Positive side effects that aren't good for the condition you would be in.

If this proves true, Roman, Hims, and BlueChew stock, if there is such a thing, is going to skyrocket. And a lot of wives might be glad to see the hubby go.

But again, thanks to the Docs trying everything.

AggieChemist said:

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Giving COVID patients Viagra has the added benefit of keeping them from rolling out of bed.

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Duncan Idaho said:

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All my preworkout mix is going to save me.

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Looks like I'm upping my dosages b4 each work out. Then calling my wife.


Sorry OP, couldn't resist. I think we need some laughs around here.

I imagine Dr. Wu jumping up and down with excitement reading about anything positive with NO. I hated that class.

AggieChemist said:

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Giving COVID patients Viagra has the added benefit of keeping them from rolling out of bed.

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They are likely already proned, so I foresee some issues with viagra treatment.

Got HAPE will hiking up to 12,100 ft in Colorado in 2013. Wow that was uncomfortable, and scary as hell, took me 6 hours to get down. House we were vacationing at was at 7300, but loads of oral viagra and nifedipine didn't move the needle much. Didn't feel well until we reached the flats of NM.

There is a Chinese trial of sildenafil therapy for mild-mod COVD-19 pts. My guess is this will be not be effective. NO inhaled is given at fairly high concentration relative to native tissue NO. I haven't seen any data but I doubt sildenafil at pulmonary HTN doses, or ED for that matter, leads to tissue NO levels similar to inhaled. There is also data that shows NO may have antiviral properties.

MA, quick question. If the theories on Covid's interaction with hemoglobin/RBC's etc has any merit. Would people with elevated hemoglobin/hematocrit/RBC's potentially be at more risk? I have consistently had high, but not dangerously high levels and just curious if I should do something about it. I'm fit and in good health, just moderately high in these counts on blood panel.

Good ? There may be something to the porphyrin attack theory. Dislodging iron. Possibly leading to the huge ferritin spikes. My anecdotal opinion of that is ferritin is being driven up by IL-6 surges. Clinically I havent seen major anemia or hemolysis which one might expect if this mechanism was a major pathway of the disease. As regards to your polycythemia- that deserves a workup. First a sleep study to r/o OSA. If normal - pulmonary function testing, imaging etc. if normal - refer to hematologist. I dont think polycythemia puts you at higher risk for COVID19. An educated guess.

My brother in law has invented a nitric oxide lozenge called NEO40 that is far more effective than the breathable stuff.

I've been popping it twice a day since this stuff started.

Marcus Aurelius said:

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Good ? There may be something to the porphyrin attack theory. Dislodging iron. Possibly leading to the huge ferritin spikes. My anecdotal opinion of that is ferritin is being driven up by IL-6 surges. Clinically I havent seen major anemia or hemolysis which one might expect if this mechanism was a major pathway of the disease. As regards to your polycythemia- that deserves a workup. First a sleep study to r/o OSA. If normal - pulmonary function testing, imaging etc. if normal - refer to hematologist. I dont think polycythemia puts you at higher risk for COVID19. An educated guess.

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So, let's assume that this is true in at least some patients. What are the treatment options, besides HCQ? How else can we protect the red blood cells?

Blood transfusions?

Blood transfusions from patients with antibodies?

Any other drugs out there?

Willy Wonka said:

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My brother in law has invented a nitric oxide lozenge called NEO40 that is far more effective than the breathable stuff.

I've been popping it twice a day since this stuff started.

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Nathan, his wife and I were in the same class in high school. I know both well. In fact, my grandparents lived next to his wife's parents for quite a while.

I know, cool story, right?

BusterAg said:

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Marcus Aurelius said:

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Good ? There may be something to the porphyrin attack theory. Dislodging iron. Possibly leading to the huge ferritin spikes. My anecdotal opinion of that is ferritin is being driven up by IL-6 surges. Clinically I havent seen major anemia or hemolysis which one might expect if this mechanism was a major pathway of the disease. As regards to your polycythemia- that deserves a workup. First a sleep study to r/o OSA. If normal - pulmonary function testing, imaging etc. if normal - refer to hematologist. I dont think polycythemia puts you at higher risk for COVID19. An educated guess.

---

So, let's assume that this is true in at least some patients. What are the treatment options, besides HCQ? How else can we protect the red blood cells?

Blood transfusions?

Blood transfusions from patients with antibodies?

Any other drugs out there?

---

https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

That paper is purely a hypothesis. No in vitro or in vivo actual research.


Interesting question. One could extrapolate to other hemoglobinopathies such as G6PD deficiency (which interestingly is more common in black pts.) Oxidative stress worsens this condition. It can be treated with drugs like HCQ, quinine, ASA, NSAIDS, quinolones, nitrofuraontoin. But these pts get anemia, hemolysis, jaundice etc. I've not seen that with COVID-19. Methemoglobinemia is another disorder associated with oxidized iron in the ferric F3+ form instead of the ferrous F2+. O2 is dissociated leading to deadly consequences. It is diagnosed by PO2/pulse oximetry discordance, and dark "brown" colored blood - both not seen in COVID-19 pts. It is treated with iron reducing agents like methylene blue.

