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'Long Covid': Why are Some People not Recovering?

posted by Fnord666 on Monday October 12 2020, @02:59PM   Printer-friendly

takyon writes:

'Long Covid': Why are some people not recovering?

For most people, Covid-19 is a brief and mild disease but some are left struggling with symptoms including lasting fatigue, persistent pain and breathlessness for months.

The condition known as "long Covid" is having a debilitating effect on people's lives, and stories of being left exhausted after even a short walk are now common.

So far, the focus has been on saving lives during the pandemic, but there is now a growing recognition that people are facing long-term consequences of a Covid infection.

Yet even basic questions - such as why people get long Covid or whether everyone will fully recover - are riddled with uncertainty.

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  • (Score: 1, Informative) by Anonymous Coward on Monday October 12 2020, @03:15PM (52 children)

    by Anonymous Coward on Monday October 12 2020, @03:15PM (#1063564)

    There is no medical definition or list of symptoms shared by all patients - two people with long Covid can have very different experiences.

    However, the most common feature is crippling fatigue.

    Others symptoms include: breathlessness, a cough that won't go away, joint pain, muscle aches, hearing and eyesight problems, headaches, loss of smell and taste as well as damage to the heart, lungs, kidneys and gut.

    Mental health problems have been reported including depression, anxiety and struggling to think clearly.

    If a patient has symptoms of scurvy and is deficient in vitamin C what should we do?

    In a forensic context, scurvy may mimic inflicted injuries and may be responsible for sudden death by mechanisms that remain unclear. Cardiac failure and rhythm disturbances with chest pain, hypotension, cardiac tamponade, and dyspnea are associated with vitamin C deficiency. In addition, syncope and seizures may occur.

    [...]

    The first manifestation of scurvy is lassitude with other psychological manifestations including depression, hypochondriasis, psychomotor retardation, “personality change,” and confusion, possibly associated with disturbances in the function of the basal motor nuclei.2,34

    https://pubmed.ncbi.nlm.nih.gov/30422823/ [nih.gov]

    In 80% of cases, the manifestations of scurvy include musculoskeletal symptoms consisting of arthralgia, myalgia, hemarthrosis, and muscular hematomas.

    https://pubmed.ncbi.nlm.nih.gov/15797491/ [nih.gov]

    Vitamin C was determined by high-performance liquid chromatography with photodiode detector (detection limit 1.5 mg/L). Vitamin C reference values in general population used to be above 5 mg/L. Seventeen paients (94.4%) had undetectable vitamin C levels and 1 patient had low levels (2.4 mg/L).

    To our knowledge, this is the first study to analyze the levels of vitamin C in patients with SARS-CoV-2-associated ARDS. Our study revealed that vitamin C levels are undetectable in more than 90% of the patients included.

    https://pubmed.ncbi.nlm.nih.gov/32847620/ [nih.gov]

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  • (Score: 2, Informative) by Anonymous Coward on Monday October 12 2020, @03:20PM (41 children)

    by Anonymous Coward on Monday October 12 2020, @03:20PM (#1063566)

    Our pilot study found low serum levels of Vitamin C and Vitamin D in most of our critically ill COVID-19 ICU patients.

    https://pubmed.ncbi.nlm.nih.gov/32964205/ [nih.gov]

    Survivors had avg of 30 uM while nonsurvivors 15 uM. They should be 50 uM:

    A further issue is consensus on the cutoffs for inadequacy; vitamin C deficiency is usually defined as plasma concentrations <11 µmol/L, however, although hypovitaminosis C is often defined as <23 µmol/L, some studies report ‘inadequacy’ as <28 µmol/L (or even <30 or 34 µmol/L), therefore making it difficult to directly compare prevalence between studies. Vitamin C ‘adequacy’ has been more recently defined as >50 µmol/L [74], however, many of the older studies report concentrations <28 µmol/L as being ‘adequate’.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400810/ [nih.gov]

    • (Score: 3, Interesting) by JoeMerchant on Monday October 12 2020, @03:25PM (40 children)

      by JoeMerchant (3937) on Monday October 12 2020, @03:25PM (#1063570)

      Do they speculate (or _gasp_ have actual data) about whether the deficiencies are pre-existing at the time of infection, or a result of the body's reaction?

      --
      Україна досі не є частиною Росії Слава Україні🌻 https://news.stanford.edu/2023/02/17/will-russia-ukraine-war-end

      • (Score: 1, Insightful) by Anonymous Coward on Monday October 12 2020, @03:29PM (33 children)

        by Anonymous Coward on Monday October 12 2020, @03:29PM (#1063571)

        What does it matter? If someone has symptoms of scurvy and is deficient in vitamin C they should correct the deficiency. Why would you not treat scurvy just because you found it in someone who had/has covid? That makes no sense.

