More than a little horrifying to me, esp since I read part of that (until the lack of subscription didn’t let me) and this article talking about potentially permanent lung damage @Snowball City directed me to earlier due to my lad and our scuba diving love:
Having just shared these with my family here, we’re more determine to not want to catch this virus rather than taking our chances with catching it and hopefully getting over it. It’s too luck of the draw with who gets bad cases plus even among the living seems to have lasting damage even if one isn’t hospitalized - esp for our ages.
If you go by the definition of obesity based on body fat percentage (rather than weight or BMI), the ranges for women are about 7% higher than for men.
Women as well as men could have higher or lower muscle weight, so that a highly muscular athlete may be “overweight” or “obese” by weight or BMI, but not by body fat percentage, while a less muscular person may be “normal weight” by weight or BMI but have a high body fat percentage, sometimes known as “normal weight obesity” or “skinny fat”.
There’s not much doubt that a woman who was 5’1" and 165 pounds was obese. Moreover, Ms. Dowd had two inches of subcutaneous fat on the abdomen. The question is whether we should expect someone like that to die because her heart literally ruptured. No; she was risking certain bad health outcomes but normally that wouldn’t be one of them. This was not a woman on the brink of death.
I’m sure that all of us know someone as young and as fat as that, if we don’t qualify ourselves. We do not expect our chubby middle aged friends and family members to drop dead because their hearts burst and blood pours out. We expect them to have many years of life ahead of them.
Interesting results from Kaiser in Northern California, reported in JAMA.
From March 1 to March 31, of the people who showed up at a Kaiser facility and got tested for COVID-19, the vast majority didn’t have it. Only 8% tested positive.
But, of those who tested positive, many were very sick. Over a third of them (38%) were hospitalized. Half of the hospitalized people were younger than 60 or younger.
Given that the patient was tested, people 59 or younger were hospitalized at the same rate of older patients. That is, for people who were tested (presumably usually because they were sick) and who tested positive, being young didn’t protect the patient against being sick enough to need to be hospitalized, nor to need to be in the ICU. Older people in the study were likelier to die, but not likelier to be hospitalized.
Oh, and this is for you, @apprenticeprof: there are some scores that Kaiser (and maybe other hospitals) use to measure co-morbidities and how sick the person is when they are admitted. COPS2 measures co-morbidities, and LAPS2 measures how bad the person’s worst vital sign is. Kaiser already has statistics about typical mortality for people with different scores on these two measures, and the COVID-19 people died at greater rates than people with those scores usually do when admitted to the hospital.
This is not good news at all. Although the younger cohort doesn’t usually die of COVID-19, being hospitalized is not good, particularly as we seem to be learning that people with bad cases of COVID-19 are ending up with permanent complications.
Yes, I liked the saliva test discussion, and the idea that the government (maybe not ours, lol) could send everyone a test in the mail with a post paid return envelope. Maybe we could put 23 and Me in charge of that part.
Without a big change in laws, practice and perception regarding data privacy, I’d be very hesitant to send a sample to 23 and Me. Not everybody is OK with the idea of having genetic and health information handed over to private companies (or the government) with few controls in place.
My husband is a neurologist in private practice in central NJ. There are 6 doctors in the group and they work on a crazy six week rotational cycle. The last time my DH had to cover the major hospital on our area was the week starting 3/16. At that time, I believe the state was officially reporting 178 cases in total, with 14 cases in our county. As of yesterday, they are reporting 109,038 and 5671 in our county. Some of this probably has to do with increased testing, but I doubt most of it.
I’ve also been looking at the patient census from the system he covers. On 3/27 (the farthest back I could find), they reported 427 confirmed cases of Covid 19. Yesterday it was 1256. And the highest number of confirmed patients was 1546 on 4/13. I am a bit more nervous for him being in the hospital now than I was back then but at least the numbers are trending in the right direction.
My periodontal office just called me again. My original appointment was April 2. It was changed to May 6. Now it’s…July 28. They have me on a cancellation list if anything opens up sooner.
To add to @evergreen5 ’s post on anticoagulants, in patients who do not respond to low molecular weight heparin at regular dose, DH’s team has had success increasing the dose, or using DOAC’s (direct oral anti-coagulants) such as Rivaroxaban (Xarelto). They are also sending people home on anticoagulants because the clotting risk lasts after the patient seems to be “out of the woods”. They have had Covid patients who were never sick enough to be hospitalized come in with DVT and other clots in the third week of illness, so they are starting to recommend outpatient anticoagulant treatment.
A majority of the Covid patients DH sees (aside from nursing home and group home patients) are essential workers or their family members who live with them.
@3SailAway If you (or anyone) comes across anything more about post virus recovery lung damage even in mild cases as per these cases found from divers:
can you post it? We’re divers. Many of our trips revolve around diving. I’m curious to learn more as the doctors learn more about the health issues involved and if they end up being permanent or temporary. We dive, but I don’t tend to follow “diving news.” We just enjoy it when we go places.
Keep in mind that people who aren’t already “very sick” have been discouraged from coming to the facilities for in-person evaluation and testing – I am assuming Kaiser has been encouraging telephone or video screening just as other facilities do. We don’t know from the report what the disposition was of the 92% who were NOT positive for Covid but must have been sick enough with something to warrant a medical visit & must have met the relatively limited criteria for Covid screening. Given what was known about Covid in March, I’d guess that would include many with flu or pneumonia from causes other than Covid, as well as individuals with comorbidities that would put them in a very high risk category.
My only point is that it is not that 38% of the cohort of all positive Covid cases who are very sick – it is 38% of the cohort of people who were sick enough to be showing up at the hospital and to meet the requirements then in place to be given testing were very sick. All of the people who fit in the “mild” category would have been told to stay home & quarantine, and never would have been tested.
Absolutely, @calmom. I never meant to imply that 38% of symptomatic cases of COVID-19 need to be hospitalized. We can only see that 38% of the people who were sick enough to go to Kaiser to be tested, and who tested positive for COVID-19, needed to be hospitalized.
Both Mr. Fang and I wondered how many people who tested negative ended up being hospitalized for whatever was wrong with them. That would be an interesting comparison. Was it less than 38%? Then again, maybe at this point they’re testing everyone they admit to the hospital for anything.
I’m sorry—I didn’t mean to worry anyone! I’m not a doctor, just constantly steeped in medical information. If I try to turn the subject of conversation away from the virus, DH tunes out—only the kids can get his mind off it.
As far as people who were not sick enough to be admitted, but did have clots, I know those DH has seen (some remotely) had obvious symptoms (mostly lower leg). Some were treated at home on anticoagulants and are fine. Others needed a procedure in the hospital where they thread a catheter into the vein and inject the clot with a clot-dissolving drug (amazing), and it worked. Doctors do not think it is common in non-hospitalized patients, just something people should be on the lookout for. I am a worrywart, so if it were me, I would probably spend a bunch of time googling, and then DH would read me the riot act and tell me to get off the internet and ask my doctor .
I hope you are feeling well, and best wishes on a complete recovery asap!
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