Can touching a barbell in the gym get you sick with the coronavirus?

[Michael Scally MD]

This document provides advice on the use of masks in communities, during home care, and in health care settings in areas that have reported cases of COVID-19. It is intended for individuals in the community, public health and infection prevention and control (IPC) professionals, health care managers, health care workers (HCWs), and community health workers. This updated version includes a section on Advice to decision makers on the use of masks for healthy people in community settings.

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

A Pilot Study of Sildenafil in COVID-19
A Pilot Study of Sildenafil in COVID-19 - Full Text View - ClinicalTrials.gov

Observe the efficacy and safety of G1(Sildenafil citrate tablets) in patients with COVID-19 under clinical actual diagnosis and treatment conditions.

 

[Michael Scally MD]

A battery-powered motor fan pushes air into the BioVYZR, creating positive pressure inside the BioVYZR's hood. This positive pressure pushes out exhaled air from inside through two filtering air vents. Inflowing air passes through a N95 filter to remove up to 95% of particulate matter from the inflowing air. This includes, but is not limited to, aerosol-transmitted pathogens, mist droplets, pollen, dust, soot, and pet dander. It's important to keep in mind that if infectious particles are caught in the filters, it is important to take precautions when replacing the filters to avoid contamination. Your BioVYZR will come with detailed instructions on how to safely replace and dispose of used filters.

 

[master.on]

Why is it that 2 weeks ago the liberals were saying “stay home or you will kill people”. People were arrested for going to work (Dallas hairdresser)

Fast forward to now, the liberals are saying “go out and gather to protest and riot”. People are not arrested for LOOTING!

I’m so confused, which one is it? Guess it depends on the narrative (which course is worse for Trump).

Vote 2020

Crowded protests during a deadly virus pandemic?
It doesn't take a scientist to figure out what the outcome will be. Darwinism at its finest.

Fact checking is and should always be an integral component of evidence based medicine, and the release "non-peer reviewed" citations during a pandemic MUST never be allowed to shadow what is or is not evidence based.

I recall when China first released their HCQ + AZM study in February, which was followed by an affirmation from France and Italy. And in spite of data craters (China's webnair results were never published while the French relied on an in vitro PCR duplication model, and Italys were anecdotal) the media driven public was clamoring for greater access to HCQ ..... my how things change.

Will HCQ, a drug used primarily to treat Malaria (a protozoa) and Collagen Vascular Diseases such as Lupus and Rheumatoid Arthritis, significantly impact the morbidity or mortality of a virus like SARS-COV-2, probably not, yet believe closely controlled clinical trials are indicated, as physicians have little more to offer patients.

JIM

The antiparasitic effect of Hydroxychloroquine or the antibiotic effect of Azithromycin don't have anything to do with that.

They both are ionophores, they "shuttle" Zinc inside the cell.
So it's really Zinc the one that really does the heavy work. Buy HCQ/AZ are needed in order for it to work.

A Pilot Study of Sildenafil in COVID-19
A Pilot Study of Sildenafil in COVID-19 - Full Text View - ClinicalTrials.gov

Observe the efficacy and safety of G1(Sildenafil citrate tablets) in patients with COVID-19 under clinical actual diagnosis and treatment conditions.

Coronavirus: Sex with someone you don't live with is illegal from today | Metro News

 

[Michael Scally MD]

The Role of High Cholesterol in Age-Related COVID19 Lethality

Coronavirus disease 2019 (COVID19) is a respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originating in Wuhan China in 2019. The disease is notably severe in elderly and those with underlying chronic conditions.

A molecular mechanism that explains why the elderly are vulnerable and why children are resistant is largely unknown. Understanding these differences is critical for safeguarding the vulnerable and guiding effective policy and treatments.

Here we show loading cells with cholesterol from blood serum using the cholesterol transport protein apolipoprotein E (apoE) enhances the endocytic entry of pseudotyped SARS-CoV-2. Super resolution imaging of the SARS-CoV-2 entry point with high cholesterol showed almost twice the total number of viral entry points.

The cholesterol concomitantly traffics angiotensinogen converting enzyme (ACE2) to the viral entry site where SARS-CoV-2 docks to properly exploit entry into the cell. Cholesterol also increased binding of SARS-CoV-2 receptor binding domains.

In mouse lung we found age and high fat diet induced cholesterol loading into lung tissue by up to 40%. Based on these findings, we propose a cholesterol dependent model for COVID19 lethality in elderly and the chronically ill.

As cholesterol increases with age and inflammation (e.g. obesity, smoking, and diabetes), the cell surface is coated with viral entry points, optimally assembled viral entry proteins, and optimal furin priming. Importantly our model suggests problems arise when cholesterol levels are high in the tissue, not the blood.