        But most likely it is both. These people were already low on vitamin C due to various comorbidities and poor diet then the oxidative stress of covid drained it even further.

        • (Score: 0) by Anonymous Coward on Monday October 12 2020, @03:43PM (22 children)

          by Anonymous Coward on Monday October 12 2020, @03:43PM (#1063579)

          Yes, regardless of whether or not having adequate Vitamin C has any impact on this illness, it's still a good idea to ensure that you've got enough of all vitamins and minerals just because they do have other health issues.

          I remember for a time, they were looking at Vitamin D, but I haven't heard anything about that in recent months, so I don't know if there was anything other than just a correlation.

          • (Score: 1, Informative) by Anonymous Coward on Monday October 12 2020, @03:51PM (5 children)

            by Anonymous Coward on Monday October 12 2020, @03:51PM (#1063583)

            Vitamin D is also an antioxidant that gets depleted the same way:

            Vitamin D is a membrane antioxidant: thus Vitamin D3 (cholecalciferol) and its active metabolite 1,25-dihydroxycholecalciferol and also Vitamin D2 (ergocalciferol) and 7-dehydrocholesterol (pro-Vitamin D3) all inhibited iron-dependent liposomal lipid
            peroxidation.

            https://pubmed.ncbi.nlm.nih.gov/8325381/ [nih.gov]

            Compared with several well-known antioxidants, vitamin D3 may be one of the most powerful antioxidants in biological organisms as shown in the present study.

            https://pubmed.ncbi.nlm.nih.gov/16179538/ [nih.gov]

            Wouldnt be surprised if vitamin c was responsible for recycling vitamin d just like for vitamin e.

            • (Score: 0) by Anonymous Coward on Monday October 12 2020, @04:32PM (4 children)

              by Anonymous Coward on Monday October 12 2020, @04:32PM (#1063601)

              Vitamin C recycles vitamin E:

              Vitamin C (ascorbic acid) and vitamin E (tocopherol) are central interacting components of
              the antioxidant defense system [1]. The interrelation between both vitamins is based on the ‘vitamin
              E recycling’: tocopherol reacts with a peroxyl radical to form a tocopheryl radical, which in
              turn is regenerated by vitamin C [2]. Although this interrelation has been demonstrated on an
              experimental level [3–6], the impact of the interrelation between both vitamins on the biomarker level
              in community-dwelling subjects and particularly in the course of ageing remains to be shown.

              Our study demonstrates a robust positive interrelation between vitamins C and E status in
              community-dwelling elderly subjects during the course of advanced ageing, even in subjects not
              taking supplements. It is well known that α-tocopherol and ascorbic acid act synergistically in
              counteracting free radicals where α-tocopherol is able to quench free radicals in a hydrophobic
              environment and the resulting tocopherol radical is then regenerated by ascorbic acid [56]. Most of
              this evidence is based on animal and in-vitro studies [3,4,6] and studies investigating this relationship
              in vivo are scarce. One study providing pharmacological doses of either vitamin C or E to a group
              of healthy middle-aged adults for six weeks showed an increase in fasting plasma ascorbic acid
              after supplementation with α-tocopherol and an increased vitamin E status after ascorbic acid
              supplementation [5]. In another intervention study, pharmacological doses of vitamin C for two
              weeks attenuated fractional disappearance rates of plasma α- and γ-tocopherol in smokers, indicating
              that plasma vitamin C reduces α- and γ-tocopheroxyl radicals resulting from oxidative stress due
              to smoking [57].

              https://pubmed.ncbi.nlm.nih.gov/32992851/ [nih.gov]

              Vitamin D is probably similar, or is perhaps downstream from vitamin E in the membranes. Most people just study the role of the vitamin D receptor and don't consider it as an antioxidant.

              • (Score: -1, Offtopic) by Anonymous Coward on Tuesday October 13 2020, @06:00AM (3 children)

                by Anonymous Coward on Tuesday October 13 2020, @06:00AM (#1063896)

                So if I eat vitamin C gummies, I can also start smoking again? Can we start a petition for Albanese to make vitamin C gummy worms?

                • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @01:28PM

                  by Anonymous Coward on Tuesday October 13 2020, @01:28PM (#1063967)

                  Vitamin c gummies are probably worthless because the glucose competes for absorption via GLUT transporters. I think those gummies are like 40:1 molar glucose to ascorbate ratio iirc.

