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Are patients with hypertension and diabetes at increased risk for COVID-19?

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Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#61

Post by Flow »

dukha wrote: post #46
mrb wrote: post #36

French sources specifically mention severe cases of covid-19 in "young and healthy" patients (eg. see https://lefigaro.fr/sciences/coronavirus-alerte-sur-l-ibupro... ) but this important piece of information has NOT been relayed by international medias. Jean Paul Hamon, medical doctor and president of the Federation of French Doctors said on TV to NOT take NSAIDs (anti-inflammatory drugs) if #covid19 is suspected. Th…

Translation from French: paracetamol is preferred over nonsteroidal anti-inflammatory drugs (NSAID). Dose of paracetamol should not exceed 3g/day and doses should be spaced throughout the day.

Maybe there are different recommendations where you live, but here in Sweden and most of the hits on a web search suggest max dosage of paracetamol is 4g/day spread out.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#62

Post by calebsurfs »

arcticbull wrote: post #60
slowmovintarget wrote: post #47

Earlier quoted context omitted.

"Paracetamol" a.k.a. "acetaminophen", common brand: Tylenol.

Which is itself the leading cause of acute liver failure in the US. The active dose is very close to the lethal dose, much more so than naproxen or ibuprofen.

The active dose is nowhere near the lethal dose. It is however close to the dose where you could see some minor damage to the liver. It causes problems because people are addicted to opioid drugs that are typically combined with acetaminophen, not because they are loading up on acetaminophen itself.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#63

Post by jakub_g »

arcticbull wrote: post #60
slowmovintarget wrote: post #47

Earlier quoted context omitted.

"Paracetamol" a.k.a. "acetaminophen", common brand: Tylenol.

Which is itself the leading cause of acute liver failure in the US. The active dose is very close to the lethal dose, much more so than naproxen or ibuprofen.

Ibuprofen is OTOH much riskier and disadvised for many groups of patients, like those with gastric problems (Ulcertativ Colitis, Crohn's etc.)

The problem is often due to people overdosing, often due to mixing different pills that each contain paracetamol. Each cure becomes poison after a threshold.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#64

Post by gopalv »

Alex3917 wrote: post #57
mrb wrote: post #36

French sources specifically mention severe cases of covid-19 in "young and healthy" patients (eg. see https://lefigaro.fr/sciences/coronavirus-alerte-sur-l-ibupro... ) but this important piece of information has NOT been relayed by international medias. Jean Paul Hamon, medical doctor and president of the Federation of French Doctors said on TV to NOT take NSAIDs (anti-inflammatory drugs) if #covid19 is suspected. Th…

Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. Normally when you see young people taking large doses of NSAIDs, it's because they're either elite athletes or have an autoimmune disease or something.

> Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense.

There are enough people who have no idea that hang-over + pop-2-advil is a deadly combination in this situation.

Also a lot of the "new year, new body" resolution folks start too hard at the gym & then push through with NSAIDs.

Young people, particularly the fit, do go through a lot of NSAIDs out of OTC convenience.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#65

Post by snapetom »

chrismeller wrote: post #3
sgroppino wrote: post #2

From the article: "ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk…

Considering that lisinopril (Prinivil, Zestrel, etc, an ACE inhibitor) is, according to any list I could find, easily in the top 10 meds prescribed in the US (and by some top three or number one), this is something that should definitely be more publicly known. I’m not saying anyone should just stop taking their hypertension drugs, that’s a horrible idea. But if you do suspect that you might have COVID-19, you should…

ACE != ACE2.

ACE inhibitors have no effect on ACE2.

https://www.nrcresearchpress.com/doi/10.1139/y02-021

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#66

Post by Donzo »

Alex3917 wrote: post #57
mrb wrote: post #36

French sources specifically mention severe cases of covid-19 in "young and healthy" patients (eg. see https://lefigaro.fr/sciences/coronavirus-alerte-sur-l-ibupro... ) but this important piece of information has NOT been relayed by international medias. Jean Paul Hamon, medical doctor and president of the Federation of French Doctors said on TV to NOT take NSAIDs (anti-inflammatory drugs) if #covid19 is suspected. Th…

Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. Normally when you see young people taking large doses of NSAIDs, it's because they're either elite athletes or have an autoimmune disease or something.