In fact, rapidly dropping cholesterol in the blood may indicate severe loading of cholesterol in peripheral tissue and a dangerous situation for escalated SARS-CoV-2 infectivity. Molecules that remove cholesterol from tissue or disrupt ACE2 localization with viral entry points or furin localization for priming in the producer cells, likely reduce the severity of COVID19 in critically ill patients.

Wang H, Yuan Z, Pavel MA, Hansen SB. The role of high cholesterol in age-related COVID19 lethality. bioRxiv 2020:2020.05.09.086249. http://biorxiv.org/content/early/2020/05/29/2020.05.09.086249.abstract

 

[SteroidsBro]

The elderly aren't more vulnerable to covid; they're more vulnerable of dying of old age and having it chaulked up to covid, which is all that is happening. They're being murdered in elderly homes. No doctors will go in there once one of them tests positive for the fake virus with the fake test

 

[Michael Scally MD]

When 511 Epidemiologists Expect to Fly, Hug and Do 18 Other Everyday Activities Again
When 511 Epidemiologists Expect to Fly, Hug and Do 18 Other Everyday Activities Again

Many epidemiologists are already comfortable going to the doctor, socializing with small groups outside or bringing in mail, despite the coronavirus. But unless there’s an effective vaccine or treatment first, it will be more than a year before many say they will be willing to go to concerts, sporting events or religious services. And some may never greet people with hugs or handshakes again.

 

[Michael Scally MD]

Within a time span of only a few months, the SARS-CoV-2 virus has managed to spread across the world. This virus can spread by close contact, which includes large droplet spray and inhalation of microscopic droplets, and by indirect contact via contaminated objects.

While in most countries, supermarkets have remained open, due to the COVID-19 pandemic, authorities have ordered many other shops, restaurants, bars, music theaters and indoor sports centers to be closed. As part of COVID-19 (semi)lock-down exit strategies, many government authorities are now (May-June 2020) allowing a gradual re-opening, where sometimes indoor sport centers are last in line to be permitted to re-open.

This technical note discusses the challenges in safely re-opening these facilities and the measures already suggested by others to partly tackle these challenges. It also elaborates three potential additional measures and based on these additional measures, it suggests the concept of a certificate of equivalence that could allow indoor sports centers with such a certificate to re-open safely and more rapidly.

It also attempts to stimulate increased preparedness of indoor sports centers that should allow them to remain open safely during potential next waves of SARS-CoV-2 as well as future pandemics.

It is concluded that fighting situations such as the COVID-19 pandemic and limiting economic damage requires increased collaboration and research by virologists, epidemiologists, microbiologists, aerosol scientists, building physicists, building services engineers and sports scientists.

Blocken B, van Druenen T, van Hooff T, Verstappen PA, Marchal T, Marr LC. Can indoor sports centers be allowed to re-open during the COVID-19 pandemic based on a certificate of equivalence? Building and Environment 2020;180:107022. Can indoor sports centers be allowed to re-open during the COVID-19 pandemic based on a certificate of equivalence? - ScienceDirect

 

[Michael Scally MD]

Psychopathic traits linked to non-compliance with social distancing guidelines amid the coronavirus pandemic
Psychopathic traits linked to non-compliance with social distancing guidelines amid the coronavirus pandemic


Blagov, Pavel S., PhD. 2020. “Adaptive and Dark Personality Traits in the Covid-19 Pandemic: Predicting Health-behavior Endorsement and the Appeal of Public-health Messages.” PsyArXiv. March 28. doi:10.31234/osf.io/chgkn. https://psyarxiv.com/chgkn/

Who embraces directions to socially distance, boost hygiene, and protect others during a pandemic of contagious respiratory disease?

Do differently phrased public-health messages appeal to different people?

I based predictions on the five-factor, triarchic psychopathy, and Dark Triad models of normal-range and dark traits; the extended parallel process model (EPPM); and schema-congruence theory.

In a survey of 502 online participants, normal-range traits (esp. agreeableness and conscientiousness) predicted endorsement of social distancing and hygiene, as well as the appeal of health messages in general. Consistent with the EPPM, conscientiousness and neuroticism had an interaction.

Dark traits (esp. psychopathy, meanness, and disinhibition) predicted low endorsement of health behaviors and the intent to knowingly expose others to risk. Most participants preferred a message appealing to compassion (“Help protect the vulnerable...”), but dark traits predicted lower appeal of that message.

Personality appears relevant to epidemiology and public-health communication in a contagious-disease context.

 

[Michael Scally MD]

[OA] Androgen Regulates SARS-CoV-2 Receptor Levels and Is Associated with Severe COVID-19 Symptoms

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led to a global health crisis, and yet our understanding of the disease pathophysiology and potential treatment options remains limited. SARS-CoV-2 infection occurs through binding and internalization of the viral spike protein to angiotensin converting enzyme 2 (ACE2) on the host cell membrane. Lethal complications are caused by damage and failure of vital organs that express high levels of ACE2, including the lungs, the heart and the kidneys.