                • (Score: 0) by Anonymous Coward on Wednesday October 14 2020, @02:21PM

                  by Anonymous Coward on Wednesday October 14 2020, @02:21PM (#1064452)

                  +1 for Albanese gummy worms

                • (Score: 2) by The Mighty Buzzard on Thursday October 15 2020, @02:51PM

                  by The Mighty Buzzard (18) Subscriber Badge <themightybuzzard@proton.me> on Thursday October 15 2020, @02:51PM (#1064988) Homepage Journal

                  If they're sugar free, you should live stream the next few days.

                  --
                  My rights don't end where your fear begins.

          • (Score: 3, Interesting) by Anonymous Coward on Monday October 12 2020, @04:25PM

            by Anonymous Coward on Monday October 12 2020, @04:25PM (#1063596)

            Of 50 patients treated with calcifediol, one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50 %) p value X2 Fischer test p < 0.001. Univariate Risk Estimate Odds Ratio for ICU in patients with Calcifediol treatment versus without Calcifediol treatment: 0.02 (95 %CI 0.002−0.17). Multivariate Risk Estimate Odds Ratio for ICU in patients with Calcifediol treatment vs Without Calcifediol treatment ICU (adjusting by Hypertension and T2DM): 0.03 (95 %CI: 0.003-0.25). Of the patients treated with calcifediol, none died, and all were discharged, without complications. The 13 patients not treated with calcifediol, who were not admitted to the ICU, were discharged. Of the 13 patients admitted to the ICU, two died and the remaining 11 were discharged.

            https://www.sciencedirect.com/science/article/pii/S0960076020302764 [sciencedirect.com]

            Here is another recent observational study confirming vitamin D deficiency is common in covid patients:
            https://www.medrxiv.org/content/10.1101/2020.10.05.20206706v1 [medrxiv.org]

            There are dozens of papers on that you can easily search on pubmed.

          • (Score: 2, Informative) by choose another one on Monday October 12 2020, @04:48PM (14 children)

            by choose another one (515) on Monday October 12 2020, @04:48PM (#1063605)

            I remember for a time, they were looking at Vitamin D

            Vitamin D connection has to be looked at very very quietly because pointing out that living at a latitude your skin hasn't yet evolved for (we are all African if you go back far enough) affects your Vit D upsets the woke because it overturns their narrative that death rates are higher among those with darker skin in Europe/US because of poverty due to white racial oppression.

            If you double down and point out that while death rates of Black Africans in Europe are at least double those of white folk, in actual Black-African countries in Africa (same people, worse poverty, but living at latitudes they are evolved for, except maybe South Africa...) death rates are far far lower, then they get even more woke-upset...

            • (Score: 0) by Anonymous Coward on Monday October 12 2020, @04:59PM

              by Anonymous Coward on Monday October 12 2020, @04:59PM (#1063612)

              Not just latitude but also time spent in the sun matters. There are plenty of vitamin D deficient people in florida, etc.

            • (Score: 2, Disagree) by RS3 on Monday October 12 2020, @05:13PM (11 children)

              by RS3 (6367) on Monday October 12 2020, @05:13PM (#1063618)

              I had to read your post several times to grasp your message. What you're saying might be true in some cases / people.

              Not expert and no time to research but IIRC people with darker skin need more sunlight to generate the same amount of D as lighter-skinned people.

              My comment to TFS and most of the posts here is that we just don't have enough data, there is so much we still don't know about COVID-19 and viruses in general, and we haven't been able to correlate the data and knowledge we do have to make sense of it all. The very point of TFA is that there is huge variation in patient symptoms and outcomes and we're not really sure why. Speculation is good as long as we can track the data to support the various theories.

              But even then people's body chemistry varies widely, and there may be human biochemistry factors we don't yet know about.

              I remember early on the science was that blood-type was a big factor in COVID susceptibility, disease length and course, etc. It's nearly impossible to gather all of the possible factors in each patient's case, but at least there's great effort.

              Personally I wish _everyone_ could take part in helping the medical science effort. Kind of like "mechanical turk", "zooniverse", etc. And maybe there are opportunities to help in the effort, and maybe it's been talked about in the media... but for me the media is so overwhelmingly politics that I barely pay attention.

              • (Score: 0) by Anonymous Coward on Monday October 12 2020, @05:28PM (7 children)

                by Anonymous Coward on Monday October 12 2020, @05:28PM (#1063625)

                But we do know what to do for scurvy. So if people are deficient in vitamin c and showing symptoms of scurvy, the next step is pretty clear.

                • (Score: 2) by RS3 on Monday October 12 2020, @05:59PM (6 children)

                  by RS3 (6367) on Monday October 12 2020, @05:59PM (#1063635)

                  Absolutely, agreed, and it's tedious to keep (over)stating the obvious.

