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An interesting explanation as to why it might have these effects, from MedCram on YouTube: https://youtu.be/Aj2vB_VITXQ
The video is interesting, but to the claim that "once it (the virus) gets inside the body, that's where it causes its greatest damage" (at 2:54 into the video) he should have added "in some cases".
Once someone gets mauled by a pack of roaming coronaviruses, give me a call. Until then, I think we can agree that coronavirus is more dangerous inside the body than outside.
I think the point is that there is no evidence too support that it always does this. Worth more investigation. Specifically on more people that had the antibodies and were never sick. Would be amazing to know when this will cause damage.
The video distiguishes between "inside the lungs" and "inside the body". It claims that there is more damage done inside the rest of body than inside the lungs. At the end of the video it becomes clear that this may happen only in certain cases. Watch the video and you will understand.
Ah, that is a relevant distinction.
Hasn't this been known for a while? I recall stroke was always a risk and one of the ways people could die from COVID-19 (including ARDS and Pneumonia)
Speculated maybe, but known? Not widely and it looks like it's now starting to get wider attention which is a good thing. The more we know about this virus the better it will be for treatment. If clotting is a significant problem we definitely have drugs to help with that.
Before the evidence is overwhelming it is highly likely; before that probable; priorly possible and previously hinted at.

So if the coronavirus is doing something in the blood then there probably was evidence of it from the start but it is still newsworthy if the evidence has passed a new threshold.

It would make for some interesting implications if coronavirus detected in the respiratory system isn't the mechanism for bad cases of COVID-19. Some of the drug trials done looking at viral loads would be partially invalidated.

These articles are not helpful and should be discouraged.
Why?
Without any meaningful context into which statements and observations like this are woven into, it's mostly counterproductive for the general public.

How about we treat side effects of alcohol drinking with the same urgency and publicity? We don't. I'm sure there is a lot happening in your body when you drink 4 beers. And you could write thousands of articles just like this right now with credible studies behind them about flying, drinking, sky diving, coffee, etc. And you could make them sound even more scary. None of which is taken seriously, because in the public there is no demand for it. Because those risks are just taken as a given for existing and participating.

But at the moment every little effect is being treated like world news. Casual medications advertised for on TV have more significant side effects.

This is a baffling viewpoint to me. You realize that alcohol abuse isn't contagious, right?
You realize that alcohol related deaths top 80,000 per year in the US? And that doesn't even include secondary deaths e.g. traffic accidents? You realize you can buy this stuff in almost every store that carries a bottle of water? And that it's taxed?

So let's assume we top out at 160,000 covid19 deaths by Christmas. Let's compare the news coverage of those 80k alcohol deaths with those 160k covid19 deaths.

That’d be 160,000 deaths even while under social distancing and isolation measures. The number would be much higher if a large portion of the country and particularly the New York Area weren’t staying at home. We’ve made it to 70k in 2 months with social distancing.

Actually, I’ve seen this tactic of argument with the number of deaths incremented for months, including from our esteemed pres. First it was “there are NO deaths, relax,” then “all this for 3,000 deaths?”, then “this many people die from the flu!”, and now the same argument with a 160k figure and alcohol. I wonder at what point this shape of argument will stop being made.

"man shot 9 times dies due to corona virus".

I question how the media is counting these deaths from corona virus. The infection fatality rate keeps going DOWN not up, in peer-reviewed journals. I suspect its going to end up like swine flu. The amount of people that actually die from this will be 10x lower than the initial media outlook, once you calculate the numbers honestly.

You may suspect whatever you like. The evidence of hard hit areas like Lombardia and NYC are enough evidence of the seriousness of this to me. But clearly your evidentiary standard differs.

Moreover I haven’t seen anything to suggest IFR isn’t in the .5% to 1% range, compared to <.1% for the average flu. Do you think the 1.3% fatality rate from the Diamond Princess was just bad luck for them?

Because the data isn't random enough? They've done random studies in a bunch of places, including germany and california and the IFR is about 0.2% - 0.38% and it keeps getting lower. There's no way in hell the IFR is 1.3%, that's just media sensationalism .
I mean, it’s not media sensationalism to point out 13 of the ~1000 people on that ship who tested positive died.

You’re so heated about your media preoccupation that you’re calling facts media sensationalism while trying to present as making a rational case.

Of course it's media sensationalism.

As an exaggerated example, if I went to people who are all on stage4 cancer, and give them the corona virus, and 20% of them die, cnn will post something like "the corona virus kills 20% of people based on that sample!"

