Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

Some interesting data here.

- Mean age of 79.5 sheds light on Italy’s extremely high fatality rates; in essence, it’s the (very) elderly that are dying due to complications from viral pneumonia. Which begs the next question...

Why are they overwhelmingly treating patients with antibiotics in cases of viral pneumonia and not antivirals (Remdesivir)/ chloroquine?

Sure, these are “experimental” therapies but decent data out of China/South Korea shows these therapies work. Perhaps they found out too late?

- The younger fatalities (17) show multiple, serious co-morbidities and smoking is not listed; an assumption can be made a fair amount of these younger patients smoke. But again, an assumption.

- Almost 50% of patients showed 3 or more co-morbidities - this is high and important to note. 25% of patients showed 2 co-morbidities. Roughly 75% of patients had 2 or more co-morbidities (!).

- Sample size (2003) is good given their current 3,500 fatality numbers.

Not a medical doctor but a few things I’m struggling to figure out:

- How did so many elderly get infected? Did the disease simply spread in close quarters where many elderly live? Elderly folks aren’t necessarily out and about drinking espresso and touching surfaces yet alone having younger asymptomatic carriers cough on them.

I wonder if Italy is similar to a Kirkland, Washington situation. High density of elderly folks spreading infection.

It’s obvious that SARS-Cov-2 is highly, highly contagious but it’s interesting how we’re seeing these somewhat “bomb” explosions of infection: Wuhan > Daegu > Kirkland > Lombardy > NYC next.

Sure, quarantine works but the rate of new infection stays rather localized and then just annihilates everyone around it.

Perhaps it’s a viral load issue; viral load increases exponentially the more we have infected. Why you see doctors and nurses infected / critical and dying even with full PPE.

Let’s hope the Italians figure out a way to get this curve to fall of ASAP. Hoping they have a similar effect to Wuhan’s curve and just drop down rather than flatten.

Probably tens of thousands of undiagnosed, asymptomatic.

Aka super carriers.

The virus is smart and has evolved from an evolutionary standpoint. Infect younger and asymptomatic patients with the goal of spreading and infecting as many as possible. Eventually, the more infected, the more that will die. The young are just carrier pigeons and don’t even know it.

This is encouraging for healthy youngsters BUT age and health are also the criteria for receiving treatment in Italy at the moment. As the epidemic grows the categories of people that get ventilation decrease and the deaths will get younger and healthier.

Plus lots of Italians live with their extended families well into their 30s.

On the elderly infections: https://www.wired.com/story/why-the-coronavirus-hit-italy-so...

On antibiotics, aside from secondary infections, there’s a paper out talking about azithromycin: “Our preliminary results also suggest a synergistic effect of the combination of hydroxychloroquine and azithromycin. Azithromycin has been shown to be active in vitro against Zika and Ebola viruses [20-22] and to prevent severe respiratory tract infections when administrated to patients suffering viral infection [23].”

Not sure of they used azithromycin but would’ve been good to see that verified.