000 die from this virus . . . that's .00025% of world population.  Not to be cliche, but being hit and killed by lightening is more likely.

those are infections, not fatalties.

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7 mins ago, fishweewee said:

that's what was initially reported.  not sure about that now - in the lancet cohort of n=41 pts, 15% of them died.  that's a higher rate than sars (10%).

 

the interesting thing is, there were only 8,500 cases of SARS in 2002-2003.

 

this is gonna blow that out of the water.

 

the lancet article said a large percentage of the infected pts (n=41) needed a ventilator.  if you run out of hospital beds, that's a problem.

I believe that the overall kill rate to date is about 2.5%. Likely to grow because that's out of reported cases not resolved cases.

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2 mins ago, Mike said:

I believe that the overall kill rate to date is about 2.5%. Likely to grow because that's out of reported cases not resolved cases.

the issue is that this is propaganda.  the rate is suspected to be much higher.

 

the lancet article = 15%.

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10 mins ago, fishweewee said:

on the other hand, there are only a few cases here.

 

maybe it's china's problem.

Most of the concerns is that if it HAD already infected others, it could be up to 10-14days before showing signs, THEN you will have to get test to see if it's positive. But by that time you have already infected others with the same virus. Being the symptoms like a common flu, most will get spread it before anyone will know. That's the scariest part.

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From CDC

 

Early on, many of the patients in the outbreak of respiratory illness caused by 2019-nCov in Wuhan, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Chinese officials report that sustained person-to-person spread in the community is occurring in China.

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27 mins ago, fishweewee said:

the issue is that this is propaganda.  the rate is suspected to be much higher.

 

the lancet article = 15%.

n=41 is much too small a sample size to extrapolate a meaningful mortality rate imo

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49 mins ago, Mike said:

From CDC

 

Early on, many of the patients in the outbreak of respiratory illness caused by 2019-nCov in Wuhan, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Chinese officials report that sustained person-to-person spread in the community is occurring in China.

So what are you saying, just don’t order the “shrimp & lobster” or refrain from all Chinese food?

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