"Swine flu's" eventual death count ended up being 10x lower than what "the news" was initially predicting.

So your argument is that the recorded death toll and infection count from the boat is media sensationalism.

(I don’t recall reading it was a cruise for stage 4 cancer patients. Darn media)

I said "exaggerated example". And the cruise had a hugely disproportionate number of elderly people, which skews the "random" sample.

So yes, it's media sensationalism.

The “it” you are taking about is a straw man interpretation. The figures are what they are. I never said the ship data proves that IFR is 1.3%, you just seem to have gotten triggered and said pointing out some evidence which could help determine what the IFR may be constitutes media sensationalism.

BTW if the at risk population is 10% and the IFR for that population is 10% and 0% for everyone else, and infections are spread evenly, that works out to 1% IFR. You have some things you’re very frustrated by, I can tell, but your attempt to substantiate your emotions with data criticism is not successful.

The true IFR rate is nowhere near 1.3% or even 1%. This, in the same way that the new york true "death toll" is nowhere near what they are reporting. It's a plain-old case of "man shot nine times dies of corona virus" headlines. These are just wildly exaggerated numbers through intellectually dishonest sampling that the media is incentivized to give.
You're just repeating assertions without basis.
My "basis" is peer-review academic journals. Not commercial media sources who are incentivized to sensationalize the numbers.
I think you're missing the point of the original comments. The argument is not about deaths, but about the way the media covers different topics.
I think the Post is about coronavirus and my comment is more on topic than the off topic content about alcohol that I was responding to.
You're right. We shouldn't talk about a bad thing when the there are other bad things to talk about.

What exactly is your point here beyond comparing apples to oranges? A contagious disease is kind of a whole different ballpark compared to alcohol and I'm having trouble parsing why you would compare the two.

The flu is a contagious disease, but you never made a big deal about it until now, at least according to your post history. The only reason you're making a big deal about it is because the media is. The IFR is actually going DOWN, not UP.
Just post “wake up sheeple!” and move on. this you’re tricked by the media shtick has no place here.

Also “aha! You never made a big deal on hacker news about this other contagious disease which has been with humanity for millennia! You are a fraud!” Is not a good argument.

But the media is known to put misleading articles because it generates more ratings. This is no different.
OK. You should take your boilerplate media conspiracy content somewhere else, it has no place here.
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The IFR is variable based on where it's sampled and the range is anywhere from 0.2 to 0.8ish. This isn't 'media bullshit', this is from actual studies. Even at the lower bounds of 0.2, that places it at double the IFR of the seasonal flu.

It seems more like the only reason why you're not making a big deal out of it is because you've bought into irrational skepticism. The fact is that I have family members that are severely at risk if they were to catch the coronavirus, so I have a vested interest in making sure that they don't get it.

But if it makes you feel better, by all means include me as part of your media conspiracy.

I have family members that "are severely at risk", which is why I am self-infecting then quarantining. That way, antibodies form naturally and I can't spread it to anyone, including my family and yours.

And the IFR keeps going down, not up.

>You realize that alcohol related deaths top 80,000 per year in the US?

Alcohol consumption is a voluntary, pleasurable activity for the vast majority of drinkers, and the complication rate is many orders of magnitude lower than it is for COVID.

Alcohol and COVID aren't anywhere close to the same league. This comparison doesn't make sense.

To put this in perspective: even responded to, covid has the capacity to double the amount of deaths per year, compared to normal. That is rather higher than alcohol.
You are aware that alcohol is not contagious?
We'll probably have 500k dead by xmas in the us alone.
How is reputable information not helpful?
well, it's Bloomberg citing one person only, it's not a scientific paper. I do find it quite worrying that when news gets hold of all kind of edge cases or special cases, with barely any scientific data to back it up (from COVID causes X, Y and Z) everyone has no issue with the scarce facts. When an actual antibody test or special cases (like the one from France with more scientific explanations and detailing how a guy who was swabbed in December got a positive result), we need to be careful as the science is not valid or there are serious doubts over minor statistical error.
> it's Bloomberg citing one person only, it's not a scientific paper.

Not sure I follow, I see a lot more citations than one person.

FTA:

https://ashpublications.org/blood/article/doi/10.1182/blood....

https://www.fip-ifp.org/wp-content/uploads/2020/04/acroische...

https://europepmc.org/article/ppr/ppr152878

> Mitchell Levy, chief of pulmonary critical care and sleep medicine at the Warren Albert School of Medicine at Brown University

> Margaret Pisani, an associate professor of medicine at the Yale University School of Medicine

https://www.hematology.org/covid-19/covid-19-and-coagulopath...