                  I will concede a shortcoming in the medical world and maybe society in general: doctors / medical workers generally overlook diseases that they think have generally been wiped out, or that people don't get because common knowledge, proper diets, etc., - like scurvy.

                  Another example that's bugging me: months ago hand washing and hand sanitizer was all the rage (in the media). More recently masks have become the rage and controversy. Just from my casual observation, many people seem to have slacked off of the hand washing and sanitizer use. Initially you could not buy sanitizer if your life literally depended on it. Store shelves were empty, not being replenished. (no clue where it was going). Jerks were selling it at 10X prices. Fake stuff popped up here and there. Homemade recipes were everywhere. Now I rarely see / hear of it.

                  It'd be nice to have 1 place- website- that accumulates ALL of the common knowledge / precautions for COVID. Blood-type, vitamins, etc.

                  BTW, BBC article yesterday said new data shows COVID can last up to 28 days on hard surfaces. Far cry and big problem compared to the 2-3 days previously thought.

                  Not to be reckless, but would a 27-day old COVID virus cell cause an infection? How many such cells would be required to infect someone? If you handled such a thing, how likely could you be infected? What would be the mechanism?

                  Which reminds me of another that belongs on the list of things we heard but aren't being talked about much anymore: not touching your face, especially eyes, nose, and mouth, without good hand washing / sanitizer.

                  • (Score: 0) by Anonymous Coward on Monday October 12 2020, @08:04PM (5 children)

                    by Anonymous Coward on Monday October 12 2020, @08:04PM (#1063685)

                    BTW, BBC article yesterday said new data shows COVID can last up to 28 days on hard surfaces. Far cry and big problem compared to the 2-3 days previously thought.

                    Translation: someone decided that "second wave" is a good time to repeat the push for abolition of cash (remember the failed campaign in the spring?) Expect more horror stories with ever more outlandish claims.
                    Observe the more direct FUD headline: "Don't touch this! Coronavirus stays on banknotes, mobile phone screens and steel for up to 28 DAYS" [dailymail.co.uk]
                    Enjoy.
                    Observe how any horror-reducing observation are relegated to "*" and "**" and tiny little unreadable font in the infographics. Isn't that nice?
                    Note that the actual facts like "Samples were incubated in the dark to limit any effect light might have on viral decay" never entered the nice article(s).
                    https://virologyj.biomedcentral.com/articles/10.1186/s12985-020-01418-7 [biomedcentral.com]
                    Note that PIN keyboards are never mentioned, apparently being miraculously protected from The Coronavirus by holy dispensation of Big Finance.

                    • (Score: 2) by PartTimeZombie on Monday October 12 2020, @08:55PM (2 children)

                      by PartTimeZombie (4827) on Monday October 12 2020, @08:55PM (#1063701)

                      WAKE UP SHEEPLE!

                      • (Score: 0) by Anonymous Coward on Monday October 12 2020, @09:37PM

                        by Anonymous Coward on Monday October 12 2020, @09:37PM (#1063715)

                        BAAAAAA!!!

                      • (Score: 0) by Anonymous Coward on Monday October 12 2020, @10:55PM

                        by Anonymous Coward on Monday October 12 2020, @10:55PM (#1063743)

                        https://www.henrymakow.com/upload_images/sheeple-masks.jpg [henrymakow.com]

                    • (Score: 2) by hendrikboom on Wednesday October 14 2020, @03:17AM (1 child)

                      by hendrikboom (1125) on Wednesday October 14 2020, @03:17AM (#1064332) Homepage Journal

                      At least Canadian banknotes can be washed with soap and water.

                      • (Score: 0) by Anonymous Coward on Thursday October 15 2020, @09:22AM

                        by Anonymous Coward on Thursday October 15 2020, @09:22AM (#1064890)

                        Slow down there, Hendrik. Everybody knows laundering money is illegal.

              • (Score: 2) by HiThere on Monday October 12 2020, @07:32PM (2 children)

                by HiThere (866) on Monday October 12 2020, @07:32PM (#1063666) Journal

                OTOH, there is also evidence, how definitive I don't know, that blacks/negros/AfricanAmericans (except the source was British)/whatever-name-you-prefer metabolize vitamin D differently than Caucasians do. It didn't mention orientals, etc. It didn't say in what way they were different, but merely suggested that using the same yardstick might be a bad idea. (IOW, it didn't have an alternative suggestion. It did suggest that lower levels might not be a problem, but gave no reasoning or evidence.)

                Sometimes the needed evidence isn't available. But keeping your levels of Vitamin D up seems like a good idea...just don't overdo it, because that also has it's problems.