Here, we established a high-throughput drug screening strategy to identify therapeutic candidates that reduce ACE2 levels in human embryonic stem cell (hESC) derived cardiac cells. Drug target analysis of validated hit compounds, including 5 alpha reductase inhibitors, revealed androgen signaling as a key modulator of ACE2 levels.

Treatment with the 5 alpha reductase inhibitor dutasteride reduced ACE2 levels and internalization of recombinant spike receptor binding domain (Spike-RBD) in hESC-derived cardiac cells and human alveolar epithelial cells. Finally, clinical data on coronavirus disease 2019 (COVID-19) patients demonstrated that abnormal androgen states are significantly associated with severe disease complications and cardiac injury as measured by blood troponin T levels.

These findings provide important insights on the mechanism of increased disease susceptibility in male COVID-19 patients and identify androgen receptor inhibition as a potential therapeutic strategy.

Ghazizadeh Z, Majd H, Richter M, et al. Androgen Regulates SARS-CoV-2 Receptor Levels and Is Associated with Severe COVID-19 Symptoms in Men. Preprint. bioRxiv. 2020;2020.05.12.091082. Published 2020 May 15. doi:10.1101/2020.05.12.091082 Androgen Regulates SARS-CoV-2 Receptor Levels and Is Associated with Severe COVID-19 Symptoms in Men

 

[Michael Scally MD]

[OA] Returning to Play after Prolonged Training Restrictions in Professional Collision Sports

The COVID-19 pandemic in 2020 has resulted in widespread training disruption in many sports. Some athletes have access to facilities and equipment, while others have limited or no access, severely limiting their training practices.

A primary concern is that the maintenance of key physical qualities (e. g. strength, power, high-speed running ability, acceleration, deceleration and change of direction), game-specific contact skills (e. g. tackling) and decision-making ability, are challenged, impacting performance and injury risk on resumption of training and competition.

In extended periods of reduced training, without targeted intervention, changes in body composition and function can be profound. However, there are strategies that can dramatically mitigate potential losses, including resistance training to failure with lighter loads, plyometric training, exposure to high-speed running to ensure appropriate hamstring conditioning, and nutritional intervention. Athletes may require psychological support given the challenges associated with isolation and a change in regular training routine.

While training restrictions may result in a decrease in some physical and psychological qualities, athletes can return in a positive state following an enforced period of rest and recovery. On return to training, the focus should be on progression of all aspects of training, taking into account the status of individual athletes.

Stokes KA, Jones B, Bennett M, et al. Returning to Play after Prolonged Training Restrictions in Professional Collision Sports. Int J Sports Med. Thieme E-Journals - International Journal of Sports Medicine / Full Text

 

[Dr JIM]

This citation suggests the risk of asymptomatic DISEASE transmission is LOW (weak"). No surprise as those with asymptomatic COVID-19 have a LOW viral load.

What does this mean?
SICK, as in symptomatic, folk are the primary source of COVID-19 transmission.

JIM

 

[master.on]

[OA] Androgen Regulates SARS-CoV-2 Receptor Levels and Is Associated with Severe COVID-19 Symptoms

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led to a global health crisis, and yet our understanding of the disease pathophysiology and potential treatment options remains limited. SARS-CoV-2 infection occurs through binding and internalization of the viral spike protein to angiotensin converting enzyme 2 (ACE2) on the host cell membrane. Lethal complications are caused by damage and failure of vital organs that express high levels of ACE2, including the lungs, the heart and the kidneys.

Here, we established a high-throughput drug screening strategy to identify therapeutic candidates that reduce ACE2 levels in human embryonic stem cell (hESC) derived cardiac cells. Drug target analysis of validated hit compounds, including 5 alpha reductase inhibitors, revealed androgen signaling as a key modulator of ACE2 levels.

Treatment with the 5 alpha reductase inhibitor dutasteride reduced ACE2 levels and internalization of recombinant spike receptor binding domain (Spike-RBD) in hESC-derived cardiac cells and human alveolar epithelial cells. Finally, clinical data on coronavirus disease 2019 (COVID-19) patients demonstrated that abnormal androgen states are significantly associated with severe disease complications and cardiac injury as measured by blood troponin T levels.

These findings provide important insights on the mechanism of increased disease susceptibility in male COVID-19 patients and identify androgen receptor inhibition as a potential therapeutic strategy.

Ghazizadeh Z, Majd H, Richter M, et al. Androgen Regulates SARS-CoV-2 Receptor Levels and Is Associated with Severe COVID-19 Symptoms in Men. Preprint. bioRxiv. 2020;2020.05.12.091082. Published 2020 May 15. doi:10.1101/2020.05.12.091082 Androgen Regulates SARS-CoV-2 Receptor Levels and Is Associated with Severe COVID-19 Symptoms in Men

There are many other receptors involved in SARS-CoV-2 cell entry besides ACE-2.

