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

[Michael Scally MD]

[OA] Plasma Therapies and Parabiosis in the COVID-19

The foreseeable increasing use of convalescent plasma to treat COVID-19 may also allow the exploration of an intriguing hypothesis in the geriatric field. In heterochronic parabiosis experiments, multiple organs, including lungs, liver, heart, kidney, and brain, can be “rejuvenated” in old mice by synergistic actions of young blood constituents.

Indeed, the plasma proteome harbors key regulators of aging. Because of the plausible interaction of aging biology with SARS-CoV-2 infection, the geroprotective properties of plasma from young convalescent donors could mitigate COVID-19 severity in older adults to a greater extent than one might expect from the sole antibody titer. Whether older men experience additional benefits from receiving plasma from young women is also worth being explored.

In conclusion, the ongoing COVID-19 pandemic and the lack of effective pharmacological therapies have set the stage for the unprecedented opportunity to test one of the tenets of contemporary geroscience on a large scale.

Calvani R, Picca A, Landi F, Marzetti E. Plasma Therapies and Parabiosis in the COVID-19 Era. J Am Med Dir Assoc. 2020;21(7):994-995. doi:10.1016/j.jamda.2020.05.066 https://www.jamda.com/article/S1525-8610(20)30523-5/fulltext?rss=yes

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

Face masks are emerging as one of the most powerful weapons to fight the novel coronavirus, with growing evidence that facial coverings help prevent transmission—even if an infected wearer is in close contact with others.

Robert Redfield, director of the Centers for Disease Control and Prevention, said he believes the pandemic could be brought under control over the next four to eight weeks if “we could get everybody to wear a mask right now.” His comments, made Tuesday with the Journal of the American Medical Association, followed an editorial he and others wrote there emphasizing “ample evidence” of asymptomatic spread and highlighting new studies showing how masks help reduce transmission.

The research Dr. Redfield cited included a newly published study suggesting that universal use of surgical masks helped reduce rates of confirmed Covid-19 infections among health-care workers at the Mass General Brigham health-care system in Massachusetts. Association Between Universal Masking and SARS-CoV-2 Positivity Among Health Care Workers

 

[Michael Scally MD]

 

[Michael Scally MD]

[Reddit] Sexual dysfunction in post COVID19 positive men?


A friend with COVID19 who got covid back in May told me that his penis and testicles shrunk after recovering and still hasn't returned to normal size. He also says that he is experiencing ED and penile numbness. He was an otherwise healthy guy in his mid 30s. At first I thought he was joking but I looked around the internet a bit, and I saw some research stating that COVID does do long term damage to the testicles and thus testosterone production in infected men. So this sounds like it could be plausible. Can anyone else speak to these symptoms? When you got it and how long it took to recover (if ever), your age and general health background would be helpful to know too.

 

[Michael Scally MD]

My pregnant physician wife and I are currently COVID positive. We are currently quarantining with our 2 yo daughter who is likely also positive based on symptoms. We have both been working in hospitals taking every precaution humanly possible, especially because of the pregnancy.

Nonetheless, we are positive. We have been masking non-stop in our hospitals and have been protected despite seeing many COVID + patients along the way. We visited family this weekend and 8 of the 11 people we saw (not all at the same time) are now lab confirmed COVID positive.

We did not mask while visiting with family because we let our guard down and thought we were safe. Every one of those positive have symptoms from congestion, headache, fever, malaise, myalgias, and anosmia. 2 of the positives are toddlers. One has been febrile for 48 hrs.

The other toddler just started showing symptoms today. We were together with these people, largely outdoors, for 24 hours this weekend and 8 out 11 are positive. Please be careful out there everyone. #COVID19 is just so contagious.

Thread by @neurooruen: My pregnant physician wife and I are currently COVID positive. We are currently quarantining with our 2 yo daughter who is likely also posit…

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

[OA] Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United States

The 2019 Coronavirus disease (COVID-19) has in a period of just months completely upended travel, commerce, and daily life throughout the world.

Medical practitioners have been forced to care for a surge of ill patients, in many cases, without access to testing and appropriate protective equipment.

