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SARS-CoV-2 & COVID-19 Notes

Please note that this is a living document, and it is mostly for myself than for others.  個人的なノートです。いずれ和訳するつもりです

Virus

Who is likely to Die?

Yet another good video by Dr. Mike Hansen.   Temple University came up with a statistical model to predict who is likely to die from COVID-19.  Less than 15% of COVID-19 patients develop severe enough to get hospitalized.  Less than 5% would require to be in the ICU because of pneumonia.  These are the people who have the Cytokine Storm

Known risk factors.
- Male (low estrogen)
- Old Age (weakened immune system and regeneration}
- Smoking (impaired lung)
- Type A Blood
- Comorbidity (having other conditions)

The research and the new discovery predict the severity of the symptoms based on blood testing... that is why this is so awesome... 

But OMG, there are too many medical terms in this... I need to learn all those before I can understand this

Here is the link to the Research Paper from the Temple University COVID-19 Research Group that he mentioned in the video.

Treatments

Opinion: The difficulty of the treatment is that the human body does not respond well to COVID-19 and the immune system starts destroying the body especially around the lung, heart, and kidney.  If enough parts of the lung are destroyed, the person will not survive even if the overall infection in the body is not that much.  If a patient is treated so that the immune system is suppressed enough not to destroy the body, then the virus could replicate fast and spread to other parts of the body and later cause different damage and cause that person to die.  But they cannot let the immune system to overreact and start destroying the body as it also destroys the virus.  So once an effective vaccine becomes available, the immune system would be able to destroy the virus without overreacting.

Mutation

Opinion: because of the pandemic, the rate of mutation of the virus is probably high compare to other viruses that cause disease yearly.  We already observed that strains of viruses could jump from human to other mammals and jump back to human, this also increases the chance of viruses evolving to more resilient strains...  If only humans are capable of reducing the infection rates, then we can slow this down...

Mechanism

This video by Dr. Mike from April 2020 is very good.

The virus attaches to ACE2 Receptor that is on the surface of the cell membranes of lungs, hearts, kidneys, intestines, arteries, tongues, etc. enter the cell, release its RNA and start to replicate.  This virus does not infect or destroy the nucleus of the host cell.  When cells detect the virus replication activities inside them, the immune reaction starts.

Angiotensin is a home that causes contraction or dilation depending on its subtype.  Angiotensin I can be converted to Angiotensin II via ACE (Angiotensin-Converting Enzyme) or to Angiotensin I-9 via ACE2 (Angiotensin-Converting Enzyme 2)Angiotensin II then could be converted to Angiotensin I-7 also via ACE2.  The Angiotensin II can be attached to AT1R (Angiotensin II Receptor Type 1) to cause constriction of blood vessels, inflammation, and Fibrosis.  The Angiotensin II can also be attached to AT2R (Angiotensin II Receptor Type 2) to cause the opposite effects (vasodilator, anti-inflammatory, and anti-fibrotic).  Angiotensin I-9 and Angiotensin I-7 can be attached to MasR to cause dilation of blood vessels and is anti-Fibrosis.  Because the virus attaches to the ACE2, it acts as the ACE2 Inhibitor and can cause more constriction of the blood vessel, inflammation, and Fibrosis.

Cytokine Storm can be triggered by the immune system detecting the virus activity and this has a devastating effect on the body, destroying cells nearby, disabling normal functions.  The destruction of the blood vessel can cause blood clots locally to destroy more cells because cells cannot get oxygen.  If this happens in the lung near Pulmonary Alveolus, the person will lose the ability to breathe.  The clots and constriction from Angiotensin II on AT2R can also cause the heart to pump more blood and can cause high blood pressure with not much oxygen reaching the lung.

That's ARDS (Acute Respiratory Distress Syndrome) and is the mechanism of the deadly symptom of COVID-19

Dr. Mike is suggesting ACEI (ACE Inhibitor) and ARB (Angiotensin II Receptor Blocker) could regulate the constriction and may stop this vicious loop.

Common Cold, Flu, COVID-19 all have similar symptoms.  One unique symptom from COVID-19 is the loss of the sense of smell or taste.  If this happens it's likely to be COVID.  It does not mean you don't have it when you still can smell or taste.


Prevention

Vaccine

Pfizer and BioNTech developed an mRNA (Messenger RiboNucleic Acid) vaccine called BNT162b2.  This vaccine seems to be effective according to Dr. John CampbellThis vaccines seem to be effective according to Dr. John Campbell

Moderna developed another mRNA (Messenger RiboNucleic Acid) vaccine called mRNA-1273.
The following are videos explaining how an mRNA vaccine is supposed to work.

Opinion: part of the danger of the COVID-19 is immune response becoming so strong and that it starts to disrupt and destroy the host body (Cytokine Storm), I wonder how that can be controlled...

Antibody Treatment

Regeneron developed an experimental antibody treatment called Casirivimab/Imdevimab Antibody Cocktail.  It was used on the 45th President when he tested positive on October 2nd, 2020.  The treatment received a limited emergency use authorization on November 21st, 2020.  The authorization is only limited to the use of it on COVID patients that are NOT critically ill. 
Here is a video explaining how antibody treatment is developed and how it is supposed to work

Here is a tracker of the cures that are being developed

Economic Impact

Opinion: The count of death over the world population so far is less than 0.017% which is one death per 5616 people, and the average death rate once contracted so far is 3.18% which means out of 100 patients, about 96 people will recover.  This can mean for some it's a very threatening disease.  And the fear can trigger society to shut down and stop functioning.  There will be a job loss, puberty, possibly riots, and violence ... I think people in ruling position are trying to find a way to avoid this escalation of chaos... 

Dark Thoughts

Opinion: This is just a small pandemic and there will be more deadly viruses waiting to appear, so humanity must be ready to combat it before it arrives.

Opinion: This was a setup to reduce the world population.  There is a growing concern of the world becoming less inhabitable, food shortage, rising sea level, devolving intelligence of the human race.  The earth may not be able to host more population than what we have which is 7.7 billion.   If the disease spreads to all people on the planet there will probably be more than 277 million will die from the pandemic reducing the population down to 7.4 billion. This was a coordinated effort to trim out some people from the map...  The ones who could not adopt or properly respond to the pandemic biologically, physiologically, or socially would perish.  The remaining population and their descendants can live on the planet.

Opinion: The way China is able to stop the pandemic seems too perfect.  They may have a way to control how the pandemic would spread or not spread.