I finally got COVID

[Guest]

40 minutes ago, tassojunior said:

Great news today that prior infection is very effective at preventing severe covid reinfections. Though less against Omicron. 

""Previous SARS-CoV-2 infection offered strong protection against severe disease from a subsequent reinfection, with little difference observed between strains, though prior Omicron BA.1 infections were less protective against another reinfection, according to a meta-analysis of 65 studies."""

https://www.medpagetoday.com/infectiousdisease/covid19/103165?xid=nl_mpt_DHE_2023-02-17&eun=g1786879d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily Headlines Evening 2023-02-17&utm_term=NL_Daily_DHE_dual-gmail-definition

I think you may have misunderstood the article. There wasn't less protection against omicron. It's that prior omicron infections (particularly with BA.1) provided less protection against reinfection than prior infection with other variants. Omicron's various subvariants are the ONLY variants of the virus currently circulating. So, ironically, a prior omicron variant infection provides less protection than a prior infection with, for example, the delta variant (against omicron). It appears to be counter-intuitive, but I suppose one could explain this finding by surmising that a more severe infection will stimulate the immune system more robustly. 

Edited February 18, 2023 by Unicorn

[+ tassojunior]

1 hour ago, Unicorn said:

I think you may have misunderstood the article. There wasn't less protection against omicron. It's that prior omicron infections (particularly with BA.1) provided less protection against reinfection than prior infection with other variants. Omicron's various subvariants are the ONLY variants of the virus currently circulating. So, ironically, a prior omicron variant infection provides less protection than a prior infection with, for example, the delta variant (against omicron). It appears to be counter-intuitive, but I suppose one could explain this finding by surmising that a more severe infection will stimulate the immune system more robustly. 

Sorry, I reversed that in my hurry. But still as a "recovered" I'm pleased it did some good diminishing any repeat.. I'm much more concerned with the clot danger my MD found out about from covid. I don't know anyone else, including people with clot problems, who were warned or put on the thinner shots. Certainly not my ex neighbor or my cousin who died of covid-induced clots the same week I was sick. This new "regimen" seems to be not followed much yet. Both may well have died because they weren't told to get the clot preventive shots. 

[+ nycman]

11 hours ago, Unicorn said:

find it extremely shocking that your physician could be so ignorant on how to prescribe Paxlovid.

And I find it shocking that you’d call another physician ‘ignorant" without knowing all the facts. Actually, I’m not…with you it’s a bad habit we’ve seen many times before. 

As you stated, Paxlovid is indicated in patients at risk for progression to severe disease. Exactly what risk factor does this patient have? As far as I can tell, he hasn’t told us that he has one. And Paxlovid is not without it’s side effects. It’s probably a decision best left to his own physician who I imagine knows him much better than you. 

Less knee jerk judgement and self righteous indignation of your professional peer group would serve you well.  

[Guest]

22 hours ago, nycman said:

And I find it shocking that you’d call another physician ‘ignorant" without knowing all the facts. Actually, I’m not…with you it’s a bad habit we’ve seen many times before. 

As you stated, Paxlovid is indicated in patients at risk for progression to severe disease. Exactly what risk factor does this patient have? As far as I can tell, he hasn’t told us that he has one. And Paxlovid is not without it’s side effects... 

I hate to correct you (well, actually I don't), but I was responding to a poster who stated "My doctor did not put me on Paxlovid because my symptoms were mild and responding to OTC cold medications." If this statement was truthful, the doctor's reasoning was simply factually wrong. The FDA approved the medication for a certain indication, namely to protect certain populations with mild, early disease from progression to severe disease. This is absolutely not a "matter of opinion." Had that poster said "My doctor didn't put me on Paxlovid because he didn't feel I was in a high-risk group," or "...because my symptoms had already gone on for 5 days, and it was too late," or "...because I was taking a medication which interacted with it, and that medication could not be safely held for 5 days," that would have been a different story. However, to withhold this medication "...because my symptoms were mild," shows shocking ignorance about how and when to prescribe this potentially life-saving medication. In fact, this medication is ONLY indicated to treat those with mild symptoms (the goal is to suppress the virus for 5 days and prevent more serious illness or death, which studies showed it did by 90%). 

This virus is extremely common, and it certainly behooves any treating physician or other prescriber to know how to approach its treatment, at least on a basic level. I'm truly shocked and flabbergasted that any primary care physician would believe that the medication shouldn't be offered because "symptoms are mild." Had a friend or relative told me that his (or her) physician had told him that, I'd tell the friend or relative (after I came to from passing out in shock) that he should find another primary care physician. How could any health care provider be so uncaring as to not educate himself about this virus and its treatment? 

