The many faces of Covid-19: The essence of applying the right treatment at the right time.
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Covid-19 disease has marveled and bewildered many medical practitioners due to it’s varying symptoms presentation.
In the early days it was difficult to treat because physicians had little understanding of the disease and we're still learning the different dimensions and symptoms that it presented. However over time the pathophysiology and the progression have become clearer making it much easier to treat.
The pathogenesis and pathophysiology of the disease have also helped in determining those that are more vulnerable to having severe outcomes when infected.
The virus have continued to mutate bringing with it the challenge of determining the new characteristics and symptoms associated with the latest variant. For instance, so far the Delta virus has been the most virulent of the sars-cov-2 variants and brought with it an avalanche of deaths. However with the more recent Omicron variant, there has been a big variation in the genome sequence and symptom presentation due to the virus having undergone antigenic shift unlike prior variants that had less difference in mutations. This came with a more milder symptom and was more concentrated on the sinus and olfactory canals and spared the vascular system.
The severity of symptoms seems to diminish with successive new variants in what is termed antigenic drift, however when there is antigenic shift in a new variant this may present with multitude of mutations that may have a combination of properties from two or more prior variants or even a different viral specie. This also is accompanied with significant variation in symptoms which may be much lesser or higher in intensity.
The Omicron variant is a classical example where the vascular system that accounted for most of the severity is not attacked unlike prior variants, which have made the infection much milder. These changes in symptoms also calls for modifications in treatment protocol which demands medical practitioners keep abreast of the evolution of the virus and the dynamics of the disease.
Physiology and Progression
COVID-19 infects us by attaching to the surfaces of cells which form the lining and mucus membranes of our nasal sinuses, throat, trachea, and lungs as well as the endothelial cells of the vascular system.
It is now generally accepted that Covid-19 is primarily a respiratory and vascular infection with a three-pronged disease starting off as a vascular and respiratory disease during the mild to moderate stages progressing into an autoimmune disease at the severe and critical stages. Most people will only experience the respiratory symptoms however for those with a weak immune status they can experience the vascular symptoms which can progress to the severe stage without early intervention.
These various stages also require different treatment regimen which has been the main factor in the controversy surrounding the efficacy of some prophylactics that have been investigated as repurpose drugs. Some of these prophylactics when applied at the wrong time in the progression of the disease do not seem to show any improvement on the patient's condition. This is particularly the case with Ivermectine.
This has lead to the discrediting of some beneficial remedies as well as inaccurate journal reports on the efficacy of such prophylactics..
When you are first exposed to sars-cov-2 virus the first areas that are attacked are your nasal and oral cavity. These are the entry points of the virus and present the first set of symptoms once exposed.
These symptoms may include nose itching, hay fever, loss of smell, running nose, dry cough, throat itching, sore throat, and voice change due to vocal chord infection.
Depending on your immune system state or early intervention with medication the symptoms may not extend beyond these areas.
When it extends beyond eroding the surfaces of these areas it then enters the blood stream progressing from mild to moderate symptoms.
At this stage the victim becomes endangered as the infection can progress to the severe stage without proper treatment.
Once the virus enters the blood streams it multiplies damaging the endothelial cells of blood vessels in the process.
At this stage the immune system becomes fully activated in fighting off the invading pathogen. If your immune system is strong enough the infection may not progress beyond this stage. The victim will present with symptoms such as fever, headache, weakness, tiredness, dizziness, and cold.
When the blood vessels are attacked they can get damaged to cause blood clots. This then results in embolism impairing arterial blood flow consequently increasing blood pressure and exerting more load on the heart. This can lead to stroke or heart attack.
In the same way the blood vessels gets attacked the internal linings of the lungs can be attacked leading to respiratory distress and pneumonia due to bacteria infection caused by the erosion of the epithelial lining of the lungs. The lungs are susceptible to bacteria infection when these protective linings are damaged.
COVID-19 Pneumonia
In pneumonia, the lungs become filled with fluid and inflamed, leading to breathing difficulties. For some people, breathing problems can become severe enough to require treatment at the hospital with oxygen or even a ventilator.
The pneumonia that COVID-19 causes tends to take hold in both lungs. Air sacs in the lungs fill with fluid, limiting their ability to take in oxygen and causing shortness of breath, cough and other symptoms.
While most people recover from pneumonia without any lasting lung damage, the pneumonia associated with COVID-19 can be severe. Even after the disease has passed, lung injury may result in breathing difficulties that might take months to improve.
Acute Respiratory Distress Syndrome (ARDS)
As COVID-19 pneumonia progresses, more of the air sacs become filled with fluid leaking from the tiny blood vessels in the lungs. Eventually, shortness of breath sets in, and can lead to acute respiratory distress syndrome (ARDS), a form of lung failure. Patients with ARDS are often unable to breath on their own and may require ventilator support to help circulate oxygen in the body.
Whether it occurs at home or at the hospital, ARDS can be fatal. People who survive ARDS and recover from COVID-19 may have lasting pulmonary scarring.
