COVID-19 News: New Study By High Altitude Specialists Attribute COVID-19 Lung Damage To Pneumolysis And Not Due To Cytokine Storms!
: A new study by scientists specializing in high-altitude diseases from the High Altitude Pulmonary and Pathology Institute (IPPA)-Bolivia have proposed a new hypothesis that states that pneumolysis and not cytokines storms are what are that are causing lung damage in COVID-19 patients.
This new findings challenges all initial assumptions about the pathogenesis and disease progression of COVID-19. The study team was also supported by researchers from Shri B.M.Patil Medical College-Karnataka, India and the Faculty of Medicine of Université Laval, Québec-Canada
Critical hypoxia in this COVID-19 pandemic results in high mortality and economic loss worldwide. Initially, this disease’ pathophysiology was poorly understood and interpreted as a SARS (Severe Acute Respiratory Syndrome) pneumonia. The severe atypical lung CAT scan images alerted all countries, including the poorest, to purchase lacking sophisticated ventilators.
However, 88% of the patients on ventilators lost their lives. It was suggested that COVID-19 could be similar to a High-Altitude Pulmonary Edema (HAPE). New observations and pathological findings are gradually clarifying the disease.
As high-altitude medicine and hypoxia physiology specialists from the highlands, the study team performed a perspective analysis of hypoxic diseases treated at high altitude and compared them to Covid-19. Oxygen transport physiology, SARSCov-2 characteristics, and its transmission, lung imaging in COVID-19, and HAPE, as well as the causes of clinical signs and symptoms, are discussed.
The study found that high-altitude oxygen transport physiology has been systematically ignored. COVID-19 signs and symptoms indicate a progressive and irreversible failure in the oxygen transport system, secondary to pneumolysis produced by SARS-Cov-2’s alveolar-capillary membrane “attack”. HAPE’s pulmonary compromise is treatable and reversible. COVID-19 is associated with several diseases, with different individual outcomes, in different countries, and at different altitudes.
The study findings were published in the peer-reviewed journal: Reviews Of Recent Clinical Trials. https://www.eurekaselect.com/186294/article
The ongoing COVID-19 pandemic has caused over 1.8 million deaths which can be attributed to its severe progressive pulmonary compromise. The necessity to understand this disease has resulted in detailed analyses of its transmission and clinical aspects published worldwide.
In the study, physicians in Bolivia who live and work at more than 3,600m from above sea level, provide a high altitude specialists’ perspective. At high-altitude, hypoxemia (low oxygen in the blood), the main complication in COVID-19, is every day’s life experience in La Paz, Bolivia centuries.
However unlike high altitude illnesses, according to lead researcher Professor Dr Gustavo Zubieta-Calleja, COVID-19 presents his transcendental new concept: “pneumolysis” (pneumo=lung, lysis=destruction).
In the beginning majority of physicians worldwide assumed that the lung affliction in COVID-19 (evidenced by CAT scans
and caused by SARS-CoV-2) was the same as in older strains SARS-CoV. However, as fatality rates increased in Intensive Care Units, it became evident that this pathology was entirely new.
The novel SARS-CoV-2 virus enters the body through inhalation of the viral load, and travels through the bronchi to the surface of the alveoli respiratory sacs where pneumocytes (alveolar lung cells), and their capillaries are located. The pneumocytes allow the diffusion of oxygen molecules to the capillaries where red blood cells capture and transport them to all tissues. They also allow the passage of carbon dioxide molecules (a waste product of respiration) to be exhaled.
The SARS-CoV-2 virus penetrates pneumocytes through the ACE2 receptors and starts self-replication of its RNA within. Pneumocytes are eventually destroyed liberating all replicated SARS-CoV-2 RNA that further infect other adjacent pneumocytes.
The study findings also suggest that multiple diseases may arise from SARS-CoV-2 entering the capillaries.
The SARS-VoV-2 coronavirus intrusion gradually reduces the lung’s gas exchange area. This results in alveoli inflammation and a superimposed alteration of lung function similar to High Altitude Pulmonary Edema (HAPE). Both in COVID-19 and HAPE, sea level patients cannot take in enough oxygen as if they were rapidly placed on the summit of Mt. Everest, without time for adaptation. Nevertheless, HAPE is entirely reversible as its mechanism is different, and there is no destruction of alveoli.
Most of the time, the extreme hypoxemia experienced in COVID-19 patients leads physicians to use ventilators (a mechanical way of pumping air into the lungs) to improve oxygenation.
However, using high pressures on partially destroyed and fragile lungs can result in the worst outcomes. Whereas non-invasive ventilation results in better outcomes.
Should a patient survive the acute pneumolysis with critically low oxygen levels in COVID-19, recovery results in irreversible fibrosis (scars) in the lungs.
This damaged tissue is no longer useful for gas exchange, so compensation can be commonly achieved by increasing the number of red blood cells (hemoglobin oxygen transporters).
Importantly this poly-erythrocythemia) is a compensation mechanism found in high-altitude residents who suffer chronic lung diseases or other oxygen transport disorders, commonly known as “Chronic Mountain Sickness.”
Also in COVID-19, normal sea level hemoglobin can also become insufficient.
The study team postulates that a fundamental treatment strategy to increase the transport of oxygen could be erythropoietin. This hormone naturally increases red blood cell production and protects the heart, brain, and vessels from hypoxia’s hazards.
The study team proposes that prompt administration of oxygen is important as it can reduce the formation of HAPE-type edema and cardiopulmonary overwork.
The use of anti-inflammatory medication, being tops Aspirin for its analgesic, anti-inflammatory, anti-fever, and anti-coagulation effects, are also proposed.
Also timely use of antibiotics (to protect from super-infection), adequate oral rehydration, antitussives (promoting a resting lung) and other anti-coagulation drugs should also be considered on each individual case.
In order to allow people to return to work, Dr Zubieta-Calleja proposes the use of space type earth suits with electric ventilator open circuit adequately filtered air, reducing contagion risk.
According to the study team the SARS-CoV-2 coronavirus is a natural biological cleansing mechanism attacking more severely those with decreased immunity, inflammatory processes, or overlapping diseases.
The team explained, “The individual ultimate survival tool under COVID-19 presence is a strong immune system.”
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