Lots of people take Ibuprofen when they have a fever.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#67

Post by DanBC »

calebsurfs wrote: post #62
arcticbull wrote: post #60

Earlier quoted context omitted.

Which is itself the leading cause of acute liver failure in the US. The active dose is very close to the lethal dose, much more so than naproxen or ibuprofen.

The active dose is nowhere near the lethal dose. It is however close to the dose where you could see some minor damage to the liver. It causes problems because people are addicted to opioid drugs that are typically combined with acetaminophen, not because they are loading up on acetaminophen itself.

Paracetamol is dangerous in overdose, and the therapeutic dose is pretty close to the overdose amount. The therapeutic index is approx 10.

Compare that to morphine, which has a therapeutic index of about 70.

(although the therapeutic index is tricky to use because of dose response curves)

We know that paracetamol is commonly used in both accidental and deliberate overdose. And this is true in countries that don't have the opioid crisis, and it was true in the US before the opioid crisis.

> It causes problems because people are addicted to opioid drugs that are typically combined with acetaminophen,

This is part of the problem, yes. But it's incomplete. We know that paracetamol alone causes problems for the liver even with small overdosing. https://britishlivertrust.org.uk/researchers-shed-new-light-...

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#68

Post by Enginerrrd »

earthtourist wrote: post #48

Any information on cough suppressants? Whether they're a good or bad for people with COVID-19? I've had my doctor recommend against cough suppressants in the past. But I've had trouble sleeping with a bad cough, and so if cough suppressants make sleep possible, it seems like a net-win. Is there any data yet?

I've looked and haven't found any. My gut says it sounds like a bad idea. Usually they want pneumonia patients to cough, and use their incentive spirometer frequently.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#69

Post by alkonaut »

gopalv wrote: post #64
Alex3917 wrote: post #57

Earlier quoted context omitted.

Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. Normally when you see young people taking large doses of NSAIDs, it's because they're either elite athletes or have an autoimmune disease or something.

> Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. There are enough people who have no idea that hang-over + pop-2-advil is a deadly combination in this situation. Also a lot of the "new year, new body" resolution folks start too hard at the gym & then push through with NSAIDs. Young people, particularly the fit, do go t…

"Massive amounts" to me sounds like at least the max dose for at least a week.

Taking 2 ibuprofen in a day against a flu like headache is what your doctor recommends, probably. Not exactly a massive amount even if repeated for a week.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#70

Post by sirtoffski »

mrb wrote: post #36

French sources specifically mention severe cases of covid-19 in "young and healthy" patients (eg. see https://lefigaro.fr/sciences/coronavirus-alerte-sur-l-ibupro... ) but this important piece of information has NOT been relayed by international medias. Jean Paul Hamon, medical doctor and president of the Federation of French Doctors said on TV to NOT take NSAIDs (anti-inflammatory drugs) if #covid19 is suspected. Th…

Interesting for sure. When I've first heard reports of ibuprofen + CoV-19, I went to check out what Harvard Health was recommending [0].

Under "What treatments are available to treat coronavirus?":

Currently there is no specific antiviral treatment for COVID-19. However, similar to treatment of any viral infection, these measures can help... ... Take acetaminophen, ibuprofen, or naproxen to reduce fever and ease aches and pains. Be sure to follow directions. If you are taking any combination cold or flu medicine, keep track of all the ingredients and the doses. For acetaminophen, the total daily dose from all products should not exceed 3,000 milligrams.

So it seems there is no widespread consensus on the matter for now. North American professionals, from what I've seen on social media, tend to disagree with their European colleagues on the matter.

Personally, I remain somewhat skeptical until there's more data available.

[0] https://www.health.harvard.edu/diseases-and-conditions/coron...

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