COVID-19

Coronavirus disease 2019 or COVID-19 is a disease first associated with some people infected with the SARS-CoV-2 virus and later associated with some recipients of the COVID-19 vaccines. In early 2020, the World Health Organization declared a COVID-19 pandemic.

COVID-19 Cases

A COVID-19 case has often been confused with a SARS-CoV-2 infection. However, viral infection has not historically implied disease. This has created substantial confusion, and made statistics harder to gather and evaluate.

Symptoms of COVID-19

COVID-19 is primarily associated with acute respiratory syndrome, gastrointestinal, and vascular problems. However, SARS-CoV-2 can cause problems in nearly every organ.1) Inflammation and organ failure lead to much of the most severe damage in COVID-19 patients.

Blood/Vascular System

The physical phenotypes of blood cells (erythrocytes, lymptocytes, monocytes, and neutrophils) are altered in COVID-19, with some effects remaining after hospital release.2)

Some research points toward SARS-CoV-2 endothelial entry via integrin pathways, eliciting vascular leakage events.3)

Myocarditis

On September 3, 2021, the CDC published a study purporting to show that COVID-19 is associated with a 16-fold higher risk of myocarditis.4)

Gastrointestinal System

Sometimes COVID-19 results in complications in the gastrointestinal system. These can include nausea, vomiting, and diarrhea, but also bile duct casts and cholangitis in some cases.5)

The bile tract plays a role in interleukin-8 cytokin storming.

Skin and Subcutaneous

Some suffers of COVID-19 suffer lesions on fingers, toes, and knees.6)

PACS/Long Haul COVID-19

Post-acute coronavirus disease 2019 syndrome (PACS), also known as “long haul COVID”, plagues a significant fraction (around one-third) of those who develop COVID-19 suffer long-term health consequences after recover from the acute form of the disease.7) Long haul symptoms can last for many months.8)

The most common sequelae of those suffering long haul COVID symptoms include fatigue, post-external malaise, brain fog, select sensorimotor symptoms, headaches and related symptoms, memory issues, insomnia, and muscle aches.9) In some cases, long haul COVID has been associated with reactivation of neurotrophic pathogens such as herpesvirus.10)

Pediatric Specific Illness

A small number of affected children suffer from pediatric inflammatory multisystem syndrome that is temporally associated with SARS-CoV-2 infection (PIMS-TS).11)

Predictive Risk

Immunoglobulin (Ig) singnature has been associated with long haul COVID, as well as age, asthma bronchiale, and some symptoms during primary infection.12)

Treatment of Long Haul COVID-19

  • February 10, 2022 - Targeting the Monocytic-Endothelial-Platelet Axis with Maraviroc and Pravastatin as a Therapeutic Option to Treat Long COVID/ Post-Acute Sequelae of COVID (PASC)13)

Asymptomatic COVID-19

We usually do not talk about an asymptomatic disease state in medicine, though it is debatably more plausible that COVID-19 is associated with increased health problems not detectable by early outward symptoms.

Theories of Disease

COVID-19 is a complex disease that potentially affects different systems all over the body.

Immune Health Dependence

A summary of risk factors can be summarized as, “COVID-19 affects people in proportion to the weaknesses in their immune system,” whether generally correlated with age or with other comorbidities such as nutrient deficiencies or diseases of the immune system including diabetes.14)

Nutrient Deficiency

Research associates COVID-19 cases and severity with deficiencies in numerous vitamins and minerals. Colleen Huber, NMD declares COVID-19 to be a “lack of nutrients, exploited by a virus,” but is somewhat vague on the mechanistic details. 15) Each of these may or may not relate to other system aspects of disease covered in this article.

Major COVID-19 Correlates and Comorbidities

COVID-19 Vaccine-Associations

A study of data of vaccinated patients who suffered from COVID-19, taking data from the QResearch database on patients from December 8, 2020 to June 15, 2021, showed,

  • 74.1% had at least two doses.
  • Down's syndrome OR: 12.7x
  • Kidney transplant OR: 8.1x
  • Sickle Cell disease OR: 7.7x
  • Care Residency home OR: 4.1x
  • Chemotherapy OR: 4.3x
  • HIV/AIDS OR: 3.3x
  • Liver cirrhosis OR: 3.0x
  • Neurological conditions OR: 2.6x
  • Organ transplant (recent) OR: 2.5x
  • Dementia OR: 2.2x
  • Parkinson's disease OR: 2.2x

16)

COVID-19 and Age

The COVID-19 age curve is steep, with the elderly effected most and the young effected the least.17) The more severe the case of COVID, the steeper is the age curve.