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.1...

https://www.cuimc.columbia.edu/news/thrombosis-emerges-signi...

> Anthony Fauci, the director of the National Institutes of Allergy and Infectious Diseases

https://pubs.rsna.org/doi/pdf/10.1148/radiol.2020201561

https://pubs.rsna.org/doi/pdf/10.1148/radiol.2020201629

> Edwin van Beek, chair of clinical radiology at the University of Edinburgh’s Queen’s Medical Research Institute

> Jean Connors, a Harvard Medical School hematologis

https://journals.lww.com/annalsofsurgery/Documents/Gastroint...

https://www.nejm.org/doi/pdf/10.1056/NEJMc2009787?articleToo...

> Frank Rasulo, a head of neuro critical care at Spedali Civili University Hospital in Brescia

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The article cited doctors from Harvard, Brown, Rhode Island, Italy, Dr. Fauci, etc.
Which also can leave stuff out for sensationalistic reasons, which the media is known for. After all the deliberately misleading information from "the news", I no longer take it seriously and instead pay attention to peer-reviewed journals with public data.
If I may, I think the GP feels that this information is stress-inducing but not really actionable for those of us not in the medical field. I don't know if I agree with their stance that it shouldn't be shared, but I sympathize.
So where will you stop? I think I'm capable of deciding that for myself without what amounts to censorship by unknown people acting on my behalf. And even if I'm not, why should my judgmental insufficiency be a watermark defining what others read?
I agree that they (article about rare effects) are not helpful in the mainstream media. However Hackernews is not mainstream media. Everyone here understands stats enough to put context around articles like these.
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So this is extremely interesting, because recently several studies have shown an association between low Vitamin D levels and severe COVID-19 outcomes. This is particularly relevant, because Vitamin D appears to play a role in clotting factors as well; low Vitamin D levels have been independently associated with an increased risk of clotting events and death. There are studies investigating whether Vitamin D deficiency can cause increased thrombin generation and a hypercoagulable state.

"Of 49 patients with mild symptoms of Covid-19 in three hospitals in southern Asian countries, only two had low levels of vitamin D; of 104 patients with critical or severe symptoms, only four did not have low levels of vitamin D." https://www.telegraph.co.uk/news/2020/05/03/time-take-seriou...

"The VDI (Vitamin D Insufficiency) prevalence in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ICU patients less than 75 years old had VDI. Coagulopathy was present in 62.5% of ICU COVID-19 patients, and 92.3% were lymphocytopenic. Conclusions: VDI is highly prevalent in severe COVID-19 patients" https://www.medrxiv.org/content/10.1101/2020.04.24.20075838v...

"Vitamin D has been shown to have an anticoagulant effect. A decrease in 25-hydroxyvitamin D [25(OH)D] concentration has also been associated with an increased risk of venous thromboembolism. " https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069050/

There is also other literature suggesting that Vitamin D can reduce the risk for the "cytokine storm" which leads to acute respiratory distress syndrome by reducing the production of pro-inflammatory cytokines (while increasing the expression of anti-inflammatory cytokines). Again, I'm not a doctor but supplementation is likely to be fairly low risk. There is increasing evidence that there's some sort of correlation and it may be worth exploring.

takes 4000iu vitamin D pill What me, easily marketed to?

I wonder if any of the results show supplements work as well as diet/sunlight?

For many people diet/sunlight is insufficient - there's a host of cofactors and things that probably play a role in this. I'm not too sure on just how effective supplements are but I've personally used them to raise my serum D levels with success.
They can be, but the oral absorption pathways are complicated. You need to be sufficient in other vitamins, I can’t remember which, in order to absorb vitamin D from your food.

Generally it’s recommended that sun > supplements, for a few reasons. But if you can’t get some sunlight supplements are not a bad choice at all.

> sun > supplements This is interesting, a recent article/study mentioned this, it appears that there is a link between sunlight and lower blood pressure in dialysis patients among other benefits. It would also explain why death rates/severe covid-19 in warmer climates is lower than colder climates.

https://www.outsideonline.com/2410015/sun-exposure-blood-pre...

