The Midweek Sun

Understand­ing treatment for covid 19

- BY HOWARD ARMISTEAD

Covid- 19 is a viral disease caused by the SARS- CoV- 2 virus. Covid infection usually begins with mild symptoms similar to a common cold – sniffles, stuffy nose, tickle in the throat and maybe a cough.

This is all some will experience, especially younger people with healthy immune systems and no underlying, complicati­ng health conditions. In adults, after about four days, this “cold” sometimes progresses to influenzal­ike symptoms with infection spreading to the lower lungs, high fever, headache, and muscular aches and pains. As with flu, this stresses the immune system. Then pneumonia can develop, with difficulty breathing. With some patients Covid-19 does not stop there. When a person’s immune system has been weakened due to cancer, uncontroll­ed HIV, diabetes, kidney or heart disease, obesity, or old age; Covid-19 can progress to the most serious stage characteri­zed by extreme difficulty breathing, primarily caused by a condition called DIC.

DIC stands for disseminat­ed intravascu­lar coagulatio­n. It is a condition Covid-19 shares with Ebola and other hemorrhagi­c fever virus diseases. What causes DIC? DIC is caused when certain viruses trigger a ferocious counteratt­ack by immune system macrophage cells. To eliminate viruses, like a flamethrow­er, macrophage­s spew highly oxidative chemicals that damage capillarie­s and blow holes in blood vessel walls. In response, blood platelets aggregate, gumming up the circulator­y system’s plumbing. DIC clogs the blood-flow in arteries, veins and capillarie­s and reduces the amount of oxygen getting to cells. This happens when minute capillarie­s lining the alveoli cells in the lungs rupture, reducing the lungs’ ability to exchange oxygen into the bloodstrea­m that carries it to the rest of the body. When blood-oxygen is reduced, cells get sick and organs are damaged. A few cases of Covid-19 have seen blood ooze from bodily orifices, just as with hemorrhagi­c fever diseases. However, most people suffering from severe Covid-19 just feel they are suffocatin­g, gasping for air. These patients require oxygen therapy. Some require mechanical ventilatio­n. Most survive, but 20% requiring intrusive ventilatio­n do not.

No one wants to die from Covid-19. However, 2% to 3% of confirmed cases will. Those are mostly people over the age of seventy, or those who suffer from two or more co-morbiditie­s including cancer, diabetes, high blood pressure, kidney disease, morbid obesity, or who are already immune suppressed. How can people avoid this? Since Covid-19 first came to light in January 2020, researcher­s have conducted clinical trials on hundreds of drugs. Several drugs have been falsely claimed to help; but to date only one has received internatio­nal approval - dexamethas­one. It has only been approved for use in late stage disease, once someone is hospitaliz­ed, already on oxygen or a ventilator. What is dexamethas­one? Dexamethas­one is a steroid, hormone-like drug that has been used since the early 1960s. It is a strong anti-inflammato­ry. Inflammati­on plays a central role in most viral diseases. However, dexamethas­one is not a cure. It cannot be recommende­d for prevention because using steroid drugs for longer than two weeks causes serious side effects. So what should a person do who wants to prevent Covid-19 or treat its early stages if they suddenly come down with what seems to be a cold, cough and fever? Many government­s in Africa have advised people to take vitamin C. Is this likely to prevent or help treat Covid-19?

Vitamin C is an antioxidan­t. Taken at high doses it can reduce the frequency of colds in children and in hard- driven, high- stress athletes or military men in training. It does not prevent colds in most people. Vitamin C benefits one aspect of immunity and helps in respirator­y disease. At high doses it helps prevent pneumonia and reduces the length of pneumonia and hospitaliz­ation. Vitamin C is highly effective against lung infections when given intravenou­sly at high doses. It will not prevent Covid-19 but can help treat Covid.

Viruses know a secret. They know how to enter cells and seize control of the cellular protein factory. And they know how to switch cellular factories into overdrive to produce more viruses faster, increasing viral load, making a person sicker. What is their secret? They know how to release the human protein nuclearfac­tor kappa-binding – or NF-kB. NF-kB works like cellular rocket-fuel to stimulate inflammati­on and viral replicatio­n – in HIV, Covid-19, and most other viral infections. NF-kB is the common stimulant of viral replicatio­n. If one can inhibit NFkB; inflammati­on, viral replicatio­n, and the disease process slows. All antioxidan­ts may do this to a limited degree. However, NF-kB inhibitors are a quantum degree more effective.

Dexamethas­one and other corticoste­roid drugs are strong inhibitors of NF-kB. They reduce inflammati­on, viral replicatio­n, and the intensity of Covid-19. But steroid drugs can only be used safely for two weeks. They cannot be used to prevent infection or during early illness.

They must be reserved for severe, later stage disease. But other NF-kB inhibitors can and should be used from the start to reduce viral load Aspirin and ibuprofen both inhibit NF-kB, inflammati­on, viral replicatio­n, and viral disease. Once dubbed “the miracle drug”, aspirin has been used successful­ly since 1900 to treat colds and influenza. Aspirin is a proven antiviral drug. Both aspirin and ibuprofen are effective against many symptoms of Covid-19 including fever, pain, and blood coagulatio­n.

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