In light of all the recent news, I have really tried to separate fact from fiction.
I have been doing my due diligence and ONLY listening to world renown speakers of infectious diseases and trusted doctors in their fields of expertise.
There is a lot of BAD information out there, and it’s honestly frustrating to know what to do.
I had to delete my facebook app on my phone, as I was frankly tired of people comparing this novel virus to flu, and making light of something that can be quite serious.
I wanted to focus on the science of the disease and some of the genetic components related to Covid-19. I also wanted to try and simplify some of the terminology, as reading these technical research papers can be arduous and time consuming.
I am by no means saying I am an expert in the genetic component of this disease or the disease all together, but I know we can be a better resource than the majority what you will find on social media.
In a recent podcast (3/14/20) with Dr. Peter Attia and Dr. Peter Hotez, they talk in detail about COVID-19 and the virus that causes it (SARS-CoV2). If you are interested in this podcast, check it out here.
I am not going to get into details of the CoronaVirus, or the theories where we are today on 3/14/20. I am going to try my best to provide some information on how this virus gains entry in our cells, to help provide clarity on a complicated subject. This novel disease is so disruptive due to its transmission through fomites. What’s a fomite? Fomites are inanimate objects that can become contaminated with infectious agents and serve as a mechanism for transfer between hosts. The classic example of a fomite is a park water fountain from which many people drink. Infectious agents deposited by one person can potentially be transmitted to a subsequent drinker.
Once transmission occurs, how does the virus travel into the human cell?
The organ systems being hit consist of heart, lungs, kidney and liver. This is why we are seeing multisystem organ failure fairly quickly as this virus progresses. What’s happening is that the virus binds to those areas, with a particular affinity for the lower respiratory portion of the lungs. This is a dangerous place to get an infection and a tough place to clear infection from. By the time the immune system responds, we have a decent viral load and the immune system is sent into overdrive. This results in what we call a cytokine storm. Thus, these systems are being destroyed by not only the virus but also the immune system’s reaction as well. This is why the hospital systems are being overwhelmed. At this point, there is not a whole lot that can be done by medical staff once it reaches this stage and the body decides to go haywire on itself.
The coronavirus is round and it has these spike proteins attached to it. The spike proteins bind to a very particular type of receptor that happen to live in the lungs, the heart, the kidney and the liver. These receptors are called Angiotensin Converting Enzyme 2 or ACE2 receptors. What does that mean to us? Researchers led by Qiang Zhou, a research fellow at Westlake University in Hangzhou, China, have revealed how the new virus attaches to an ACE2 receptor on respiratory cells and have been shown to be the entry point into human cells for some coronaviruses, including the SARS virus. Thus, if you’re on an ACE inhibitor drug such as lisinopril or any other hypertension medication, these drugs organically up-regulate your ACE2 receptors on your cells by default. This means, if you are on a ACE inhibitor medication, you’re probably walking around with a higher number of ACE2 receptors. Certain anti-diabetic drugs are also having these effects. The thought is that this could be putting these populations at higher risk. Interestingly, Asian men genetically also have more ACE2 receptors so perhaps that’s also why we are seeing a propensity of more men succumbing to this virus compared to women.
So what does all this mean? Well with a novel disease, like covid 19 we don’t really know because the definition of novel means new. What are some things that we do know at this point?
- From current studies we know that the elderly and those with comorbidities are at the highest risk.
- The initial reports out of China are showing that males are having the worst outcomes over females.
- People with high blood pressure, diabetes or basically any cardiometebolic conditions (a large majority of the general population of North America) are at greater risk.
- Best prevention strategies still include proper hand washing and cleaning techniques.
I know this blog post isn’t going to answer all questions, but hopefully it provides some clarity to the mechanisms that infectious disease experts are explaining.
Now everyone with access to a TV or phone knows that we can help prevent the spread of the disease and flatten the curve by prevention. You know the drill, washing hands for 20 seconds with moderate to aggressive scrubbing, social distancing, staying away from people who are already sick and so on. Other suggestions supported by this research include taking a quality Vitamin D3 as a preventative strategy.
In conclusion, fear of the unknown is fostering the panic around us. The more research that we do will help us better understand this novel virus and equip us with the tools necessary to flatten the curve. Do your part to educate yourself with quality resources and please make smart health choices to protect yourself and those around you.
References
Scientists figure out how new coronavirus breaks into human cells
By Stephanie Pappas – Live Science Contributor 3/10/20
J Biol Chem. 2009 Nov 20;284(47):32725-34. doi: 10.1074/jbc.M109.043547. Epub 2009 Sep 30.
Role of spike protein endodomains in regulating coronavirus entry. Shulla A1, Gallagher T. https://www.ncbi.nlm.nih.gov/pubmed/19801669
FOMITE-Science Direct
Structure, Function, and Evolution of Coronavirus Spike Proteins https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457962/
Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?
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