Sunlight involves going outside, which we know is good for your health (barring pollution, of course).
——
People are taking more walks and runs in my neighborhood than ever before. Social distancing != hiding indoors.
Also, and probably the direct mechanism of action, sun exposure doesn’t just produce vitamin d. It also increases nitric oxide levels which should reduce BP
Ecuador (literally on the equator) being the catastrophic and tragic exception.
You might want to take Vitamin K along with your Vitamin D, particularly if you're taking large doses of the latter, which can cause calcification of the soft tissues in your body, while Vitamin K makes sure that calcium gets deposited in your bones, as it should. Here is one of many articles that talks about the connection:

https://www.healthline.com/nutrition/vitamin-d-and-vitamin-k

I believe Vit K deficiency is less common than Vit D deficiency
Yep. K2 MK7 specifically. Cheese (most) and natto are good dietary sources of K2. The better D3 supps are formulated with an optimal D3 to K2 ratio.
Vitamin K also increases risk of blood clots. https://health.clevelandclinic.org/vitamin-k-can-dangerous-t...
When you get a blood clot, Warfarin that they give you for it is literally a vitamin K blocker.
Warfarin is also literally used as rat poison, with the same mechanism of action.
"The dose makes the poison."

Botox is a pretty powerful tool for doctors when applied locally in small quantities, but often fatal in Botulism. Water is necessary for life, but hyponatremia is a real thing.

To my understanding, not if you don't take warfarin. There's no upper limit of vitamin K intake for healthy people.
> because recently several studies have shown an association between low Vitamin D levels and severe COVID-19 outcomes

Closer research shows it probably isn't relevant.

https://www.cebm.net/covid-19/vitamin-d-a-rapid-review-of-th...

How do you get to that conclusion from that paper?

All I see from that paper is that there is "no evidence" that Vitamin D is beneficial with COVID-19 (and some qualified evidence that it may help other respiratory infections).

They mentions several planned/registered studies on the question, but none that have reported results yet.

I'm glad someone has looked into but it doesn't confirm or deny much. They were -measuring mortality- against those already infected and those "instituionalized but asymptomatic". It doesn't seem to say anything about making symptoms milder for those that contracted covid-19 after taking supplements or for those who have already contracted, which is what I think OP was suggesting.
That’s calling out a lack of formal trials providing evidence, not discrediting the data that is emerging.

Either way, they still recommend supplementing if deficient(which the numbers for people with IVD are quite high in most regions).

This is interesting, because although circumstantial, what's happened here in Iceland, is that we have had markedly better outcomes than other countries. If you're interested:

http://covid.is

It would be correct to think that at 66 degrees north, and a lot of cloud cover, there is significant risk for Vitamin D deficiency. The consequence is near religious attention to taking fish oil supplements. Doctors routinely screen, Vitamin D tablets are prominently on sale in all the supermarkets etc. It's definitely a data point.

Yes but the population of Island (364K) is way less than many other countries, so it's much easier to control the disease.

To put things in perspective, the US population is 328M.

The population of Iceland is also highly concentrated in one spot on the west of the island. We're talking over 1/3 of the country. If you take in the Greater Reykjavik area, you're talking about 2/3 of the population.

People bring this up when it comes to smaller countries, but it doesn't take into account population concentration, which is much more important than sheer population size or density.

Iceland has been very effective.

Iceland is also far less densely populated
Honest question, is that relevant? Two thirds of the population live in the capital region, measuring just over 1% of the area of the country. Iceland is according to some measures one of the most urbanized countries in the world [0]. The virus can't "feel" there are vast swathes of uninhabited land out there, can it?

0: https://en.m.wikipedia.org/wiki/Urbanization_by_country

No packed mass transit like other dense urban centers. Even their "urban center" is much less dense than other cities.
In India,one of the slogans of Lockdown is Stay Home,Stay Safe. I think many other countries have urged their citizens to stay at home aswell.

My concern is, if the risk of transmission is more indoors than outdoors as this study indicates(https://theprint.in/health/sharing-indoor-space-major-infect...), Is staying at home making people Vit-D deficient coz of less exposure to sunlight?

And If this is true, is it one of the factors responsible for severe Covid19 outcomes?

Is this also the reason why old folks are severely affected from Covid19, coz they may tend to stay indoors more, relative to other age groups?

