Merged 2019-nCoV / Corona virus

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Capsid said:
Viruses are usually frozen down in culture supernatant at low temperatures preferably -80C and are stable for a long time like this. I don’t know of exceptions. All have protein capsules ( they are called capsids!) and some also have lipid envelopes. The main aim is to protect the delicate RNA or DNA inside.


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Your expertise is wonderful.
 
Planigale said:
In answer to the highlighted. No. You naturally produce about 4 pints of mucus a day in the lungs. This normally flows up to your throat, is swallowed and any germs digested. The GI tract has an active immune system that processes swallowed germs and helps develop an immune response. Thin mucus will be coughed up or naturally flow up. The problem is the thick mucus that plugs up the lungs. So things that loosen up mucus, e.g. expectorants or steam are good.

PS dextromethorphan is not a placebo but is a real cough suppressant and so in this situation is a 'bad thing'.
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Four pints of mucus in the lungs, really?

I'm going to stick my neck out here without checking and say that is absurd. We'd all be drowning.

That wouldn't be your lungs anyway, it would be your bronchi and trachea.

And I do use dextromethorphan as a cough suppressant, again, when you need to control the symptom. There are times you do.
 
alfaniner said:
I'd like something like crossing one arm across the chest, with a slight head nod. In fact, I might start that -- a sign that "I'll keep my hands to myself, please."
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You could always use my traditional holiday greeting of "Hail Ming!" :



As a bonus it would give me an excuse to wear a sword outside of class.
 
I don't if this is true, but I read that...

This coronavirus infection creates a dry cough and is not associated with congestion. Also no runny nose with this one.
 
Skeptical Greg said:
I'll see your study and raise you one.

Fever: suppress or let it ride?

( There's a lot more. I spared you the wall-o-text. )

Skin that one, and I'll go get another one.
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I didn't post a wall of text, I posted a wall of citations the review article on fever used to support its conclusions.

There are lots of papers hypothesizing about not treating fevers. It's been speculated since at least the 70s that maybe fever has a purpose.

Observe -> generate hypothesis -> test said hypotheses -> confirm results.

Let's look at the one study you found:
Despite this evidence, treatment of fever is common in the ICU setting and likely related to standard dogma rather than evidence-based practice. In this prospective controlled trial by Young et al. published in the NEJM on December 3, 2015, 700 ICU patients with fever of known or suspected infectious etiology were randomized to receive either 1 g of intravenous acetaminophen or placebo every 6 hours until ICU discharge, resolution of fever, cessation of antimicrobial therapy, or death (20). The patients in the treatment group did have a statistically, but likely not clinically, relevant lower mean daily average temperature (absolute difference −0.28 °C, P<0.001). Sustained resolution of fever was also significantly higher in the treatment versus placebo group (22.8% vs. 16.9%, P=0.05). The main outcome was ICU-free days until day 28, which was not shown to be decreased in the treatment arm. Secondary outcomes, including 28 and 90-day mortality and ICU and hospital length of stay, were also not significantly different between groups. However, acetaminophen was associated with a shorter ICU stay than placebo among survivors and a longer stay in non-survivors. In terms of adverse events, there was no difference between groups in discontinuation of the drug due to liver dysfunction, and one patient in the placebo group suffered from markedly elevated temperature associated with death. It should be noted that the study population was predominantly non-surgical and that the treatment period was relatively short. More and more high-level randomized controlled trials are supporting the “let it ride” philosophy compared to the original prospective observational studies, which seem to support the opposite.
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It's that why you said ski[p] it?

You can hunt down all the studies you want. Why not first actually look at the literature review I posted and the 72 citations they cited?

No doubt there are going to be studies of kids, of people with influenza, of people with RSV, whatever with variable results. I'm not suggesting all the research that needs to be done has been done.

But the idea fever evolved as part of the immune system therefore it must be important is where the fallacy is here. It sounds nice, that doesn't make it a fact.