[+ nycman]

5 hours ago, Unicorn said:

I hate to correct you…..

Nice try. 

My point still stands and I stand by what I said. You have no knowledge of any reason that this patient was at high risk for progression to severe disease. In fact you have VERY limited knowledge about this patient at all, and yet you didn’t hesitate to insult his physician’s decision making. 

I’m only asking that you try to be less condescending to others in your profession. It’s doesn’t make you look smart. It makes you look like a jerk. 

[Guest]

7 hours ago, nycman said:

Nice try. 

My point still stands and I stand by what I said. You have no knowledge of any reason that this patient was at high risk for progression to severe disease. In fact you have VERY limited knowledge about this patient at all, and yet you didn’t hesitate to insult his physician’s decision making. 

I’m only asking that you try to be less condescending to others in your profession. It’s doesn’t make you look smart. It makes you look like a jerk. 

Sorry, but you're wrong and you know it. As you well know, the reason the physician gave (according to the poster) was that his disease "wasn't severe enough," not that the poster wasn't at high risk for progression. I'm only asking that you don't continue to argue a point when you know you're factually wrong. It makes you look like a stubborn dumb-ass. 

[+ tassojunior]

I just had a second friend die of a clot in the first week of covid with no clot history. He was 64 and was also on Paxlovid. This not long after my cousin dying of a clot a month after covid. (he had a clot history). None of the 3 were on the new mini-shot thinner regimen for covid my doc put me on because I had a clot two years ago. It makes me wonder how well the new mini-shot covid regime is being used and if all three would be alive if they got the very cheap shot regime as I did. People who have or had covid should really ask their MDs about this shot thinner regimen for covid. A small prick to the tummy once a day for 2 weeks is no great fun but it's only $12 co-pay and may save your life. 

 

[+ nycman]

6 minutes ago, tassojunior said:

People who have or had covid should really ask their MDs about this shot thinner regimen for covid.

I agree patients should discuss this with their physicians.

The only data I know of showed that only "moderately ill hospitalized patients" 
with COVID benefited from blood thinners. Surprisingly, patients with more 
advanced COVID disease in the ICU did not show a benefit from blood thinners. 
In fact, it may have harmed them. So much so, that the study was stopped early. 

I know of no guidelines that recommend it for patients who are not hospitalized.
In theory, it may sound good, but medicine is often an illogical world and
interventions do not always yield the expected results. 

Talk to your doctor.
Have them help you understand the guidelines, the risks, and the benefits.
Then make a decision that you and your physician feel is best for you, 
based on the current data and your personal wishes. 

There isn’t always a "right" answer. 

[Guest]

These are the current guidelines, last updated less than 3 months ago (National Institutes of Health):

https://www.covid19treatmentguidelines.nih.gov/therapies/antithrombotic-therapy/#:~:text=Antithrombotic Therapy for Hospitalized%2C Nonpregnant,COVID-19 ( AIII ).

Antithrombotic Therapy for Nonhospitalized Patients Without Evidence of Venous Thromboembolism

• In nonhospitalized patients with COVID-19, the Panel recommends against the use of anticoagulants and antiplatelet therapy (i.e., aspirin, P2Y12 inhibitors) for the prevention of VTE or arterial thrombosis, except in a clinical trial (AIIa). This recommendation does not apply to patients with other indications for antithrombotic therapy.
• The Panel recommends against routinely continuing VTE prophylaxis for patients with COVID-19 after hospital discharge unless they have another indication or are participating in a clinical trial (AIII). For patients discharged after COVID-19-related hospitalization who are at high risk of VTE and at low risk of bleeding, there is insufficient evidence for the Panel to recommend either for or against continuing anticoagulation unless another indication for VTE prophylaxis exists. 

I'm sorry about your two friends. Hopefully, physicians practice on the basis of hard data, science, and professional guidelines, not on "The last time I had a patient like this...". Anticoagulants definitely have risks in addition to potential benefits. 

[+ tassojunior]

On 2/22/2023 at 3:45 PM, nycman said:

I agree patients should discuss this with their physicians.

The only data I know of showed that only "moderately ill hospitalized patients" 
with COVID benefited from blood thinners. Surprisingly, patients with more 
advanced COVID disease in the ICU did not show a benefit from blood thinners. 
In fact, it may have harmed them. So much so, that the study was stopped early. 

I know of no guidelines that recommend it for patients who are not hospitalized.
In theory, it may sound good, but medicine is often an illogical world and
interventions do not always yield the expected results. 

