HOT TOPICS -- WEEK OF 4/27 --

ANTIBODY DEPENDENT EHNANCEMENT SYNDROME (ADE)

Molecular Mechanism for Antibody-Dependent Enhancement of Coronavirus Entry

4 Myths About Coronavirus Antibodies

If people, when first infected, had mild symptoms or were asymptomatic and now get re-infected will they mount Antibody Dependent Enhancement (ADE) because they have only mounted a mild immune response the first time and this can trigger the pathway for ADE leading to new severe symptoms due to cytokine storm (pus and inflammatory cells migrate to lungs and other organs) and complement cascade leading to coagulopathy -(clotting in arteries and veins leading to heart attacks, strokes, kidney failure, pulmonary emboli and vascular ischemia-dead limbs, et)c?

During ADE, the body's immune system can increase the virulence of the virus. The virus hijacks the immune response to help bring more virus into the cells to replicate and it stimulates inflammatory pathways which can cause more harm to the patient.

WHO released a report on Aril 25, 2020 and Dr. Birx stated on April 26, 2020 that antibodies may not provide protection.I wonder if they are referring to this situation? What is the level and type of antibodies needed to get protection from re-infection or the development of ADE? How does this impact vaccines and other therapeutics?

When will coronavirus end in the US? | The Independent

Click here to read.

STATES BEGIN TO OPEN INCLUDING IN COLORADO THROUGH SOME CITIES/TOWNS REMAIN CLOSED

-My basic points in article--opening will be rolling, regional and revolving between containment (surveillance-testing, tracing, quarantine, isolation and infrastructure-supples, staff, sites) and mitigation-social distancing

More men die of coronavirus than women ... | The Independent

Click here to read.

Can Estrogen and Other Sex Hormones Help Men Survive COVID-19?

- Sex impact--Studies are now launched to evaluate sex hormones (estrogen, progesterone, testosterone) and impact on:

* immune/inflammatory systems

*vascular permeability (leaky vessels) and stability (leading to clot formation)

*epigenetics- environment influences the genome

- Testis has ACE2 receptors which attach to coronavirus -potentially increase viral load and poor outcomes

-Gender impact--smoking, alcohol, nutrition, access to care

-Impact of sex.gender on design elements such as PPE, therapeutics, vaccines

CLINICAL TRIALS ON THERAPEUTICS NEED TO ANSWER:

-What--what is the most effective and safe dose?

-How-how is the drug administered such as by pill, injection, infusion, patch?

-When-when should the drug be administered during the course of the illness?

There is interest in the use of Pepcid as well as hormonal therapies to prevent serious outcomes.

Points to consider:

-Pepcid is being studied at high does intravenously and may be combined with hydroxycloroquine. People should not be going to their medicine cabinets and take Pepcid as a therapeutic for COVID-19.

-Men should not be taking their female partners hormone therapies which contain estrogen and progesterone such as birth control pills or menopausal hormone treatments. In the body, testosterone is converted into estrogen in fat cells so men have estrogen circulating in the body. Additionally, the early studies on estrogen and heart disease were done in men and found that men had higher heart attack rates. Furthermore, these studies are using pharmacologic (high) doses of sex hormones not what is used in conventional treatment.

-Men and women metabolize medications differently. FDA has suggested that this be considered in dosage recommendations, but often not followed. For example, it is recommended that Ambien be used at half the dose given to men. We need to consider dosage for men and women for medications and vaccines for COVID-19 which may prevent more side effects and increase the availability of the medication or vaccine.

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