Sickle cell trait (heterozygous SA) is seen in 1/10 black pts. Fascinating to me. Could very well be playing a role. These pts don't do well with lung injury. Not to mention sickle cell disease (homozygous SS) (1/365 blacks). But once again hemolysis is profound in these pts and I haven't seen much in the COVID-19 ARDS patients.

Then there's thallasemias - too much to get into!! Need a hematologist to chime in.

Blood transfusion can be used for methemoglobinemia and sickle cell disease.

One last forest/trees comment re this. These severe pts have profound hypoxia (PO2) in dissolved blood. Hemoglobin damage itself isnt going to effect PO2 levels.

Marcus Aurelius said:

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Good ? There may be something to the porphyrin attack theory. Dislodging iron. Possibly leading to the huge ferritin spikes. My anecdotal opinion of that is ferritin is being driven up by IL-6 surges. Clinically I havent seen major anemia or hemolysis which one might expect if this mechanism was a major pathway of the disease. As regards to your polycythemia- that deserves a workup. First a sleep study to r/o OSA. If normal - pulmonary function testing, imaging etc. if normal - refer to hematologist. I dont think polycythemia puts you at higher risk for COVID19. An educated guess.

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Thanks...it's actually result of trt...I'm prob due to give blood, just been avoiding that place for the last month or so. Appreciate all of your insight (as well as others, on these boards. No use worrying, just going to keep working out, eating healthy and doing reg cardio until I can give blood again. Kind of got concerned when I saw a thread hypothesizing that it could be reacting with hemoglobin.

I'd still get a sleep study IMO. T worsens OSA anyway. See a ton of men sent for this and it's there. Treat it and Hgb goes down within 2 mos.

ok, I'm her brother... so who are you?

Willy Wonka said:

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ok, I'm her brother... so who are you?

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PM sent

Marcus Aurelius said:

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BusterAg said:

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Marcus Aurelius said:

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Good ? There may be something to the porphyrin attack theory. Dislodging iron. Possibly leading to the huge ferritin spikes. My anecdotal opinion of that is ferritin is being driven up by IL-6 surges. Clinically I havent seen major anemia or hemolysis which one might expect if this mechanism was a major pathway of the disease. As regards to your polycythemia- that deserves a workup. First a sleep study to r/o OSA. If normal - pulmonary function testing, imaging etc. if normal - refer to hematologist. I dont think polycythemia puts you at higher risk for COVID19. An educated guess.

---

So, let's assume that this is true in at least some patients. What are the treatment options, besides HCQ? How else can we protect the red blood cells?

Blood transfusions?

Blood transfusions from patients with antibodies?

Any other drugs out there?

---

https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

That paper is purely a hypothesis. No in vitro or in vivo actual research.


Interesting question. One could extrapolate to other hemoglobinopathies such as G6PD deficiency (which interestingly is more common in black pts.) Oxidative stress worsens this condition. It can be treated with drugs like HCQ, quinine, ASA, NSAIDS, quinolones, nitrofuraontoin. But these pts get anemia, hemolysis, jaundice etc. I've not seen that with COVID-19. Methemoglobinemia is another disorder associated with oxidized iron in the ferric F3+ form instead of the ferrous F2+. O2 is dissociated leading to deadly consequences. It is diagnosed by PO2/pulse oximetry discordance, and dark "brown" colored blood - both not seen in COVID-19 pts. It is treated with iron reducing agents like methylene blue.

Sickle cell trait (heterozygous SA) is seen in 1/10 black pts. Fascinating to me. Could very well be playing a role. These pts don't do well with lung injury. Not to mention sickle cell disease (homozygous SS) (1/365 blacks). But once again hemolysis is profound in these pts and I haven't seen much in the COVID-19 ARDS patients.

Then there's thallasemias - too much to get into!! Need a hematologist to chime in.

Blood transfusion can be used for methemoglobinemia and sickle cell disease.

One last forest/trees comment re this. These severe pts have profound hypoxia (PO2) in dissolved blood. Hemoglobin damage itself isnt going to effect PO2 levels.

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Thanks. I appreciate this.

Any other ideas on what can cause such low PO2 levels besides lungs that are not functioning properly?

My understanding is that viruses don't have a metabolism, so I'm pretty sure that the virus can't be consuming O2, right?

Just trying to think outside the box so I can continue to sharpen my bull**** meter.

Marcus Aurelius said:

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There is a Chinese trial of sildenafil therapy for mild-mod COVD-19 pts. My guess is this will be not be effective. NO inhaled is given at fairly high concentration relative to native tissue NO. I haven't seen any data but I doubt sildenafil at pulmonary HTN doses, or ED for that matter, leads to tissue NO levels similar to inhaled. There is also data that shows NO may have antiviral properties.

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Yes, I think so too. there are so many theories and speculation on different meds these days.. I have been buying such ED pills from Canadian Pharmacy for me, but I doubt they have any anti-viral effects... I think that we should wait for a good and tested vaccine. Anything else is not safe IMO

Just great! First there was a run on toilet paper and hand sanitizer. Next there was a run on Pepcid and mouth wash. Now, there will be a run on beet juice, the natural viagra. Damn you, COVID!