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pitdakota, have you heard/read anything . . .

. . . about this being primarily a blood disorder affecting the physiology of blood oxygenation, with the lung impairment a secondary result? Or something along those lines? To @pitdakota .

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Re: pitdakota, have you heard/read anything . . .


@noodleann wrote:

. . . about this being primarily a blood disorder affecting the physiology of blood oxygenation, with the lung impairment a secondary result? Or something along those lines? To @pitdakota .


 

@noodleann   

 

Obviously, I'm not @pitdakota, as you see, however,

 

Nothing I've seen has convinced me that COVID19 is a true blood dyscrasia in the sense of sickle cell, or hemophilia.

 

I'm going with the clotting being another of the body's attempts to throw off the disease, just like fever, and phlegm.  A little of either is sometimes a good thing,  too much is a problem.

 

But, we're learning new things daily.

 

"Animals are not my whole world, but they have made my world whole" ~ Roger Caras
Respected Contributor
Posts: 3,970
Registered: ‎03-16-2010

Re: pitdakota, have you heard/read anything . . .


@noodleann wrote:

. . . about this being primarily a blood disorder affecting the physiology of blood oxygenation, with the lung impairment a secondary result? Or something along those lines? To @pitdakota .


___________________________________________________________

 

@noodleannI have not read anything linking some type of blood dyscrasias as a factor that leads to low oxygenation levels (hypoxia) being seen in covid-19 patients.  Clinical data has revealed significant involvement of the lungs as documented by simple x-rays and CT scans.  

Everything I have seen has directly related the servere hypoxia to primary lung involvement.

 

The vascular involvement has to do with clotting disorders in that patients with covid are experiencing blood clots causing stroke, heart attack, and pulmonary embolus (blot clot to the lung).  In adults there have also been situations in which multiple blood clots in the extremities have lead to amputation of the lower extremity.  

 

So as @Drythe stated blood dyscrasias or the inability of red blood cells to adequately carry oxygen to tissue do not appear to be playing any role in the hypoxia. 

 

Hope that helps.

 

 

 


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Respected Contributor
Posts: 3,458
Registered: ‎06-10-2015

Re: pitdakota, have you heard/read anything . . .


@pitdakota wrote:

@noodleann wrote:

. . . about this being primarily a blood disorder affecting the physiology of blood oxygenation, with the lung impairment a secondary result? Or something along those lines? To @pitdakota .


___________________________________________________________

 

@noodleannI have not read anything linking some type of blood dyscrasias as a factor that leads to low oxygenation levels (hypoxia) being seen in covid-19 patients.  Clinical data has revealed significant involvement of the lungs as documented by simple x-rays and CT scans.  

Everything I have seen has directly related the servere hypoxia to primary lung involvement.

 

The vascular involvement has to do with clotting disorders in that patients with covid are experiencing blood clots causing stroke, heart attack, and pulmonary embolus (blot clot to the lung).  In adults there have also been situations in which multiple blood clots in the extremities have lead to amputation of the lower extremity.  

 

So as @Drythe stated blood dyscrasias or the inability of red blood cells to adequately carry oxygen to tissue do not appear to be playing any role in the hypoxia. 

 

Hope that helps.

 

 

 


Thanks so much for your thoughtful answer, @pitdakota . Just to be clear, I find these topics fascinating, but I don't have background beyond doing transcriptions of interviews with KOLs and clinicians in different medical fields. I often have to look up a word or two that you're using, and today's is the fascinating "dyscrasia." 

 

Back to blood, I asked about this because I'd read an interview on Medscape with Dr. Cameron Kyle-Sidell called "Do COVID-19 Vent Protocols Need a Second Look?" https://www.medscape.com/viewarticle/928156

 

The interview itself raises questions about venting, but it was in the 113 responses to the article--more than I've ever seen for a Medscape piece--that I read a long post by Dr. Isabela Angelelli, dated April 10, that pointed to the possibility of another explanation of the way the virus works, and an explanation for why those patients presenting with 70% oxygen readings were able to talk, were not short of breath, etc. She provides a link to sources in her post. Two snippets from Dr. Angelelli:

-----------

- If the computer modeling is right, it shows that the virus hijacks our [red] blood [cells] and makes it unable to carry O2 to a patient's tissues/organs, and likewise unable to carry CO2 out of them. This would lead to organ and tissue death, roughly in the same way as if a patient were being suffocated. Even when a patient can breath [sic] (fill lungs with air), the oxygen isn't getting to the cells in their body.

 

- The inflammation in the lungs results from the lungs not being able to perform the oxygen/CO2 exchange, and would therefore appear to be a SECONDARY result of the hijacking of the blood. The lungs not working is a result of lack of O2 in blood, not the cause of it. Hence the "ground glass opacities".

 

-------------

I was just interested in what you thought of the interview and the thinking about the blood target idea, if you have the time, etc. to look at this. I value your insights and your balanced views.