Seealso : Risk Stratification

COVID-19 and Autoimmune Health

Autoimmune disorders and immunodeficiency might be described as the “primary COVID-19 correlate and comorbidity”, but is strangely underdiscussed by public health officials and the mainstream media.

COVID-19 and Blood Clots

It has been noted that blood clotting is associated with worse outcomes for COVID-19 patients,18) though it is not clear whether blood clotting results in more severe COVID-19, whether COVID-19 causes the clots in some patients—or which patients those would be.

COVID-19 and Blood Type

There is conflicting discussion of a correlation between COVID-19 and blood type, but evidence of a link may have thinned over time.

COVID-19 and BMI

COVID-19 and Diabetes

COVID-19 and Household/Family Factors

Researchers studying data from March 2020 in New York City found a positive association between COVID-19 and overcrowded and multigenerational households.19)

COVID-19 and Mental Illness/Learning Disabilities

Published research shows that when mental illness and learning disabilities are considered comorbidities, they are the most common among those who die from COVID-19 in hospitals.20) This has driven speculation that hospitals targeted the mentally ill for termination.21) An early study from July 2021 found mental illness to be the most associated risk factor for mortality in 16 observational studies in the 7 nations Denmark, France, Israel, South Korea, Spain, the United Kingdom, and the United States.22)

  • Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis23)
  • COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review24)

COVID-19 and Poverty

When poverty is considered, it turns out to have the second-highest comorbidity risk to age.25)

COVID-19 and Vitamin D Deficiency

Other Risk Research

COVID-19 has been observed in some research to increase odds ratios of mortality the most with those suffering from diabetes (6.426), renal failure (4.338), and hypertension (3.261). 26)

https://pubmed.ncbi.nlm.nih.gov/34779496/

https://pubmed.ncbi.nlm.nih.gov/34485092/

Prion Disease

There is some evidence that prion-like domains in the spike protein enable higher affinity for ACE2 receptor binding. https://www.youtube.com/watch?v=fNFzfwLM72c&t=2s

SARS-CoV-2 spike protein interactions with amyloidogenic proteins: Potential clues to neurodegeneration: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7988450/

Other (Imported--Organize needed)

Most common comorbidities (one hospital, Berlin):

Hypertension Ischemic heart disease Obesity

Causes of death and comorbidities in hospitalized patients with COVID-19

Most common comorbidities (larger study, global data)

Hypertension (27,4%) Diabetes (17,4%) CVD (8,9%) Chronic obstructive pulmonary disease (7,5%) Cancer (3,5%) Chronic kidney disease (2,6%)

Prevalence of comorbidities among individuals with COVID-19: A rapid review of current literature

Autopsy study of first 80 consecutive cases in Germany, relevant comorbidities (in descending order of frequency): (1) diseases of the cardiovascular system, (2) lung diseases, (3) central nervous system diseases, (4) kidney diseases, and (5) diabetes mellitus:

Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany

Myocarditis rare in COVID-19 autopsies:

Initial review of the data indicate that myocarditis was present in 20 hearts (7.2%); however, closer examination of additional reported information revealed that most cases were likely not functionally significant and the true prevalence of myocarditis is likely much lower (<2%).

Myocarditis is rare in COVID-19 autopsies: cardiovascular findings across 277 postmortem examinations

Johan observes: if that bit on myocarditis holds, I suppose that would be a possible candidate for a … comorbidity divergence.

Maybe this divergence explains what we are seeing in young, fit athletes suffering from heart conditions.