Talk to your doctor.
Have them help you understand the guidelines, the risks, and the benefits.
Then make a decision that you and your physician feel is best for you, 
based on the current data and your personal wishes. 

There isn’t always a "right" answer. 

but the urgent message from my MD above was that Kaiser hematology had alerted her there was a brand-new regimen she was unaware of for those at risk for clots or any history of clots.

""""" The hematologist reviewed your chart and said that recent expert recommendations for blood clot prevention in patients at higher risk include use of Lovenox 40 mg sq injection once daily for 2 weeks."""

I'm not sure how often CDC or NIH updates their recommendations. I do know when I went to pick up the shots next day the pharmacy worker said they were out because dozens of people were suddenly coming to get them and they gave me 2 to last 2 days until more came in on an urgent order they had placed.  

I have a new appreciation for Kaiser (!) after 2 friends and a cousin recently dying of clots with covid and no thinner shots. Maybe it's just a sad coincidence. But I tell everyone I can now to ask their MD about that new regimen. 40mg is a very low dose of Lovenox. When I had a clot two years ago I was on large shots for two weeks and Pradaxa for 3 months which I also understand is the regimen. I was glad not to run the risk of thinners long-term. 

I'm not trying to pretend I understand the medicine or have some knowledge trained people don't. It's just that having 3 dead from covid and clots these couple past weeks and my MD's hematologist finding this brand new regimen for me I thought it my duty to let others know. I guess I feel guilty from my cousin and two friends not knowing of it and dying of probably covid-induced clots.  

But 100% agree it's a matter of asking your MD to look up that new regimen and maybe ask a hematologist. Mine knew nothing about it until she did.

 

 

Edited February 23, 2023 by tassojunior

[+ augustus]

Just read an article that there has been a 30% increase in heart attacks among people 25-48 in the last 2 years.  Many people believe it's the vaccine.

[Guest]

8 hours ago, augustus said:

...Many people believe it's the vaccine.

[Marc in Calif]

11 hours ago, augustus said:

Just read an article that there has been a 30% increase in heart attacks among people 25-48 in the last 2 years.  Many people believe it's the vaccine.

I read a bunch of similar articles that cited the same study that found a 30% increase in those who were 25 to 44 in the first two years of the COVID-19 pandemic.

The articles also mentioned some of the possible causes of this increase. They talked about these four specific factors:

1. This age group was less likely to use masks or distancing.
2. This age group waited longer to get vaccinated. So if they did eventually get the vaccine, they were already much later into the pandemic. 
3. They might have had a mild infection that later developed into heart problems. (COVID-19 can accelerate the development of heart issues***.)
4. Someone who suffered a heart attack might have survived if emergency care wasn't already strained during those first two years of the pandemic.

 *** COVID-19 can greatly impact the cardiovascular system.

It appears to be able to increase the stickiness of the blood and increase the likelihood of blood clot formation. It seems to stir up inflammation in the blood vessels. It seems to also cause in some people an overwhelming stress — whether it’s related directly to the infection or situations around the infection — that can also cause a spike in blood pressure.

The reason for the relative rise in young people in particular is unclear, but one theory is that the virus's impact on the cardiovascular system in some people may be due to an excessive immune system response and that young people are more likely to have stronger immune systems.

I really wish the articles had also talked about common beliefs -- for example, that this particular group's heart attacks were caused by the vaccine. 

Edited February 23, 2023 by Marc in Calif

[Guest]

There are almost countless possible good explanations for the increase in heart attacks during the first two years of the pandemic, including, of course, the virus itself, fewer opportunities to go to the gym/play sports/exercise, increased weight, decreased socialization, increased stresses (financial and emotional), and so on. Of course, there are probably multiple factors at work. The fact that the effect was noted in the first year of the pandemic, when the vaccine was not available to young adults, rules out the possibility of the vaccine being a source of noted statistics. 

[+ augustus]

Interesting that more than half of all nursing home resident have not received a booster shot this winter despite the fact that the vast majority of deaths are among seniors.  The booster shot is paid for by the federal government and they will even send people to administer the shots.  It is also supposed to be mandated by the Feds too.  The SAME people who are saying get vaxxed are the ones who thought it was unsafe when the vaccine first came out!  People don't know what to believe anymore.  I'll never get vaxxed.

 

https://skillednursingnews.com/2023/01/couldnt-have-happened-at-a-worse-time-nursing-homes-struggle-to-increase-booster-rates-as-covid-surges/

 

[+ augustus]

12 hours ago, Marc in Calif said:

I really wish the articles had also talked about common beliefs -- for example, that this particular group's heart attacks were caused by the vaccine. 