                Anyone who is dogmatic about ANY of these points is a fool. The evidence isn't there to support the claim. But the evidence for moderate levels of various vitamins and minerals is pretty strong, and SOME people benefit from doing so. (OTOH, there's also evidence that viruses often do better in people who are "well-nourished", but that term was not defined in the report I read. So perhaps that just meant overweight.)

                --
                Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.

                • (Score: -1, Troll) by Anonymous Coward on Monday October 12 2020, @07:56PM (1 child)

                  by Anonymous Coward on Monday October 12 2020, @07:56PM (#1063679)

                  Anyone dogmatic about trying vitamin c for someone with low vitamin c levels and symptoms of scurvy is a fool?

                  • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @06:10AM

                    by Anonymous Coward on Tuesday October 13 2020, @06:10AM (#1063898)

                    More like a vitamin C addict, snorting lemons and oranges. Get help.

            • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @08:25PM

              by Anonymous Coward on Tuesday October 13 2020, @08:25PM (#1064136)

              i agree with your proposal to send 'em all home for their own benefit.

        • (Score: 3, Insightful) by JoeMerchant on Monday October 12 2020, @03:56PM (3 children)

          by JoeMerchant (3937) on Monday October 12 2020, @03:56PM (#1063586)

          If it is depletion, then supplements upon diagnosis are much more urgent.

          If it is pre-existing, the odds of non-causal correlation are much higher.

          --
          Україна досі не є частиною Росії Слава Україні🌻 https://news.stanford.edu/2023/02/17/will-russia-ukraine-war-end

          • (Score: 0) by Anonymous Coward on Monday October 12 2020, @04:01PM (2 children)

            by Anonymous Coward on Monday October 12 2020, @04:01PM (#1063588)

            Do you think someone with covid who also has scurvy is better off than a covid patient without scurvy? How would that happen?

            • (Score: 0) by Anonymous Coward on Monday October 12 2020, @06:33PM (1 child)

              by Anonymous Coward on Monday October 12 2020, @06:33PM (#1063649)

              I think the serum concentration definition level of Scurvy may be a poor correlation for COVID survival rates, but the jury is still out on that one.

              Take some chloroquinine while you're at it.

              • (Score: 0) by Anonymous Coward on Monday October 12 2020, @06:42PM

                by Anonymous Coward on Monday October 12 2020, @06:42PM (#1063651)

                I think the serum concentration definition level of Scurvy may be a poor correlation for COVID survival rates, but the jury is still out on that one.

                Based on what? There is one study published on that. The deaths had levels of 15 uM and survivors 30 uM, when healthy is 50 uM. Seems like a pretty clear correlation to me.

        • (Score: 5, Touché) by epitaxial on Monday October 12 2020, @05:52PM (5 children)

          by epitaxial (3165) on Monday October 12 2020, @05:52PM (#1063633)

          My car has a flat tire and won't start. Clearly the flat tire is causing the engine to fail.

          • (Score: 0) by Anonymous Coward on Monday October 12 2020, @06:46PM

            by Anonymous Coward on Monday October 12 2020, @06:46PM (#1063654)

            So you would conclude there is no reason to fix the flat tire since it isnt causing the engine issue? What is that supposed to mean?

          • (Score: 2) by Tork on Monday October 12 2020, @07:20PM

            by Tork (3914) on Monday October 12 2020, @07:20PM (#1063664)
            What if your tire flapping around caused vibrations in the engine that disconnected something vital to the starter?
            --
            🏳️‍🌈 Proud Ally 🏳️‍🌈

          • (Score: 0) by Anonymous Coward on Monday October 12 2020, @08:34PM

            by Anonymous Coward on Monday October 12 2020, @08:34PM (#1063694)

            Connecting this [wikipedia.org] to an ignition lockout wouldn't be difficult.

          • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @12:16AM (1 child)

            by Anonymous Coward on Tuesday October 13 2020, @12:16AM (#1063781)

            Fix the tire. Then you can at least push it (or have it towed) to where you can fix the engine. Even if not related, you should fix the obvious problems to make fixing the less obvious problems easier. Seems like common sense. Right?

            • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @06:02AM

              by Anonymous Coward on Tuesday October 13 2020, @06:02AM (#1063897)

              You sound like a vitamin C addict to me. We should ban vitamin C.