The impact of COVID-19 on research has been no less profound, with restrictions in terms of access and funding.

The disease has been politicized from many angles; the economic consequences of this crisis will be long-lasting and unpredictable.

For sexual medicine providers, the effects of COVID-19 are also numerous and multifactorial.

In this article, we highlight some key aspects of the effects of COVID-19 on sexual medicine and how we can respond.

Shindel AW, Rowen TS. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United States. The Journal of Sexual Medicine 2020;17:1216-9. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United States - ScienceDirect

 

[Michael Scally MD]

Why does COVID-19 kill more elderly men than women? Is there a role for testosterone?

Background: Recent epidemiological data indicate that there may be a gender predisposition to COVID-19, with men predisposed to being most severely affected, and older men accounting for most deaths.

Objectives: Provide a review of the research literature, propose hypotheses and therapies based on the potential link between testosterone (T) and COVID-19 induced mortality in elderly men.

Materials and methods: A search of publications in academic electronic databases, and government and public health organization web sites on T, aging, inflammation, severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) infection, and COVID-19 disease state and outcomes was performed.

Results: The link between T, the immune system and male aging is well-established, as is the progressive decline in T levels with aging. In women, T levels drop before menopause and variably increase with advanced age. Elevated IL-6 is a characteristic biomarker of patients infected with COVID-19 and has been linked to the development of the acute respiratory distress syndrome (ARDS).

Thus far, half of the admitted COVID-19 patients developed ARDS, half of these patients died, and elderly male patients have been more likely to develop ARDS and die. Low T is associated with ARDS.

These data suggest that low T levels may exacerbate the severity of COVID-19 infection in elderly men. It may also stand to reason that normal T levels may offer some protection against COVID-19. SARS-CoV-2 binds to the angiotensin-converting enzyme 2, present in high levels in the testis.

Conclusion: At present, it is not known whether low T levels in aging hypogonadal males create a permissive environment for severe responses to COVID-19 infection or if the virus inhibits androgen formation. Given the preponderance of COVID-19 related mortality in elderly males, additional testing for gonadal function and treatment with T may be merited.

Papadopoulos V, Li L, Samplaski M. Why does COVID-19 kill more elderly men than women? Is there a role for testosterone? [published online ahead of print, 2020 Jul 18]. Andrology. 2020;10.1111/andr.12868. doi:10.1111/andr.12868 https://onlinelibrary.wiley.com/doi/abs/10.1111/andr.12868

 

[Michael Scally MD]

[OA] Targeting TMPRSS2 in SARS-CoV-2 Infection

SARS-coronavirus 2 (SARS-CoV-2) has rapidly caused a global pandemic associated with a novel respiratory infection now termed coronavirus disease-19 (COVID-19). ACE2 is necessary to facilitate SARS-CoV-2 infection, but due to its essential metabolic roles, it may be difficult to target it in therapies. TMPRSS2, which interacts with ACE2, may be a better candidate for targeted therapies.

Using publicly-available expression data, we show that both ACE2 and TMPRSS2 are expressed in many host tissues, including lung. The highest expression of ACE2 is found in the testes, whereas the prostate display the highest expression of TMPRSS2. Given the increased severity of disease among older males with SARS-CoV-2 infection, we address the potential roles of ACE2 and TMPRSS2 in their contribution to the sex differences in disease severity.

We show that expression levels of ACE2 and TMPRSS2 are overall comparable between males and females in multiple tissues suggesting that differences in the expression levels of TMPRSS2 and ACE2 in the lung and other non-sex-specific tissues may not explain the gender disparities in SARS CoV-2 severity. However, given their instrumental roles for SARS-CoV-2 infection and their pleiotropic expression, targeting the activity and expression levels of TMPRSS2 is a rational approach to treat COVID-19.