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Registered: ‎12-01-2012

Re: pitdakota, have you heard/read anything . . .

 


@noodleann wrote:

@pitdakota wrote:

@noodleann wrote:

. . . about this being primarily a blood disorder affecting the physiology of blood oxygenation, with the lung impairment a secondary result? Or something along those lines? To @pitdakota .


___________________________________________________________

 

@noodleannI have not read anything linking some type of blood dyscrasias as a factor that leads to low oxygenation levels (hypoxia) being seen in covid-19 patients.  Clinical data has revealed significant involvement of the lungs as documented by simple x-rays and CT scans.  

Everything I have seen has directly related the servere hypoxia to primary lung involvement.

 

The vascular involvement has to do with clotting disorders in that patients with covid are experiencing blood clots causing stroke, heart attack, and pulmonary embolus (blot clot to the lung).  In adults there have also been situations in which multiple blood clots in the extremities have lead to amputation of the lower extremity.  

 

So as @Drythe stated blood dyscrasias or the inability of red blood cells to adequately carry oxygen to tissue do not appear to be playing any role in the hypoxia. 

 

Hope that helps.

 

 

 


Thanks so much for your thoughtful answer, @pitdakota . Just to be clear, I find these topics fascinating, but I don't have background beyond doing transcriptions of interviews with KOLs and clinicians in different medical fields. I often have to look up a word or two that you're using, and today's is the fascinating "dyscrasia." 

 

Back to blood, I asked about this because I'd read an interview on Medscape with Dr. Cameron Kyle-Sidell called "Do COVID-19 Vent Protocols Need a Second Look?" https://www.medscape.com/viewarticle/928156

 

The interview itself raises questions about venting, but it was in the 113 responses to the article--more than I've ever seen for a Medscape piece--that I read a long post by Dr. Isabela Angelelli, dated April 10, that pointed to the possibility of another explanation of the way the virus works, and an explanation for why those patients presenting with 70% oxygen readings were able to talk, were not short of breath, etc. She provides a link to sources in her post. Two snippets from Dr. Angelelli:

-----------

- If the computer modeling is right, it shows that the virus hijacks our [red] blood [cells] and makes it unable to carry O2 to a patient's tissues/organs, and likewise unable to carry CO2 out of them. This would lead to organ and tissue death, roughly in the same way as if a patient were being suffocated. Even when a patient can breath [sic] (fill lungs with air), the oxygen isn't getting to the cells in their body.

 

- The inflammation in the lungs results from the lungs not being able to perform the oxygen/CO2 exchange, and would therefore appear to be a SECONDARY result of the hijacking of the blood. The lungs not working is a result of lack of O2 in blood, not the cause of it. Hence the "ground glass opacities".

 

-------------

I was just interested in what you thought of the interview and the thinking about the blood target idea, if you have the time, etc. to look at this. I value your insights and your balanced views.


I read all the comments following that interview, too @noodleann.  Amazing the things that come up in comments, not just this interview in particular.  I think they're on to something. 

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Re: pitdakota, have you heard/read anything . . .

@noodleann, and I love that you find reading and learning fascinating!  

 

The issue of silent hypoxia in covid patients is interesting and frustrating at the same time.  Yes, there are docs out there with hypotheses that red blood cells are being directly attacked by the virus might help explain the silent hypoxia.  Problem is they can't provide microbiological evidence that is exactly what is actually happening.  At least to date.   That might change though in time.

 

There are further questions about that theory in that they have used extracorporeal membrane oxygenation (ECMO).  ECMO is something like a heart lung bypass process they use during open heart surgery.  They put  catheters into both a major artery and major vein.   All of the blood is routed through the machine that functions to oxygenate the blood and then returns it back to the body to circulate. 

 

When they use this process, oxygen saturation does improve.  And patients have successfully recovered.  So that begs the question that  if ECMO can be effective in these severely hypoxic patients with red blood cells being able to transport the oxygen why would it be that the problem resides in a problem with the virus attacking the red blood cell to interfere with its ability to transport oxygen.

 

There are different thoughts out there as to when to place a patient on a ventilator, quite different from the standards in the past with other respiratory situations.  I think most have learned to let ABG results get to a level they never would have in the past before resorting to intubation and placing the patient on a ventilator.  One thing in the article that is heard by all doctors and nurses out there working with covid patients though is that they have never seen anything like this.  Quite a sobering statement that is universal among health care providers all across the country taking care of covid patients.

 

No doubt there is still quite a bit about this virus they don't know.  What is clear from this point in time though is that covid does present as a respiratory virus but it is anything but just primarily a respiratory disease.  It has neurological, cardiovascular, renal, and clotting involvement associated with infection.  And we are now starting to see that recovery for some is problematic as well.  And still much more to learn and current thinking evolving as they continue.  

