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Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

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Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#111

Post by vkou »

jfnixon wrote: post #58
JoeAltmaier wrote: post #20

Earlier quoted context omitted.

Probably not for even another month. Because it will stop working, for practical reasons. People will have to go back to work, or be evicted. Go out for necessities, shopping around to find any, increasing their exposure instead of decreasing it. Go job interviewing. All sorts of fallout, which actually increases travel and potential infection, instead of reducing it. Its easy for us middle-class folks to say "Just s…

Infrastructure will begin to break down if we don't do regular maintenance. That means spare parts, which means manufacturing, which means raw materials. Food has a similar supply chain issue. Break the infrastructure enough that public sanitation stops working properly, and the Covid-19 deaths will be a rounding error in the excess death rate.

Except we are still doing all those things. Maintenance[1] is happening. Factories are working. Food is being grown. Truckers are still hauling.

Read the shut down orders issued by your state. Read the list of essential jobs listed in those orders. All of those things that you listed are essential jobs, that are still being done. If your factory makes masks, you're essential. If your factory makes screws that are used in a factory that makes masks, you're also essential. If your mine digs up iron ore that goes to a smelter, that goes to a factory that makes screws that are used in a factory that makes masks - you're also essential.

Yes, this means that a lot of people are essential. But even halving the number of person-to-person interactions the average person has leads to a big reduction in transmissions.

[1] I live in Seattle, three weeks into a shutdown, and just two days ago, power crews were doing preventative maintenance on the power line leading into my building.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#112

Post by krooj »

daxorid wrote: post #87
throwawaylalala wrote: post #56

Scroll down to figure 1. Non survivors end up with cardiac and kidney injury. Interesting that this might shine light on the cause. https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Thanks. Specifically, from your citation: "In addition, angiotensin converting enzyme 2, the receptor for SARS-CoV-2, is expressed on myocytes and vascular endothelial cells, so there is at least theoretical potential possibility of direct cardiac involvement by the virus" The most sane hypothesis I've seen is that the virus will attack any cell with the ACE2 receptor, including the heart and kidneys: "Angiotensin co…

Interesting point about the ACE2 receptors in the GI tract. I wonder if that's why certain infections present with GI symptoms?

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#113

Post by downerending »

cowpig wrote: post #33

There's so much blind speculation in this comment section. The kind that's intriguing and fun when it's about engineering/math/whatever, but dangerous when it's about the health effects of an ongoing pandemic. I hope moderators do something about it.

Arguably there's a lot of blind speculation on HN about engineering/math/whatever as well, some of it quite dangerous.

That's the price we pay for open discourse.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#114

Post by andy_ppp »

paulsutter wrote: post #109
dcolkitt wrote: post #28

This headline is definitely a lot scarier than the actual body of the study. The most likely cause of the heart damage by far is the systemic inflammation induced by pneumonia. We know this because pneumonia patients of all types often have heart strain afterwards[1]. But that damage is very rarely permanent as the risk subsides back to baseline given enough time. Until we see evidence of heart issues in patients wit…

Hospitalization rates for people aged 20-44 are in the range of 15% to 20%. You might want to read up on the experience of COVID-19 hospitalization before you decide that there's little risk from infection. https://www.statista.com/statistics/1105402/covid-hospitaliz...

I'm not sure I buy it as we don't have any idea how many people actually have the disease. I have to assume the denominator is of those tested, X% required hospitalisation. If it is those confirmed to have the disease, and because clearly the whole population hasn't been tested the results are skewed as we only test people with severe symptoms.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#115

Post by throwanem »

Random speculation aside, if you (like me) are currently at the tail end of COVID-19 and beginning your convalescence from it, it's wise to assume you have some degree of myocarditis and behave accordingly - that is, as best you can, avoid activities that may strain your heart and circulatory system for a couple weeks to a month following end of active COVID-19 symptoms.

I'm not a doctor, and this isn't medical advice, but it isn't alarmism either. It's well known that pneumonias, however caused, tend to be rough on the heart. So it's just common sense to regard this pneumonia the same way.

Look at it this way. If you aren't at risk, but assume that you are, the worst that happens is nothing. If you are at risk, and assume that you aren't, you may well not be so lucky. So, especially when you may not be able to rely on the usual degree of hospital support - better safe than sorry.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#116

Post by nradov »

andy_ppp wrote: post #114
paulsutter wrote: post #109

Earlier quoted context omitted.

Hospitalization rates for people aged 20-44 are in the range of 15% to 20%. You might want to read up on the experience of COVID-19 hospitalization before you decide that there's little risk from infection. https://www.statista.com/statistics/1105402/covid-hospitaliz...