Unusual Aspects of COVID-19

Antidepressants

Researchers note that depressed COVID-19 patients respond far better than expected to SSRI antidepressants.27)

Major Topics Surrounding COVID-19

3)
March 15, 2022 | preprint | Danielle Nader and Steve Karrigan | Vascular dysregulation following SARS-CoV-2 infection involves integrin signaling through a VE-Cadherin mediated pathway | doi: https://doi.org/10.1101/2022.03.15.484274
5)
April 19, 2021 | David Sanders et al | Cureus (journal) | COVID-19-Induced Bile Duct Casts and Cholangitis: A Case Report | doi: 10.7759/cureus.14560
6)
March 8, 2022 | A Bassi et al | J Eujr Acad Dermatol Venereol | Not only toes and fingers: COVID vaccine-induced chilblain-like lesions of the knees | doi: 10.1111/jdv.18025
7) , 12)
January 25, 2022 | Carlo Cervia et al | Nature Communications | Immunoglobulin signature predicts risk of post-acute COVID-19 syndrome | doi.org/10.1038/s41467-021-27797-1
8) , 9) , 10)
June 23, 2021 | Amy D. Proal and Michael B. VanElzakker | Frontiers in Microbiology | Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms | https://doi.org/10.3389/fmicb.2021.698169
13)
February 10, 2022 | Bruce Patterson et al | Targeting the Monocytic-Endothelial-Platelet Axis with Maraviroc and Pravastatin as a Therapeutic Option to Treat Long COVID/ Post-Acute Sequelae of COVID (PASC) | DOI: 10.21203/rs.3.rs-1344323/v1
14)
November 18, 2021 | Eric Levinson | Naturally Connected Life | What The Research Says About Diet and COVID (Plus Practical Nutrition Guide)
15)
September 7, 2020 | Colleen Huber, NMD | PrimaryDoctor.org | COVID-19 is a lack of nutrients, exploited by a virus
16)
September, 2021 | Julia Hippisley-Cox et al | BMJ | Risk prediction of covid-19 related death and hospital admission in adults after covid-19 vaccination: national prospective cohort study | DOI: 10.1136/bmj.n2244
17)
Ledford, H. (2021). Deaths from COVID ‘incredibly rare’ among children. Nature, 595(7869), 639. https://doi.org/10.1038/d41586-021-01897-w
18)
April 21, 2020 | Medical Xpress | Could tiny blood clots make COVID-19 more lethal?
19)
September, 2021 | Ghosh et al | Public Health (journal) | Association between overcrowded households, multigenerational households, and COVID-19: a cohort study | doi: 10.1016/j.puhe.2021.07.039
20)
April 29, 2022 | Beaney et al | Nature Communications | Trends and associated factors for Covid-19 hospitalisation and fatality risk in 2.3 million adults in England | https://doi.org/10.1038/s41467-022-29880-7
22)
July 27, 2021 | Fond et al | JAMA Psychiatry | Association Between Mental Health Disorders and Mortality Among Patients With COVID-19 in 7 Countries A Systematic Review and Meta-analysis | DOI: 78(11):1208-1217. doi:10.1001/jamapsychiatry.2021.2274
23)
September, 2021 | Vai et al | Lancet Psychiatry | Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis | doi: 10.1016/S2215-0366(21)00232-7
24)
January 13, 2022 | De Hert et al | Frontiers Psychology | COVID-19-Related Mortality Risk in People With Severe Mental Illness: A Systematic and Critical Review | doi: 10.3389/fpsyt.2021.798554
25)
December 1, 2020 | Helen Salisbury | BMJ | Helen Salisbury: Poverty as a pre-existing condition | doi: https://doi.org/10.1136/bmj.m4607 ==== COVID-19 and Race ====
  • Shimizu et al (Dec 2, 2021): Identification of TCR repertoires in functionally competent cytotoxic T cells cross-reactive to SARS-CoV-2.
  • * Gene associated with less severe COVID more common in Asia.
  • * The Washington Free Beacon, Nov 29, 2021: Discussing this research is racist.
==== COVID-19 and Vitamin/Mineral Deficiencies ==== === COVID-19 and Vitamin A Deficiency === Tepasse et al, 2021 showed significant association between Vitamin A and many endpoints of disease progression such as hospitalization, ARDS, and mortality.((Tepasse, P. R., Vollenberg, R., Fobker, M., Kabar, I., Schmidt, H., Meier, J. A., Nowacki, T., & Hüsing-Kabar, A. (2021). Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis. Nutrients, 13(7), 2173. https://doi.org/10.3390/nu13072173
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