Medical worker describes terrifying lung failure from COVID-19 -- even in his young patients

[LiberalArkie]

As of Friday, Louisiana was reporting 479 confirmed cases of COVID-19, one of the highest numbers in the country. Ten people had died. The majority of cases are in New Orleans, which now has one confirmed case for every 1,000 residents. New Orleans had held Mardi Gras celebrations just two weeks before its first patient, with more than a million revelers on its streets.

I spoke to a respiratory therapist there, whose job is to ensure that patients are breathing well. He works in a medium-sized city hospital’s intensive care unit. (We are withholding his name and employer, as he fears retaliation.) Before the virus came to New Orleans, his days were pretty relaxed, nebulizing patients with asthma, adjusting oxygen tubes that run through the nose or, in the most severe cases, setting up and managing ventilators. His patients were usually older, with chronic health conditions and bad lungs.

Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators.

His hospital had not prepared for this volume before the virus first appeared. One physician had tried to raise alarms, asking about negative pressure rooms and ventilators. Most staff concluded that he was overreacting. “They thought the media was overhyping it,” the respiratory therapist told me. “In retrospect, he was right to be concerned.”

Snip

https://www.alternet.org/2020/03/medical-worker-describes-terrifying-lung-failure-from-covid-19-even-in-his-young-patients/

[soryang]

1. ADE?

antibody dependent enhancement.

[Native]

4. I looked this up, but I don't understand it. Can you please explain it?

[soryang]

12. This article is a source

I'm not competent to explain it myself but this article in the introduction section explains it in relation to other viruses:

Antibody-dependent enhancement (ADE) occurs when antibodies facilitate viral entry into host cells and enhance viral infection in these cells (1, 2). ADE has been observed for a variety of viruses, most notably flaviviruses (e.g., dengue virus) (3–6). It has been shown that when patients are infected by one serotype of dengue virus (i.e., primary infection), they produce neutralizing antibodies targeting the same serotype of the virus. However, if they are later infected by another serotype of dengue virus (i.e., secondary infection), the preexisting antibodies cannot fully neutralize the virus. Instead, the antibodies first bind to the virus and then bind to the IgG Fc receptors on immune cells and mediate viral entry into these cells. A similar mechanism has been observed for HIV and Ebola viruses (7–10). Thus, subneutralizing antibodies (or nonneutralizing antibodies in some cases) are responsible for ADE of these viruses. Given the critical roles of antibodies in host immunity, ADE causes serious concerns in epidemiology, vaccine design, and antibody-based drug therapy.

Molecular Mechanism for Antibody-Dependent Enhancement of Coronavirus Entry
Yushun Wan, Jian Shang, Shihui Sun, Wanbo Tai, Jing Chen, Qibin Geng, Lei He, Yuehong Chen, Jianming Wu, Zhengli Shi, Yusen Zhou, Lanying Du, Fang Li
Tom Gallagher, Editor

(it's not clear to me what the date is on this article. when i checked on the link it said 2019 12 11)

https://jvi.asm.org/content/94/5/e02015-19

These are my comments which are just a layman's opinion and incompetent by definition:

So relevant antibodies to a related virus close enough to bind to the current virus and the host cell wall can enhance the progress of infection rather than inhibiting it. I think it says in the abstract that the molecular mechanism is not completely understood. In covid 19, the speculation goes this can result in a cascade event in an acute patient, which is life threatening. I see that Zhengli Shi is one of the authors.

[Native]

14. Thank you! I think I get it now.

[doc03]

2. Frightening I had to stop reading.... nt

[SaveOurDemocracy]

3. Very scary.

[Native]

5. And this isn't even the most scary paragraph:

“When someone has an infection, I’m used to seeing the normal colors you’d associate with it: greens and yellows. The coronavirus patients with ARDS have been having a lot of secretions that are actually pink because they’re filled with blood cells that are leaking into their airways. They are essentially drowning in their own blood and fluids because their lungs are so full. So we’re constantly having to suction out the secretions every time we go into their rooms.”

[SWBTATTReg]

6. And articles like these are scaring us (me at least) on DU. What's the benefit of posting such?

[tazkcmo]

8. Information.

I appreciate these posts. I'm sorry you find them upsetting but we have millions of people not taking this seriously and hopefully theses accounts of how the virus behaves and the harm it does just might convince them that this isn't "just the flu".

[Ms. Toad]

9. Yup.

It's a tough balance - but I'm still encountering too many people who believe it is nothing more than the flu or a bad cold.

[tazkcmo]

11. Covidiots.

A perfect descriptor.

[budkin]

13. To keep us on our guard. This is REAL.

It is KILLING people.

[SWBTATTReg]

15. Yes, I know that. We all that, but like some say, not taking it seriously. NT

[Mosby]

7. JFC.

[Takket]

10. "They thought the media was overhyping it,"

gee, i wonder where they got that idea