I'm not sure I buy it as we don't have any idea how many people actually have the disease. I have to assume the denominator is of those tested, X% required hospitalisation. If it is those confirmed to have the disease, and because clearly the whole population hasn't been tested the results are skewed as we only test people with severe symptoms.

Right those population level samples only started on a limited basis in a few areas last week. For now the actual denominator is a total unknown; the range of upper and lower bounds is so wide as to be effectively useless for planning.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#117

Post by btilly »

paulsutter wrote: post #109
dcolkitt wrote: post #28

This headline is definitely a lot scarier than the actual body of the study. The most likely cause of the heart damage by far is the systemic inflammation induced by pneumonia. We know this because pneumonia patients of all types often have heart strain afterwards[1]. But that damage is very rarely permanent as the risk subsides back to baseline given enough time. Until we see evidence of heart issues in patients wit…

Hospitalization rates for people aged 20-44 are in the range of 15% to 20%. You might want to read up on the experience of COVID-19 hospitalization before you decide that there's little risk from infection. https://www.statista.com/statistics/1105402/covid-hospitaliz...

That is percentage of confirmed cases that wind up with hospitalization.

However we mostly don't try to confirm cases if it won't affect the care we give. We just tell them to self-isolate. We therefore will not have good statistics on what percentage of cases are confirmed until after the immediate crisis is over and we test to see how many have antibodies.

So your figure is, "Of young people who have it severely enough to get tested, 15-20% get hospitalized." This says nothing about what fraction of cases are severe enough to get tested.

Also note that we undercount deaths. If a person dies and was never confirmed to have COVID-19, they are also not counted as a COVID-19 death. Nobody knows how big this undercount factor is.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#118

Post by throwanem »

jacquesm wrote: post #86

So, I've been battling this bug for the last three weeks or so, probably caught it on the way back from my last job in Finland. I expected an empty plane instead it was packed like it was the last train out of San Fernando and everybody was scared there never would be another one. After a week or so symptoms started in spite of having self-isolated already after the flight, so that's why I figure that is where I caug…

It does sound like you're close to shaking the bug, and congrats on that! I think I'm a couple days ahead of you; I didn't monitor RHR while I had active symptoms, but anecdotally, I did start feeling a little less rough a couple days before the fever broke this past Saturday. (I also only had active symptoms for about 12 days all told, so I may have had a less severe case just in general.)

Not that you probably need telling, but don't assume that the end of active symptoms means straight back to status quo ante. There's a lot we don't know about COVID-19, but it is a pneumonia, and the association between pneumonia and myocarditis in general is well known. Safer to assume you have it than don't, and give yourself at least a couple of weeks to convalesce, making sure to avoid straining your heart.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#119

Post by krooj »

thomashobohm wrote: post #78
411111111111111 wrote: post #31

let me preface this by mentioning that i havent been tested for covid-19. two weeks ago i've been having real issues breathing. it felt like my upper body was borderline paralyzed and i had to really force myself to fully breathe in. this wasn't constant but happened every day for several hours each. especially at night. i got worried that i might have the virus so i checked my temperature and oxygen blood saturation…

I deal with a panic disorder and what you're describing sounds super similar to what a garden-variety panic attack is like. Especially the part about your heart rate rising but your oxygen saturation staying pretty much the same (the difference between 94-97 and 97-100 is within the normal variation during physical activity). What's likely happening is that your brain is latching onto some small thing, like laying do…

Absolutely this. I've struggled with panic attacks that came on secondary to medical issues in the past couple years, and the elevated heart rate and perceived breathing problems are textbook. Other things to lookout for are: impending sense of doom (fixated on the idea something's wrong), lights appear brighter or have halos, bounding pulse (you feel your heart beating hard), eyelid twitching, amongst others.

Block breathing will help. Inhale into your belly until you can't hold more air, hold for 5, exhale slowly. Take a couple of normal breaths, then repeat the block breath. Do it for 10 minutes.

Other things to note: before and after the panic attack, you're in a "prodromal period", which means you're susceptible to subsequent attacks. Try to stay away from stimulants, like caffeine, and, honestly, get the hell off the internet and away from news.

Re: Mysterious heart damage, not just lung troubles, befalling Covid-19 patients

#120

Post by _bxg1 »

downerending wrote: post #113
cowpig wrote: post #33

There's so much blind speculation in this comment section. The kind that's intriguing and fun when it's about engineering/math/whatever, but dangerous when it's about the health effects of an ongoing pandemic. I hope moderators do something about it.

Arguably there's a lot of blind speculation on HN about engineering/math/whatever as well, some of it quite dangerous. That's the price we pay for open discourse.

> That's the price we pay for open discourse.

I don't think this is true. It's entirely possible to have open discourse without over-selling one's own loosely-informed speculation.

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