 

I will provide a picture of a patient receiving ECMO since it may a new concept you may not have heard about.  It is kind of difficult to actually see the patient because of all the equipment.  But the person in the picture is receiving ECMO

 

image.png

 

So the ECMO really functions as artifical lungs if you will to provide oxygen to the blood as it circulates through this process and then is returned back into the patient. 

 

 

 

 


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Registered: ‎04-20-2020

Re: pitdakota, have you heard/read anything . . .

@pitdakota my husband is on a statin and has been for a few years.  I take an Andrew Lessman product that contains plant sterols.  In your opinion do you think this would protect us from blood clots in the event we got corona?  

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Re: pitdakota, have you heard/read anything . . .


@germanshepherdlove wrote:

@pitdakota my husband is on a statin and has been for a few years.  I take an Andrew Lessman product that contains plant sterols.  In your opinion do you think this would protect us from blood clots in the event we got corona?  


______________________________________________

 

Hi @germanshepherdlove,  I am a nurse, not a medical physician and in no way would dispense any advice regarding specific medications or treatments for individuals.  If I knew of any clinical studies would be glad to pass those along for your review but I don't know of any nor have I seen any medical blogs discussing those specific topics.  Doesn't mean they aren't out there, just haven't come across any to date.  

 

But specific advice and recommendations would need to come from your primary care provider.  

 

Certainly if you have an appointment with your primary care provider in the future, it would be an important discussion to have with him/her about what you can specifically do to keep yourself in the best health possible.   I think many docs are going to be getting those questions and know that many of their patients will be concerned about various issues.

 

 

 


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Posts: 794
Registered: ‎04-20-2020

Re: pitdakota, have you heard/read anything . . .

@pitdakota thanks for your input.  I don't have a need to go to a doctor this year, knock on wood and have not been going with my husband lately to his appointments...fewer people present the better.  I do think that there needs to be more information put out there that is useful when it is reported that some patients are getting blood clots not only in their legs but in their lungs.  I wish the people who are reporting were more responsible by giving the whole picture and I'm sure there are reporters who specialize in medical information gathering.....

 

The medical community does not give press conferences per se, so we are at the mercy of reporters who unfortunately have a slant, an agenda etc..

 

I want to hear it directly from the horse's mouth who is getting what and what is considered protective to avoid complications.   

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Posts: 13,774
Registered: ‎07-09-2011

Re: pitdakota, have you heard/read anything . . .


@pitdakota wrote:

@noodleann, and I love that you find reading and learning fascinating!  

 

The issue of silent hypoxia in covid patients is interesting and frustrating at the same time.  Yes, there are docs out there with hypotheses that red blood cells are being directly attacked by the virus might help explain the silent hypoxia.  Problem is they can't provide microbiological evidence that is exactly what is actually happening.  At least to date.   That might change though in time.

 

There are further questions about that theory in that they have used extracorporeal membrane oxygenation (ECMO).  ECMO is something like a heart lung bypass process they use during open heart surgery.  They put  catheters into both a major artery and major vein.   All of the blood is routed through the machine that functions to oxygenate the blood and then returns it back to the body to circulate. 

 

When they use this process, oxygen saturation does improve.  And patients have successfully recovered.  So that begs the question that  if ECMO can be effective in these severely hypoxic patients with red blood cells being able to transport the oxygen why would it be that the problem resides in a problem with the virus attacking the red blood cell to interfere with its ability to transport oxygen.

 

There are different thoughts out there as to when to place a patient on a ventilator, quite different from the standards in the past with other respiratory situations.  I think most have learned to let ABG results get to a level they never would have in the past before resorting to intubation and placing the patient on a ventilator.  One thing in the article that is heard by all doctors and nurses out there working with covid patients though is that they have never seen anything like this.  Quite a sobering statement that is universal among health care providers all across the country taking care of covid patients.

 

No doubt there is still quite a bit about this virus they don't know.  What is clear from this point in time though is that covid does present as a respiratory virus but it is anything but just primarily a respiratory disease.  It has neurological, cardiovascular, renal, and clotting involvement associated with infection.  And we are now starting to see that recovery for some is problematic as well.  And still much more to learn and current thinking evolving as they continue.  

 

I will provide a picture of a patient receiving ECMO since it may a new concept you may not have heard about.  It is kind of difficult to actually see the patient because of all the equipment.  But the person in the picture is receiving ECMO

 

image.png

 

So the ECMO really functions as artifical lungs if you will to provide oxygen to the blood as it circulates through this process and then is returned back into the patient. 

 


@pitdakota 

 

Years ago DH did some studies on ECMO and factor Xiii Deficient Beagles - very sad.  

 

I have been reading about ECMO, and CPAP with COVID.  Hey, if necessary I’d like to try a CPAP before a respirator!

 

To give a disease it’d due, COVID is one sneaky, multifaceted, disease.  It leaves a trail of damage to it’s host even when it’s ‘cured’.  I agree, that we’ll be learning new things about it for a good while. 

 

Best to you & Yours

"Animals are not my whole world, but they have made my world whole" ~ Roger Caras