so your under 40 cases

obesity?

McInnis 03 said:

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I would just do the Plaquenil, the azithromycin is unnecessary and just increases the risk of detrimental drug effects. People are giving it as prophylaxis against superimposed bacterial pneumonia, but we know from China that's a very uncommon complication in COVID patients. And many bacteria that cause superimposed bacterial pneumonia, HAP and VAP are resistant to azithro anyway.

In fact, strep pneumo resistance is so high to azithromycin now that the guidelines recommend against it as mono therapy for pneumonia in stable outpatients. In other words, nobody should be getting Z packs by themselves for really anything anymore, apart from unique infections that are managed specifically by ID docs like bartonellosis.

cone said:

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so your under 40 cases

obesity?

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Only one, and the BMI just barely qualifies as obese

cone said:

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that's the strangest thing so far

Italy is a hellscape, but no deaths under 30

30-39 CFR ~0.3%

median case age is 63

whereas I've heard of a half dozen deaths or close to deaths of people under 30 just in Texags anecdotes

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Its the same in any healthcare system, if your death wasn't coded as C19-related, it doesn't make the official count. C19 did not kill you if you didn't get a positive test. They are focused on testing the elderly, not the young. So, it skews the numbers for young adults.

Really bummed the drug cocktail did not have a positive response, and hope he improves in the next day or two.

What a depressing thread. I've been trying to eat better and exercise since this all broke out, but hard to get back in shape in only a week or two. This outbreak has "scared me straight " so to speak.

Drifter. said:

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What a depressing thread. I've been trying to eat better and exercise since this all broke out, but hard to get back in shape in only a week or two. This outbreak has "scared me straight " so to speak.

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Anything that gets you started is better than never starting at all. Stick with it

so no comorbidities

which makes the Italy data vs the American data even stranger

so you're saying Italian young people are dying but they are coding it as something else?

cone said:

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so no comorbidities

which makes the Italy data vs the American data even stranger

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One has high cholesterol well controlled on a statin, one has hypertension well controlled with one medication, one has absolutely nothing. Two are objectively very healthy by eating and workout habits.

that would be remarkable if the American younger cohort succumbs more than the Italian

would be a really bad sign

of course the younger cohort here may be the iceberg of infection right now since the olds are generally separated and acting like shut ins

Young people have died in Italy, South Korea and in China. Its probably the same % here as other countries, the difference though, is that every time a young person dies, its blasted all over the news. You don't hear about the 80 year old grandma.

https://www.epicentro.iss.it/coronavirus/bollettino/Infografica_24marzo%20ENG.pdf

zero deaths under 30, still

Believe what you want, but I have a hard time believing that the country that has the most deaths and the most overwhelmed healthcare system has zero deaths under 30. Even if true, how many under 30 have died here? It's probably less than 5.

Maybe it's due to the US having more younger people that are obese than Italy?

cone said:

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so you're saying Italian young people are dying but they are coding it as something else?

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Yes. Bilateral interstitial pneumonia or myocardial infarction being the most common. Americans are also dying but not being coded.

Marcus- are flu related deaths similar to what you see in COVID deaths? Do patients usually succumb while on respirator/ventilator? It is scary learning about COVID deaths but wondering if Flu deaths are just as traumatic

JP_Losman said:

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Marcus- are flu related deaths similar to what you see in COVID deaths? Do patients usually succumb while on respirator/ventilator? It is scary learning about COVID deaths but wondering if Flu deaths are just as traumatic

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I am not Marcus and speaking a bit out of my realm of expertise but:

Most pneumonia flu deaths are secondary bacterial infections that occur due to airway inflammation and opportunistic bacterial infection usually day on day 7-10 of the flu and usually with MRSA. I'm sure in the elderly there is a component of COPD or CVD that worsens this problem.

COVID seems to be an actual viral infection of the lung tissue itself, Specifically the bronchioles and avoilae. This is very different from a secondary bacterial pneumonia which we are all very comfortable treating. This viral inflammation of the distal lung tissue is really unique and VERY DIFFICULT to treat.

Feel free to correct me if I am wrong!

What makes it attack the lungs? I went to the corner clinic the other day because of a soar throat. I was told it was likely viral, but not to worry about it. Chest has been feeling tight since then. Not difficult to breathe, but have the desire to cough if I take a deep breath.

Philip J Fry said:

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What makes it attack the lungs? I went to the corner clinic the other day because of a soar throat. I was told it was likely viral, but not to worry about it. Chest has been feeling tight since then. Not difficult to breathe, but have the desire to cough if I take a deep breath.

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The viral spike proteins allow binding to the ACE2 receptors found in great abundance in lung tissue.

all name checked on this website it seems

so you think all the countries are hiding the fatalities under 30

Thomas Ford 91 said:

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cone said:

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so you're saying Italian young people are dying but they are coding it as something else?

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Yes. Bilateral interstitial pneumonia or myocardial infarction being the most common. Americans are also dying but not being coded.

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Why would they not code young patient deaths as CV19? I've seen reports of older patients being even test post-mortem.

Philip J Fry said:

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What makes it attack the lungs? I went to the corner clinic the other day because of a soar throat. I was told it was likely viral, but not to worry about it. Chest has been feeling tight since then. Not difficult to breathe, but have the desire to cough if I take a deep breath.

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That really sounds like COVID assume you have it and be safe.

infectious answered your lung question accurately as usual.

cone said:

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so you think all the countries are hiding the fatalities under 30

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I'm not the guy that made the original comment I agree with his point to the extent that I think the numbers are hiding some things. Tests are being conducted very selectively. 30 and under with no obvious co morbidities and I bet you have a hard time getting a test unless the case is severe enough for hospital admission.

More likely asthma is the comorbidity affecting Americans under 30

so what's the listed cause of death for those 30 year olds?

pneumonia?

I don't think they are intentionally hiding deaths, just underreporting. As of now, a death is not a C19 death unless you have a positive test either pre or postmortem

so we're seeing higher numbers of below 30 dead in general compared to the previous years at this time?

where is this data?

JP_Losman said:

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Marcus- are flu related deaths similar to what you see in COVID deaths? Do patients usually succumb while on respirator/ventilator? It is scary learning about COVID deaths but wondering if Flu deaths are just as traumatic

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Agree with kidoc. I lived thru swine flu. The lung inury and ARDS was due to secondary MRSA bacterial pneumonia. Many community acquired young people. MRSA usually seen in hospital settings so that was weird. Fulminant bad ARDS.

COVID-19 can cause a primary viral pneumonia with subsequent ARDS. 10% of cases if I recall. The lung injury patterns I'm seeing are probably more dramatic with COVID-19. 10x fatality rate > H1N1. And the cardiac manifestations (fulminant CHF and VT/VF) are nightmarish.

Is there any sense of predictors for the poor cardiac outcomes? That does sound nightmarish

I don't think so. Underlying cardiac pts do worse with the ARDS. Don't think those pts are dying of viral myocarditis. I read about a healthy 29 y/o marathoner. No health issues. Got COVID-19. Was doing fine / defervescing and then at day 10 died suddenly died of VT/VF related to acute myocarditis.

That is my friends daughter. She was a new nurse. Every single Covid 19 symptom, literally text book. First Covid test came back negative two days before she passed. Cause of death at this point is bilateral pneumonia which led to heart failure. (Obviously I don't know the formal language) Hopefully another test will be done as everyone is sure the test was a false negative. Absolutely tragic.

i don't think you can get current stats for heart attacks or pneumonia. You can get 2-week old reports for influenza-like illnesses.

Any updates?