The fact that they did NOT speaks volumes.

[Marc in Calif]

6 hours ago, augustus said:

The fact that they did NOT speaks volumes.

Yes, it does speak volumes -- because scientific studies never collect "beliefs" as data or evidence. 

For example, statements such as "Many people believe... " mean nothing unless those individuals are described, attributed, and counted as part of a systematic study. Without this sourcing, we call such statements hearsay or anecdotes.

 

[+ tassojunior]

The American Heart Association citing the British Health System records of 1.5 Million covid cases:

Researchers found that the first week after a COVID-19 diagnosis, the risk of an arterial blood clot – the kind that could cause a heart attack or ischemic stroke by blocking blood flow to the heart or brain – was nearly 22 times higher than in someone without COVID-19. That risk dropped sharply, to less than four times higher, in the second week.

"Between 27 and 49 weeks, there is an approximately 30% increased risk for arterial clots, Sterne said. "But the elevation is greater for longer" for clots in veins, which include deep vein thrombosis and pulmonary embolism, when a clot travels to the lungs.

In the first week after a COVID-19 diagnosis, the risk of such venous problems was 33 times higher. By the third and fourth weeks after diagnosis, the risk was still about eight times higher. And between 27 and 49 weeks later, the risk was still 1.8 times higher than in somebody who had never had COVID-19.

https://www.heart.org/en/news/2022/09/19/blood-clot-risk-remains-elevated-nearly-a-year-after-covid-19#:~:text=Researchers found that the first,in someone without COVID-19.

No idea why the 33X and 22X are different.

My cousin and two friends recently all died of clots the first week after testing positive for covid with no major covid symptoms. Even though that UK study was pre-Omicron and before 4 shots, I have to think there's a link to clots from covid. I'm not trying to second-guess other MD's or support my own but it's something people at risk of clots may consider if they get covid to ask their MD's to check on new current regimens.    

[+ tassojunior]

I'm borderline diabetic and my MD left it up to me whether to take Metformin. Then in January I finally got covid and I read that Metformin helps with covid so I started immediately. Today MedPage has news of a study that seems to confirm that. Not sure if it's otherwise given for covid to non-diabetics. 

Early Metformin Cuts Long COVID Risk

— Ivermectin and fluvoxamine, meanwhile, showed no benefit in randomized COVID-OUT study

https://www.medpagetoday.com/infectiousdisease/longcovid/103450?xid=nl_mpt_DHE_2023-03-08&eun=g1786879d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily Headlines Evening 2023-03-08&utm_term=NL_Daily_DHE_dual-gmail-definition

[Guest]

2 hours ago, tassojunior said:

I'm borderline diabetic and my MD left it up to me whether to take Metformin. Then in January I finally got covid and I read that Metformin helps with covid so I started immediately. Today MedPage has news of a study that seems to confirm that. Not sure if it's otherwise given for covid to non-diabetics. 

Early Metformin Cuts Long COVID Risk

— Ivermectin and fluvoxamine, meanwhile, showed no benefit in randomized COVID-OUT study

https://www.medpagetoday.com/infectiousdisease/longcovid/103450?xid=nl_mpt_DHE_2023-03-08&eun=g1786879d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily Headlines Evening 2023-03-08&utm_term=NL_Daily_DHE_dual-gmail-definition

Well, this information only pertains to the unvaccinated (no significant difference in the vaccinated):

Vaccination status did correlate with metformin benefit, however, such that the unvaccinated participants appeared to experience the bulk of the reduction in cumulative long COVID risk:

• Unvaccinated: 6.3% vs 14.1% with placebo (HR 0.43, 95% CI 0.23-0.78)
• Vaccinated: 6.1% vs 7.2% (HR 0.85, 95% CI 0.46-1.56)

[+ tassojunior]

34 minutes ago, Unicorn said:

Well, this information only pertains to the unvaccinated (no significant difference in the vaccinated):

Vaccination status did correlate with metformin benefit, however, such that the unvaccinated participants appeared to experience the bulk of the reduction in cumulative long COVID risk:

• Unvaccinated: 6.3% vs 14.1% with placebo (HR 0.43, 95% CI 0.23-0.78)
• Vaccinated: 6.1% vs 7.2% (HR 0.85, 95% CI 0.46-1.56)

also overweight:

Bramante told MedPage Today that metformin may also be particularly effective in those with overweight or obesity (median body mass index [BMI] in this study was 30), as the subgroup with a BMI of 30 or greater saw a substantial reduction in long COVID risk (5.6% vs 12.8%; HR 0.43, 95% CI 0.23-0.78).