Kids= low testosterone, almost immune
Teens = raging high testosterone = almost immune
Elderly = low testosterone, highly susceptible

So there's no correlation, between testosterone and disease severity.

Some suggest that males with LOW testosterone are actually at higher risk?

There's no clear correlation.

 

[Michael Scally MD]

Belongia EA, Osterholm MT. COVID-19 and flu, a perfect storm. Science 2020;368:1163. COVID-19 and flu, a perfect storm

The world is in uncharted waters for the 2020 respiratory virus season. For the first time in modern history, the Northern Hemisphere faces the prospect of the coronavirus disease 2019 (COVID-19) pandemic and a simultaneous epidemic of seasonal influenza. Each causes life-threatening illness and death, especially in older adults, people with chronic diseases, and other vulnerable populations. How can we prepare for this convergence?

The timing and severity of a COVID-19 wave in the fall and winter are uncertain, but past experiences with the 1918 and 1957 influenza pandemics point to the possibility of a resurgence. Almost nothing is known about the interaction of influenza virus and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, the cause of COVID-19) within individuals. Does coinfection increase the risk of severe illness or amplify virus shedding? Few coinfections have been reported from China during the early phase of the pandemic. The Southern Hemisphere influenza season is just beginning, and it may provide some clues as to what can be expected in the Northern Hemisphere later this year.

Much of the population remains susceptible to SARS-CoV-2, and the stress on hospitals will be greatest if the COVID-19 and influenza epidemics overlap and peak around the same time. …

 

[Michael Scally MD]

Kupferschmidt K. Big studies dim hopes for hydroxychloroquine. Science 2020;368:1166. Big studies dim hopes for hydroxychloroquine

Through the fog of alleged misconduct, hope, hype, and politicization that surrounds hydroxychloroquine, the malaria drug touted as a COVID-19 treatment, a scientific picture is now emerging.

Praised by presidents as a potential miracle cure and dismissed by others as a deadly distraction, hydroxychloroquine was spared a seeming death blow last week. On 4 June, after critics challenged the data, The Lancet suddenly retracted a paper that had suggested the drug increased the death rate in COVID-19 patients (see p. 1167), a finding that had stopped many clinical trials in their tracks. Authors, elite journals under fire after major retractions

But now three large studies, two in people exposed to the virus and at risk of infection and the other in severely ill patients, show no benefit from the drug. Coming on top of earlier smaller trials with disappointing findings, the new results mean it's time to move on, some scientists say, and end most of the trials still in progress.

…

 

[Michael Scally MD]

 

[Michael Scally MD]

Worse progression of COVID-19 in men: Is Testosterone a key factor?

Background: The novel Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) disease 2019 (COVID-19) seems to have a worse clinical course among infected men compared to women, thus, highlighting concerns about gender predisposition to serious prognosis. Therefore, androgens, particularly testosterone (T), could be suspected as playing a critical role in driving this excess of risk. However, gonadal function in critically ill men is actually unknown, mainly because serum T concentration is not routinely measured in clinical practice, even more in this clinical context.

Objective: To overview on possible mechanisms by which serum T levels could affect the progression of COVID-19 in men.

Methods: Authors searched PubMed/Medline, Web of Science, EMBASE, Cochrane Library, Google, and Institutional websites for medical subheading terms and free text words referred to "SARS-CoV-2", "COVID-19", "testosterone", "male hypogonadism", "gender" "immune system", "obesity", "thrombosis" until May 19th 2020.

Results: T, co-regulating the expression of angiotensin-converting enzyme 2 and transmembrane protease serine 2 in host cells, may facilitate SARS-CoV-2 internalization. Instead, low serum T levels may predispose to endothelial dysfunction, thrombosis and defective immune response, leading to both impaired viral clearance and systemic inflammation.

Obesity, one of the leading causes of severe prognosis in infected patients, is strictly associated with functional hypogonadism, and may consistently strengthen the aforementioned alterations, ultimately predisposing to serious respiratory and systemic consequences.

Discussion and conclusion: T in comparison to estrogen may predispose men to a widespread COVID-19 infection. Low serum levels of T, which should be supposed to characterize the hormonal milieu in seriously ill individuals, may predispose men, especially aged men, to poor prognosis or death. Further studies are needed to confirm these pathophysiological assumptions and to promptly identify adequate therapeutic strategies.

Giagulli VA, Guastamacchia E, Magrone T, et al. Worse progression of COVID-19 in men: Is Testosterone a key factor? [published online ahead of print, 2020 Jun 11]. Andrology. 2020;10.1111/andr.12836. doi:10.1111/andr.12836 Error - Cookies Turned Off

 

[Michael Scally MD]