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How coronavirus works - and diabetes

Discussion in 'Diabetes Discussions' started by LucySW, Apr 1, 2020.

  1. LucySW

    LucySW Type 1 · Well-Known Member

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    HI guys,

    For anyone who's interested, a paper which is very relevant to us. It's making the rounds on epidemiology Twitter,** and may be very important. It's dense, but readable. Link is below, but I've also pasted in the summary that accompanied it in the original thread.

    **I'm not in any way medical, but I read medical and epidemiological Twitter. I'm funny that way.

    TL;DR: The paper finds that, contrary to what we thought, the virus works not by attacking the lungs directly, but by disabling respiration in the blood. It strips hemoglobin out of red blood cells, which are the mechanism for respiration in the human body, and converts it to something else. Result: less O2 is delivered round the body, less excess CO2 can be taken away. Bad, bad news. The authors say that acute respiratory distress syndrome in ICUs is a consequence, not a cause, of respiration difficulties.

    Still more importantly, they look at these hemoglobin-hijacking processes and find that chloroquine & some other drugs can prevent it. And they say clinical data shows that treating EARLY with these drugs can be more effective.

    They say that a high A1C does indeed mean we need to protect ourselves, because it means we have less oxygen-transporting hemoglobin available (glycated hemoglobin can't transport O2).

    LSW

    Link: you have to download it but it's free.

    https://chemrxiv.org/articles/COVID...e_Metabolism_by_Binding_to_Porphyrin/11938173

    And here is the summary:

    "This paper appears to yield a number of VERY USEFUL hypotheses and treatment for critical patients if true: https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

    Using computational analysis (modeling the behavior of a molecule in a computer), they’ve worked out the probable mechanism by which SARS-nCov-2 wreaks havoc on patients, as well as why chloroquine and favipiravir seem to work. Here’s what I’ve figured out:

    Inside our red blood cells, there is a molecule called hemoglobin, which contains heme groups. Each heme group is a molecular “ring” (called a porphyrin) that can hold an iron (Fe) ion inside. Having an iron ion inside is what allows this heme to carry O2 (and CO2) in our blood.

    Red blood cells with hemoglobin inside pick up O2 on the heme groups as they pass through our lungs, and can also carry back CO2 to be exchanged again for O2. This is how our bodies move O2 to our tissues and remove CO2 waste products, i.e. “cardiovascular.”

    The virus’s RNA also codes for a number of non-structural proteins. These are pieces that get made during viral replication but aren’t part of the main virus particle. Many viruses have these; they’re like helper proteins that facilitate things that the virus does.

    The paper modeled these and found that the proteins “collaborate” to knock iron ions out of heme groups (HBB) and replace them with one of the proteins. This makes the red blood cell unable to transport O2 and CO2.

    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 breathe (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.

    The paper models the behavior of chloroquine and faviparavir as well, which appear to bind to the non-structural viral proteins that hijack the heme groups, thus inhibiting them from knocking out the iron and wrecking the O2-carrying ability of the red blood cells.

    This also explains the observation made by various ER docs (incl this one in New Orleans) that patients tend to have elevated ferritin: ferritin is used to store excess iron. If a lot of iron is knocked out of heme groups and floating around, the body produces more ferritin:

    https://t.co/nnTvcbwh1V?amp=1

    If true, this may mean a few things: 1. Starting drug treatment while symptoms are mild keeps virus from hijacking too much blood, enabling a still-healthy body to mount an immune response. Explains why early drug treatment (first week of symptoms) is often successful.

    2. Drug treatment and intubation once patient is critical will rarely work because tissues/organs are already damaged, blood can’t carry O2, and the body is too weak to produce new red blood cells able to carry Fe (and thus oxygen/CO2) even if drugs inhibit more hijacking.

    3. Thus: start severe patients on drug treatment upon hospital intake to suppress further hijacking of blood by the virus, then give them a blood transfusion of new red blood cells immediately that are unhijacked. If all this is true, we would see rapid patient improvement.

    (i.e. this theory should be very testable) Also, if it’s true, we’re gonna need a lot of blood donations. So far as I know, there are no studies where we’ve tried transfusing blood from a patient who HASN’T had or recovered from COVID-19."
     
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  2. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Thanks so much, @LucySW, for posting this useful information and your clear explanation. You've done a fabulous job describing the mechanism.
     
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  3. Jaylee

    Jaylee Type 1 · Moderator
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    Hi & thanks for posting this up @LucySW ,

    Oddly it also explains why i've noticed a massive run on tonic water down my local.. ;)
     
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  4. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    Will read and try and improve my own 02 circulation by keeping moving and getting sugars lower. Very interesting. I am hoping that the virus that survive into our futures, will be less virulent since they will replicate more successfully by keeping human hosts upright for longer.
     
  5. JohnEGreen

    JohnEGreen Other · Master

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    @LucySW Thanks for posting this.

    Sadly won't help me much quinine is is a no no for me can trigger a myasthenic crisis which would put me in an ICU on a ventilator oh the irony of it.

    I wonder how this would effect someone with anemia my daughter already has an iron deficiency and is probably diabetic also waiting on a second HbA1c test.
     
  6. Jaylee

    Jaylee Type 1 · Moderator
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    Hi John,

    Hope you're well & safe.

    Yep, I've been doing a little cross referencing. I doubt the tonic contents of quinine or the unsteady social distancing inhibiting action of the gin would help anyone? I've had some experince with malaria tabs on my travels. Side effects stated are gum bleeding & ulcers?

    I've noticed is certain items void on the shelves & search for the logic..?
    For a nation of animal lovers.. Pet food seems plentiful.

    I wish your daughter all the best with her A1c result.
     
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  7. Josie66

    Josie66 Type 2 · Active Member

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    I have a very high A1c and I'm anemic. More worried than ever! I'm an nhs worker but been advised to shield due to last weeks blood results. Hoping I can stay safe at home
    Thanks for posting the links. Will have a read later
     
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  8. LucySW

    LucySW Type 1 · Well-Known Member

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    Wishing you and your daughter all the best, John. All we can do is look after ourselves as best we can, & then be hopeful & positive, having done it. Best is to keep safe. Take care,

    Lucy
     
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  9. Josie66

    Josie66 Type 2 · Active Member

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    Received my stay at home for 12 weeks letter today. Feel relieved
     
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  10. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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  11. Max68

    Max68 · Well-Known Member

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    Sorry to bump this but I watched a video on You Tube tonight and it seemed to partner up quite well with the summary at the start of the thread. In a nutshell the NYC Doctor in the video doesn't seem to think that the problem with this virus is pneumonia but a lack of oxygen akin to altitude sickness (I think!!) and that in his opinion seemed to believe that ventilating patients could be doing more harm than good. With the numbers of recovery not being to positive in those who have had serious ventilation procedure could he be right, but at the same time why would every medical centre on the planet be doing the wrong thing?!

    Link

     
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