      • (Score: 4, Informative) by nishi.b on Monday October 12 2020, @07:07PM (1 child)

        by nishi.b (4243) on Monday October 12 2020, @07:07PM (#1063662)

        It seems that most severe cases have a different immune reaction that involves neutrophils producing large amounts of oxydants to attack the pathogen, which might explain antioxidants being "used up" ?
        Ref: https://www.nature.com/articles/s41577-020-0407-1 [nature.com]

        • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @03:50AM

          by Anonymous Coward on Tuesday October 13 2020, @03:50AM (#1063859)

          Any source of ROS will do it, but it does seem to be more extreme in covid than usual critical illness.

      • (Score: 2) by choose another one on Monday October 12 2020, @11:07PM (1 child)

        by choose another one (515) on Monday October 12 2020, @11:07PM (#1063751)

        Do they speculate (or _gasp_ have actual data) about whether the deficiencies are pre-existing at the time of infection, or a result of the body's reaction?

        Whichever, it isn't relevant to _long_ covid, which is symptoms several months after infection.

        EITHER someone's diet is seriously deficient and they get scurvy, in which case they would have had Scurvy before covid, in which case they would also have had these symptoms before covid (many/most long covid sufferers report being fit and healthy beforehand),
        OR someone's diet has enough Vit C, so they will not be deficient months after Covid (even if Covid depletes it in the acute phase, and remember many of these folk had very mild acute phase), so they will not have Scurvy now.

        Only, kind of, other possibility is that covid _causes_ dietary changes in people (all ships' biscuits and no fruit) or _causes_ some kind of problem with vit C absorption - in which case treating for Scurvy (oral Vit C...) ain't going to do any good. On the other hand, why not give vit C, if not better in 2-3 days then "long covid" ain't scurvy. Quick, practically zero risk, eliminates a differential, holy shit why the heck ain't someone tried it already. Oh, wait... https://www.newsletter.co.uk/health/coronavirus/pastor-reveals-battle-long-covid-six-months-after-leaving-hospital-2986226 [newsletter.co.uk]

        • (Score: 0) by Anonymous Coward on Monday October 12 2020, @11:20PM

          by Anonymous Coward on Monday October 12 2020, @11:20PM (#1063757)

          They probably always had low vitamin C, but covid depleted it and their diet was never sufficient to get the oxidative stress under control. It could be easily answered with a 100 dollar blood test in a few of them.

          His sister-in-law, an NHS dietician, is giving him Vitamin C, zinc and probiotics for his immune system.

          This doesn't mean anything. A dietician is probably giving like 1 g/day max, more likely 100 mg or something sufficient for healthy people but not someone who is currently ill. How much is she giving him and what are the blood levels?

      • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @12:32AM (1 child)

        by Anonymous Coward on Tuesday October 13 2020, @12:32AM (#1063785)

        Surprises of surprises but people who come to the ER to seek care for infectious diseases tend to be undernurished. If you are coming to the ER for an infectious disease, it is because it has lasted a long time, is severe, or both. Not surprisingly when someone feels bad for a long time or really bad for a short time, they often don't eat well. If you don't eat well, it doesn't take too long for serum levels for all sorts of things to drop.

        • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @01:46AM

          by Anonymous Coward on Tuesday October 13 2020, @01:46AM (#1063823)

          Why would it be surprising? All critically ill people require 30-300x more vitamin C to maintain healthy levels. There are many papers on this.

  • (Score: 1, Interesting) by Anonymous Coward on Tuesday October 13 2020, @12:59AM (9 children)

    by Anonymous Coward on Tuesday October 13 2020, @12:59AM (#1063802)

    Do you even read the sources and items you cite? Or is the problem that you just ignore everything that you don't think matches with your conclusion? Seriously, the paper you keep throwing around for this stuff even disagrees with you if you make it all the way to the next sentence. It is even worse for you if you actually finish the conclusion because they actually know the limits of their study and are unafraid to acknowledge them.

    And on a related point, scurvy at the levels you are talking about are easy to spot and tell apart from other diseases. Most of that ease is because of all the signs scurvy has that "long" COVID-19 doesn't and the ones "long" COVID-19 has that scurvy doesn't. A 2-way frequency table makes that difference obvious. No clinician would mistake COVID-19-associated ARDS or "long COVID-19" with scurvy precisely for that reason. If it really were as obvious as you said a paper on Vitamin C and COVID would have at least mentioned scurvy somewhere in discussion.

    • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @01:37AM (8 children)

      by Anonymous Coward on Tuesday October 13 2020, @01:37AM (#1063819)

      What sentence says they do not have low vitamin C?

      • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @02:29AM (7 children)

        by Anonymous Coward on Tuesday October 13 2020, @02:29AM (#1063835)

        What sentence had anything to do with them having scurvy.

        • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @02:50AM (6 children)

          by Anonymous Coward on Tuesday October 13 2020, @02:50AM (#1063840)

          They don't go into the symptoms at all in those covid papers. Just report that once in the ICU the vitamin C levels were low. Symptoms of scurvy are very common in covid patients though. Strange how they have low vitamin C and symptoms of scurvy but you don't want to check their vitamin C levels or try correcting that deficiency.

          Scurvy:

          Examination showed gingival inflammation (Appendix 1, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.190934/-/DC1) and diffuse lower-extremity nonpalpable purpura in a perifollicular distribution (Figure 1). Laboratory investigations showed microcytic anemia, with normal platelet count and coagulation studies. Serologic testing for vasculitides, hepatitis B and C viruses, HIV and cryocrit were negative. A skin biopsy showed erythrocyte extravasation, hemosiderin deposition, and fibrin thrombi within small blood vessels; there was no evidence of dermatitis or vasculitis.

          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6989015/ [nih.gov]

          One of the striking observations in the older literature is of death being quite sudden in apparently stable individuals. One of the best descriptions of this was in a passage from Ansons’ A Voyage Around the World (1740–1744): “For many of our people, though confined to their hammocks, appeared to have no unconsiderable share of health; for they ate and drank heartily, were cheerful, and talked with much seeming vigor, and with a loud strong tone of voice; and yet on being the least moved, though it was only from one part of the ship to the other, and that in their hammocks, they have immediately expired. And others, who have confided in their seeming strength, and have resolved to get out of their hammocks, have died before they could well reach the deck. And it was no uncommon thing for these who would do some kind of duty, and walk the deck, to drop down dead in an instant on any endeavors to act with their utmost vigour.” 42 Lind also commented that “they are apt, upon being moved, or exposed to fresh air, suddenly to expire.” 4 It is recorded that only 4 men died from enemy action during Anson’s voyage, with more than 1300 dying of disease, which was primarily scurvy. 4

          [...]

          In a forensic context, scurvy may mimic inflicted injuries and may be responsible for sudden death by mechanisms that remain unclear. Cardiac failure and rhythm disturbances with chest pain, hypotension, cardiac tamponade, and dyspnea are associated with vitamin C deficiency. In addition, syncope and seizures may occur.

          [...]

          The first manifestation of scurvy is lassitude with other psychological manifestations including depression, hypochondriasis, psychomotor retardation, “personality change,” and confusion, possibly associated with disturbances in the function of the basal motor nuclei.2,34

          https://pubmed.ncbi.nlm.nih.gov/30422823/ [nih.gov]

          In 80% of cases, the manifestations of scurvy include musculoskeletal symptoms consisting of arthralgia, myalgia, hemarthrosis, and muscular hematomas.

          https://pubmed.ncbi.nlm.nih.gov/15797491/ [nih.gov]

          ###############################################3
          Covid:

          1) gingival inflammation

          In summary, almost half of patients with mild to moderate COVID-19 admitted in a field-hospital during a two-week period show mucocutaneous findings. Oral cavity is frequently involved and deserves specific examination under the appropriate circumstances to avoid contagion risk.

          https://pubmed.ncbi.nlm.nih.gov/32969503/ [nih.gov]

          Reddness an swelling of the hands and feet, fine palmoplantar desquamation and reddish-to-brown macules can help us to diagnose COVID-19 infection and should be routinely checked.

          https://pubmed.ncbi.nlm.nih.gov/32969503/ [nih.gov]

          2) diffuse lower-extremity nonpalpable purpura in a perifollicular distribution

          Other maculopapules (47%). Some of them showed perifollicular distribution and varying
          degrees of scaling (Fig 2a). Some had been described as similar to pityriasis rosea. Purpura may
          also be present, either punctiform or on larger areas. A few cases showed infiltrated papules in
          the extremities, mostly dorsum of the hands, that look pseudovesicular (Fig 2b) or resemble
          erythema elevatum diutinum or erythema multiforme (Fig 2c).

          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267236/ [nih.gov]

          3) microcytic anemia
          mean corpuscular volume appears normal:
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414516/ [nih.gov]

          4) erythrocyte extravasation

          Additional frequent findings included erythrocyte extravasation (82%) (Fig 3); papillary dermis edema (76%), which was massive in 4 cases, resulting in the formation of subepidermal pseudobullae (Fig 1); endothelial cell swelling (65%) (Fig 3); and moderately increased interstitial mucin deposition (41%). Less frequent, although remarkable, findings included the presence of vascular microthrombi within superficial dermal capillaries and more rarely in dermal venules

          https://www.sciencedirect.com/science/article/pii/S0190962220310227 [sciencedirect.com]