Sepsis-Autoimmune disease
Another possible complication of a severe case of COVID-19 is sepsis. Sepsis occurs when an infection reaches, and spreads through, the bloodstream. This normally provokes an autoimmune reaction causing widespread tissue damage everywhere the infection spreads.
These two areas, the blood vessels and the lungs determine the pathogenesis of the infection and can present with two different sets of symptoms and the extent to which they are affected will determine the disease progression and prognosis.
Vulnerability
A number of research has been conducted on the people most at risk of the infection using the enormous amount of medical data obtained in the course of the pandemic.
The pathophysiology of the infection can also help in determining people most at risk of having severe Covid-19.
Most research publication indicates that people with comorbidities and the obese, are at high risks of severe Covid-19.
Such morbidities in the high risks category includes diabetes, high blood pressure, blood diseases, lung diseases, heart diseases, vascular diseases, autoimmune disease and the immuno-compromised.
Because of the pathophysiology of the disease it is easy to determine that those already having diseases associated with blood and blood vessels, the heart and lungs as well as auto Immunity would be at high risk of severe Covid-19.
When the diseases enters the severe stage without adequate medical intervention this can cause the immune system to start to fail or malfunction due to excess and prolonged inflammation of the cells or blood contamination. This leads to auto immune reactions which is a critical point of the ailment where it becomes an emergency.
Treatment
What differentiates Sars-covid-2 from common cold and influenza is being a vascular and a respiratory disease unlike the other two that are mainly respiratory disease this is why covid-19 is more deadlier than the others at the severe stage.
Because of being a three pronged disease, it also requires three sets of treatments to address the symptoms at these three stages to ameliorate the vascular symptoms, respiratory and autoimmune symptoms.
Fortunately Omicron infection does not seem to affect the vascular system eliminating the risks of thrombosis. However the risk of lung infection still exists for those with weak immune system hence such people need to be protected from Omicron infection.
At the early onset of the infection at the asymptomatic phase, any one with a strong immune system will be able to subdue the infection.
When it progresses to the mild phase, symptoms associated with allergy such as hay fever, itching, dry throat, dry cough can be ameliorated with such medication as antihistamine for hay fever and allergy symptoms, lozenges for throat discomfort, cough syrups for dry cough, immune boosters such as vitamin C combined with Zinc and Vitamin D can be taken also to boost the immune response. Ivermectin can be commenced at this stage for prevention from the infection progressing to the moderate stage.
Therapies such as sun bathing, sauna or steam bath, hot beverages, tea , lemon and ginger, Bitter cola have been found useful to alleviate the symptoms at the early stages.
When the virus enters the blood stream at the moderate stage a 12 mg of Ivermectin can be commenced every 3 days with anticoagulant such as 75 mg of aspirin taken daily against thrombosis.
At the severe and critical stage of the disease the immune system would have been impaired and will require an infusion of immune boosters. Monoclonal anti body therapy would be most useful at this stage along side steroids such as Prednisone against inflammation of the cells and immune dysfunction, antibiotics against bacterial pneumonia. Also anticoagulants will be essential against pulmonary embolism, heart attack and stroke.
Long Covid-19
People that recover from severe covid-19 infection seem to have lingering symptoms due to the erosion of the epithelial cells of the lungs and damage to some internal tissues including the endothelial cells. These symptoms are common to most severe respiratory illness such as pneumonia except that it now has additional symptoms relating to blood vessel damage and the poisoning of the blood.
The patient becomes very sensitive to a number of internal and external stimuli leading to secondary symptoms such as anxiety, depression, allergies etc.
It's expected that the patient will start feeling much better once the damaged cells heal but this may take a number of months.
Conclusion
A number of Covid-19 protocols have been developed by various medical practitioners based on their personal experiences in treating patient alongside clinical information sharing with colleagues. Some of these popular protocols include that of Dr. Vladimir Zelanko (2) and Dr. Shankara Chetty (3) protocols. A number of them can also be found on Front Line COVID-19 Critical Care (FLCCC) Alliance (1) website.
The major challenge of Sars-cov-2 infection is keeping abreast of the variants of concern which requires knowing what characteristics of the virus changed as treatment protocols may need to be adapted since the latest symptoms the virus express can differ.
Early treatment of the infection using any of the effective protocols is recommended. However your medical adviser will be in a position to know what is appropriate based on the symptoms that are currently manifesting.
An effective protocol will use the right combination of prophylactics at the determined stage of the infection otherwise treatment may fail.
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Disclaimer:
This article has been written strictly for general knowledge and information and not intended to encourage self medication or as a substitute for professional medical advice and should not be relied on as a health guidance or personal advice.
Readers should always seek the advice of a board certified medical doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.
1. https://covid19criticalcare.com/
2. https://vladimirzelenkomd.com/
3. https://www.drshankarachetty.com/dr-shankara-chetty-8th-day-protocol/