Baughn LB, Sharma N, Elhaik E, Sekulic A, Bryce AH, Fonseca R. Targeting TMPRSS2 in SARS-CoV-2 infection. Mayo Clinic Proceedings. Redirecting

 

[DrinkFlintWater]

It’s official: No fans at Giants, Jets and Rutgers football games because of coronavirus

 

[Millard]

These data suggest that low T levels may exacerbate the severity of COVID-19 infection in elderly men. It may also stand to reason that normal T levels may offer some protection against COVID-19

Everyone seems eager to suggest ADT. It's good to see some researchers consider the restoration of normal T levels instead

 

[Michael Scally MD]

 

[Michael Scally MD]

Peter Hotez MD PhD is Professor of Pediatrics and Molecular Virology & Microbiology, and Dean of the National School of Tropical Medicine at Baylor College of Medicine where he is also Co-Director of the Texas Children’s Center for Vaccine Development.

Within a few weeks, we will reach the awful milestone of 100,000 new COVID19 cases per day, next 225,000 deaths by October 30, and possibly 300,000 deaths by the end of 2020. However, it is not too late to chart a different course. By October 1, we could safely reopen our schools, colleges, and businesses. Potentially we could even launch a college football season or the NFL?

Our homeland security threat

COVID19 has gone beyond dangerous levels in America. We just surpassed 65,000 new cases per day, and I estimate that currently one-quarter of all the world’s COVID19 cases now occur in the Southern US.

Soon we will reach Dr. Anthony Fauci’s projected apocalyptic benchmark of 100,000 new cases per day (Fauci Says U.S. Could Reach 100,000 Virus Cases a Day as Warnings Grow Darker). In addition, we are experiencing dramatic increases in hospitalizations and ICU admissions across the southern half of the United States, and as predicted, the number of deaths has spiked.

The University of Washington just estimated that 225,000 Americans will die by October 30 (IHME | COVID-19 Projections), and potentially that number could reach close to 300,000 by the end of 2020.

To place that number in perspective the terrible 1918 influenza pandemic that lasted until 2020 (or some say 2022) caused 675,000 deaths in the US (1918 Pandemic (H1N1 virus) | Pandemic Influenza (Flu) | CDC).

This COVID19 public health impact does not include the many “recovered” patients with long-lasting disabilities resulting from virus injury to their lungs, vascular system, and heart, as well as potentially long-term neurologic and cognitive deficits.

Soon, practically every American will personally know someone who has gotten very sick or hospitalized with COVID19.

Still another aspect is my concern that low-income neighborhoods across the South – where social distancing is often more difficult and essential workers must physically be in their place of employment – are now being decimated. COVID19 is a health disparity, and LatinX, African American, and Native American people are pouring into emergency rooms, hospitals, and ICUs.

For me this is the most heart-wrenching aspect of COVID19 and a reason I speak out.


…

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

COVID-19 and Andrology: Recommendations of The French-Speaking Society of Andrology

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) metamorphosed our medical practice. In early June 2020, more than 6,400,000 COVID-19 (coronavirus-19 disease) cases were diagnosed across the world and more than 380,000 deaths were linked to COVID-19. Many medical symptoms of COVID-19 were reported.

We will focus, here, on potential impacts of COVID-19 on men's andrological health. Our society (French-speaking society of andrology, SALF) also emitted some recommendations in the andrological management of men infected by SARS-CoV-2.

First, considering the fever and the potential presence of SARS-CoV2 in semen, SALF recommends waiting for 3 months (duration of one spermatogenesis cycle and epididymal transit) before re-starting ART in the case of men diagnosed COVID-19 positive.

Whatever the nature of testosterone and COVID-19 relationships, we recommend an andrological examination, sperm parameters, and hormonal evaluation at the time of the COVID-19 is diagnosed, and several months later. Furthermore, we are concerned by the potential morbid-mortality of the COVID-19, which mainly affects men.

This "andrological bias", if proven, must be reduced by specific andrological diagnosis, therapeutic and prophylactic measures. Research in this direction must be substantiated and financially supported over the next few months (years).

Hamdi S, Bendayan M, Huyghe E, et al. COVID-19 and andrology: Recommendations of the French-speaking society of andrology (Société d'Andrologie de langue Française SALF). Basic Clin Androl. 2020;30:10. Published 2020 Jul 13. doi:10.1186/s12610-020-00106-4 COVID-19 and andrology: Recommendations of the French-speaking society of andrology (Société d’Andrologie de langue Française SALF)