          5) hemosiderin deposition

          Hemosiderin-laden macrophages (4/8), hemorrhage (4/8), mucus aspiration (3/8), emphysema (2/8), and microthrombi (1/8) were seen (Figure 2).

          https://wwwnc.cdc.gov/eid/article/26/9/20-2095_article [cdc.gov]

          6) fibrin thrombi within small blood vessels

          “The extent of thrombosis we are seeing with covid is extraordinary,” Roopen Arya, clinical director for haematology at King’s College Hospital, told The BMJ. “I would say that one third of those severely affected with covid in critical care is a conservative estimate.”

          https://www.bmj.com/content/369/bmj.m2058 [bmj.com]

          7,8,9,10)

          However, the most common feature is crippling fatigue.

          Others symptoms include: breathlessness, a cough that won't go away, joint pain, muscle aches, hearing and eyesight problems, headaches, loss of smell and taste as well as damage to the heart, lungs, kidneys and gut.

          Mental health problems have been reported including depression, anxiety and struggling to think clearly.

          https://www.bbc.com/news/health-54296223 [bbc.com]

          11)

          The results of autopsy studies indicate the presence of pulmonary endothelial damage and microthrombosis. In a case series of 4 autopsies of COVID-19-infected patients from New Orleans with sudden respiratory decompensation, it was shown that there were no thromboembolisms in the major pulmonary arteries, but small thrombi were present in sections of the peripheral lung parenchyma.41 Furthermore, the microscopic findings confirmed that small vessels contained thromboembolisms and small thrombi together with scattered areas of diffuse alveolar damage, indicating that small vessels can a be affected by microthrombosis. d-dimers determined near the time of death were elevated in only 2 of the 4 patients.

          https://journals.sagepub.com/doi/10.1177/1076029620938149 [sagepub.com]

          • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @04:01AM (5 children)

            by Anonymous Coward on Tuesday October 13 2020, @04:01AM (#1063863)

            I actually read all of that. Let me say, That's a lot to put just to say "I just ignore everything that I don't think matches with my conclusion."

            And next time you want to claim what I want to do with COVID patients or those presenting any vitamin deficiency, you may want to check the treatment guidelines and standard of care in general.

            But please, put even more copypasta.

            • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @04:06AM (3 children)

              by Anonymous Coward on Tuesday October 13 2020, @04:06AM (#1063864)

              I actually read all of that. Let me say, That's a lot to put just to say "I just ignore everything that I don't think matches with my conclusion."

              What was ignored?

              • (Score: -1, Troll) by Anonymous Coward on Tuesday October 13 2020, @06:28AM (2 children)

                by Anonymous Coward on Tuesday October 13 2020, @06:28AM (#1063902)

                About 80% of the paper corpus cited and a basic understanding of medical research, diagnostic methods, and statistics.

                • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @01:22PM (1 child)

                  by Anonymous Coward on Tuesday October 13 2020, @01:22PM (#1063966)

                  So you got nothing then. Just dogmatic believe that vitamin c deficiency shouldn't be treated with vitamin c for some reason. Probably learned from a textbook written before the internet existed.

                  • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @09:13PM

                    by Anonymous Coward on Tuesday October 13 2020, @09:13PM (#1064161)

                    You are the one who started this by claiming that they had scurvy. Scurvy is not the same thing as Vitamin C deficiency and it doesn't have the same symptoms as COVID-19, long or short, acute or chronic. If they have a Vitamin C deficiency, then treat it. It is easy to spot because it is so obvious and fix because there are almost no side effects or adverse events. That's why hospitals are giving patients Vitamin C and D and others despite your claim that they aren't and such action is in the guidelines despite your claims its not. But not everything is a Vitamin C deficiency. The fact that the papers you cited disagree with your conclusion of scurvy on a basic analysis, if not on their face, and you don't see it speaks volumes. And a number of them says that patients don't have a symptom that you say they do and instead sound similar on their face. That probably comes from you not knowing your jargon and medical terms.

                    But if you aren't, prove it instead of just relying on your feeling and focusing on where they look the same. Do the 2-way frequency table. You could do the statistical testing. Even better establish estimates of what the sensitivity and specificity of your diagnostic signs are. You could save tens of thousands of lives through your efforts, especially if you got it in a big journal or in the blogosphere. You could be a household name for making the connection between "long COVID" and Vitamin C deficiency despite the evidence being against you.

            • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @04:16AM

              by Anonymous Coward on Tuesday October 13 2020, @04:16AM (#1063868)

              Anyway, I was going to encrypt it but not worth the effort at the moment.

              Everything you say I am ignoring is going to be symptoms counteracted by the hypoxemia.