As someone who suffers from a significant autoimmune disease, I can attest to the fact our immune systems are far from perfect.


And I don't care how many single studies you post, they are not as definitive as a thorough literature review.

Now if you want to post an extensive literature review you will get my attention.
 
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Steve said:
An article with no conclusion. Maybe this, maybe that.

"One could hypothesize that treatment of fever compromises immune competence and renders patients more susceptible to infection." Waffling at its finest.
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:thumbsup:

But but, evolution....
 
I'd like to make a request that any member who posts fever temperatures please include both Celsius and Fahrenheit so that your fellow members do not have to do the conversion themselves. Thanks.
 
Skeptic Ginger said:
Why don't you read it before you dismiss it because it doesn't fit your confirmation bias?

It's a pretty thorough review paper.
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Here are the results of the study which was number one on your list.


Association of body temperature and antipyretic treatments with mortality of critically ill patients with and without sepsis: multi-centered prospective observational study.

RESULTS:
We recorded body temperature 63,441 times. Antipyretic treatment was given 4,863 times to 737 patients (51.7%). We found that treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen independently increased 28-day mortality for septic patients (adjusted odds ratio: NSAIDs: 2.61, P=0.028, acetaminophen: 2.05, P=0.01), but not for non-septic patients (adjusted odds ratio: NSAIDs: 0.22, P=0.15, acetaminophen: 0.58, P=0.63). Application of physical cooling did not associate with mortality in either group. Relative to the reference range (MAXICU ≥ 39.5°C increased risk of 28-day mortality in non-septic patients (adjusted odds ratio 8.14, P=0.01), but not in septic patients (adjusted odds ratio 0.47, P=0.11) [corrected].
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You want me to find the next one?
 
Steve said:
Cherry picked by who, exactly, in the case at hand?
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I would have to look closer at the review and see who sponsored it.

These things don't get done without grants.

This particular review may be benign, but it's interesting that the first cite had the opposite conclusion that SG was claiming.

P.S.

Here is more from the conclusions of the review SG cited..

It is not clear which patients are most at risk, but it is likely that the individual’s physiological response, as well as the duration of the hyperthermia, may be important. Further work is needed to clarify how genotypic and phenotypic differences predispose an individual to developing neurological deficits. Current treatment is essentially limited to urgent cooling by physical methods;
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So, according to the review, fever reducing drugs are not considered a first line of treatment.
 
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Steve said:
An article with no conclusion. Maybe this, maybe that.

"One could hypothesize that treatment of fever compromises immune competence and renders patients more susceptible to infection." Waffling at its finest.
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Did you read the conclusions of SG's review?

I would say a waffle with extra syrup..
 
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William Parcher said:
I don't if this is true, but I read that...

This coronavirus infection creates a dry cough and is not associated with congestion. Also no runny nose with this one.
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That seems to be correct - fever and dry cough to start, turning to pneumonia in some cases.

I'd love to know whether the ones who croaked treated the fever - there's a good study for someone there when it's finally vanquished.
________________

New Zealand doing its bit to join the other nations that have proven hopeless at stopping the spread of the disease.

Nice of her to spread it all over North Island: https://www.stuff.co.nz/dominion-po...coronavirus-second-confirmed-new-zealand-case
 
Skeptical Greg said:
Here are the results of the study which was number one on your list.


Association of body temperature and antipyretic treatments with mortality of critically ill patients with and without sepsis: multi-centered prospective observational study.



You want me to find the next one?
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Actually, Skeptic Ginger already said that sepsis was an exception.

Anyway, the argument that it has an evolutionary benefit therefore it must apply to the modern world is dubious. We were evolved to crave certain food that was scarce in prehistory, but in a world where the food is abundant we just make ourselves fat or get diabetes eating it. Similarly, while fever may have to adaptive trait in evolutionary terms, it doesn’t mean running a high fever when there is medicine around is the optimum strategy.
 
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