"Stay home, stay safe" only works if the other people in your home stay home too. It's not surprising people get infected indoors - one sick person in a household, office building, or restaurant will infect those nearby. You're far less likely to get it from a random passerby on the sidewalk, as your exposure time is much more limited.
Does Nitric oxide make the blod clot less?
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I thought this was going to be a roundabout article about the effects of being on my chair all day during lockdown.
Perhaps it is, tangentially, if you don't get any sun from your chair, and the vitamin D link turns out to be true.
I bought a (cheapish) height adjustable desk. Would recommend. Stand up occasionally and walk on the spot or dance or something. Especially good during online meetings :D
This story in today's Washington Post seems relevant too:

"15 children in New York City have developed a puzzling and serious inflammatory syndrome possibly linked to covid-19

- The condition is similar to what doctors have observed in Europe"

https://www.washingtonpost.com/health/2020/05/05/coronavirus...

I remember how shocked I was when I first read about the increase in strokes associated with covid-19. Every time I read a new development about what the virus can do, I'm just dumbfounded. Either the virus is mutating, it has multiple drastically strands, or there is so much we still don't know about it. Either way, it makes me very hesitant about going out even if things are opened up.
My (armchair) assumption is that we are still learning.

I'm reminded of the film, "The Andromeda Strain" (1971) — such an intelligent movie. Still feels cogent almost 50 years later.

Based off a fantastic Crichton book, fwiw.
I'm confused about why everyone is surprised that something that elicits an inflammatory response in the body can increase your risk of blood clots. Increased inflammation -> increased clotting in a number of diseases, not limited to coronavirus. A quick literature search reveals that this is the case for a other viruses and autoimmune diseases.

This was a particularly enlightening paragraph from StatPearls: There is an interplay between inflammation and the coagulation system. Inflammation triggers a hypercoagulable state.[45] Endotoxin activates the complement system leading to thrombocytopenia and hypercoagulability.[46] The relation between inflammation and coagulation can be observed clinically in patients with purpura, vasculitis, and septic thromboembolism.[47][48] Coagulation helps to limit the expansion of infection, and some bacteria use fibrinolytic properties to oppose this response. Autoimmune diseases like systemic lupus erythematosus, immune thrombocytopenic purpura, polyarteritis nodosa, polymyositis, dermatomyositis, inflammatory bowel disease, and Behcet's syndrome increase the risk of thrombotic events.[49][50][51] The cytomegaly virus (CMV) has correlations to atherogenesis through a change of the cellular lipid metabolism and leukocyte adherence.[52]

https://www.ncbi.nlm.nih.gov/books/NBK538251/

According to the literature I have read, there is no evidence that Its mutating rapidly, nor is there multiple distinct strands. The increase in strokes is real, but your risk if you are <60 years old of having one is still vanishingly small. We don’t know much about the virus, nor will we for a while. Knowing things is hard, science takes a long time. We still don’t fully understand many of the pathogens that have been around for all of our collective lifetimes, so you shouldn’t expect us to be able to fully characterize one that just showed up a few months ago. What we do know from places which have been hit very hard, like bergamot is that if you are less than 60 your chance of dying from the virus is about the same as that of your risk for dying in a year, which if you are young and don’t have co morbidities is a very small number.
There seems to be a through-line that the whole thing is related to clotting and coagulation. That basically it's not destroying lung tissue so much as preventing the blood from properly absorbing oxygen from the lungs.
I don't think it's mutating. I think it's just very novel, and also came with its own red herring in the form of the respiratory symptoms. Doctors treated the problem in front of them and assumed it was like other things they'd seen, when in reality that was just the tip of the iceberg. But it's reassuring to me to see discoveries being made and treatment evolving. I think the disease will become much less deadly long before we have a vaccine, just due to new discoveries in how to treat it.
This condition was observed in the UK and had similar symptoms as Kawaskai Disease:

>The cases have in common overlapping features of toxic shock syndrome and atypical Kawasaki Disease with blood parameters consistent with severe COVID-19 in children.

https://www.hsj.co.uk/acute-care/exclusive-national-alert-as...

Quite alarming. Not even all kids' immune systems can deal with SARS-CoV-2.

15! There are some 2 million kids in New York. Surely you'll find more gruesome fates among some of them.
See D-dimer concentration in surviving and non-surviving patients: https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachme... It sky-rockets in non-surviving patients. For the context, D-dimer is a fibrin degradation product, a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.

(Fig. 2 Temporal changes in laboratory markers from illness onset in patients hospitalised with COVID-19 from "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study" https://www.thelancet.com/journals/lancet/article/PIIS0140-6...)

Time to buy shares in makers of novel anticoagulants.
Does not explain why Spain and Italy that are Mediterranean countries with lots of sun were hit hard, but Norway was spared, for example.
It's supposed to look like HAPE -- blood clots are actually coming in and blocking blood vessels in the lungs.