Standardized Covid Treatment Protocols?

[W2R]

Glad your hair is coming back...so it's interesting that both strong antibiotics and steroids can cause hair loss. Almost certainly you got both of those during your hospital treatment. This is what makes long covid and it's treatment so elusive and hard to treat.

That's right, I did have both (I think by IV) in the ICU back in September of 2021. So who knows, maybe they were involved. On the other hand I haven't heard that either of those medications can cause Covid brain fog (which is essentially a debilitating forgetfulness/dementia that also isn't permanent), or months of constant exhaustion, both of which I experienced at the same time. Oh well. Anyway, I'm glad my hair is growing back and I'm just about done with the other symptoms too. And I didn't die or get permanent lung damage from pneumonia which is nice too.

Earlier this month I did my taxes all by myself (with Turbo-Tax) and what a relief that was! For months I have been so worried that the brain fog would make that impossible for me.

 

[audreyh1]

That's right, I did have both (I think by IV) in the ICU back in September of 2021. So who knows, maybe they were involved. On the other hand I haven't heard that either of those medications can cause Covid brain fog (which is essentially a debilitating forgetfulness/dementia that also isn't permanent), or months of constant exhaustion, both of which I experienced at the same time. Oh well. Anyway, I'm glad my hair is growing back and I'm just about done with the other symptoms too. And I didn't die or get permanent lung damage from pneumonia which is nice too.

Earlier this month I did my taxes all by myself (with Turbo-Tax) and what a relief that was! For months I have been so worried that the brain fog would make that impossible for me.

So glad you are healing. But so much to overcome and a long time too! Dang!

 

[timekeepr]

JAMA: Efficacy of Ivermectin Treatment on Disease Progression Among Adults

Conclusions and Relevance In this randomized clinical trial of high-risk patients with mild to moderate COVID-19, ivermectin treatment during early illness did not prevent progression to severe disease. The study findings do not support the use of ivermectin for patients with COVID-19.


Efficacy of Ivermectin Treatment on Disease Progression Among Adults With Mild to Moderate COVID-19 and Comorbidities

https://jamanetwork.com/journals/ja...ccessKey=58760460-df0f-4790-9257-8f3682dca39b

 

[MichaelB]

Threads merged

 

[ivinsfan]

Conclusions and Relevance In this randomized clinical trial of high-risk patients with mild to moderate COVID-19, ivermectin treatment during early illness did not prevent progression to severe disease. The study findings do not support the use of ivermectin for patients with COVID-19.


Efficacy of Ivermectin Treatment on Disease Progression Among Adults With Mild to Moderate COVID-19 and Comorbidities

https://jamanetwork.com/journals/ja...ccessKey=58760460-df0f-4790-9257-8f3682dca39b

let's see... 10 went on vents in non ivermectin group and 4 went on vents in the ivermectin group and yet "it does not help with disease progression".. yadayadayada yes I read beyond the headline.. I dunno if I managed to stay off a vent due to ivermectin I'd consider that a win.

 

[Another Reader]

That's right, I did have both (I think by IV) in the ICU back in September of 2021. So who knows, maybe they were involved. On the other hand I haven't heard that either of those medications can cause Covid brain fog (which is essentially a debilitating forgetfulness/dementia that also isn't permanent), or months of constant exhaustion, both of which I experienced at the same time. Oh well. Anyway, I'm glad my hair is growing back and I'm just about done with the other symptoms too. And I didn't die or get permanent lung damage from pneumonia which is nice too.

Earlier this month I did my taxes all by myself (with Turbo-Tax) and what a relief that was! For months I have been so worried that the brain fog would make that impossible for me.

I'm 23 months since exposure and I'm having trouble putting together the tax documents for the CPA. Some days, even some hours, are better than others. No treatments yet. Relieved you are doing well!

 

[W2R]

I'm 23 months since exposure and I'm having trouble putting together the tax documents for the CPA. Some days, even some hours, are better than others. No treatments yet. Relieved you are doing well!

Thank you! I am very relieved about it too.

I'm so sorry you are still suffering from brain fog. That was the most awful symptom for me, when it was at its worst. What you are saying is another illustration of the fairly common observation that every Covid patient seems to have a different set of symptoms with different timing and different intensities. Never experienced a viral infection like that, before. Makes me wonder what is going on sometimes.

I know what you mean about some days/hours being better than others. Be nice to yourself, as you would be to your best friend in similar circumstances; I'd advise that if you can't do taxes one evening, do something fun, no guilt, and resume the effort when you feel more mental acuity, maybe in a day or two.

For me, as time progresses, the good days/hours predominate more and more. Improvement is all in the tiniest of baby steps but I am cherishing each one, and trying to be patient as they add up to the significant improvement that I have had. I am definitely not looking for treatments these days since Mother Nature has pushed me in basically the right direction, however slowly.

Hang in there, get lots of rest and good food, move around when you can but don't push yourself to extremes when exercising, avoid emotional stress whenever possible, and let's hope your symptoms subside ASAP!

 

[ExFlyBoy5]

Thank you! I am very relieved about it too.

I'm so sorry you are still suffering from brain fog. That was the most awful symptom for me, when I had it. What you are saying is another illustration that every Covid patient seems to have a different set of symptoms with different timing and different intensities. Never experienced a viral infection like that, before. Makes me wonder sometimes.

I know what you mean about some days/hours being better than others. But for me, as time progresses, the good days/hours predominate more and more. I am definitely not looking for treatments these days.

Hang in there, get lots of rest and good food, avoid stress whenever possible, and let's hope your symptoms subside ASAP!

My SIL is extremely annoyed at her symptoms and the lack of medical care she has gotten from several clinics/providers. Her chief complaint has been debilitating fatigue along with the brain fog. She has also had a couple of flare ups of shingles, so her life since getting COVID (over a year ago) has really been miserable. It's sad to see since she was pretty darn healthy for her age (50) until COVID came around. I think there is still so much to learn about COVID and its lingering effects.

 

[anethum]

let's see... 10 went on vents in non ivermectin group and 4 went on vents in the ivermectin group and yet "it does not help with disease progression".. yadayadayada yes I read beyond the headline.. I dunno if I managed to stay off a vent due to ivermectin I'd consider that a win.

You omitted the following from the study (https://jamanetwork.com/journals/ja...ccessKey=58760460-df0f-4790-9257-8f3682dca39b) :

"52 of 241 patients (21.6%) in the ivermectin group and 43 of 249 patients (17.3%) in the control group progressed to severe disease"

"In 2021, 2 randomized clinical trials from Colombia and Argentina found no significant effect of ivermectin on symptom resolution and hospitalization rates for patients with COVID-19. A Cochrane meta-analysis18 also found insufficient evidence to support the use of ivermectin for the treatment or prevention of COVID-19."

 

[Sojourner]

let's see... 10 went on vents in non ivermectin group and 4 went on vents in the ivermectin group and yet "it does not help with disease progression".. yadayadayada yes I read beyond the headline.. I dunno if I managed to stay off a vent due to ivermectin I'd consider that a win.

I think those numbers are too small to be considered statistically significant. Relying on those numbers would be kind of like saying "Well, they gave my brother-in-law ivermectin when he was hospitalized with COVID, and he didn't have to go an a ventilator... so I guess it works."

The total number of participants in the study was 490. Out of those, 52 in the ivermectin group and 43 in the control group went on to develop severe COVID. That seems to be the statistically significant finding here, and it shows that ivermectin did not reduce the odds of developing severe COVID.

 

[ivinsfan]

You omitted the following from the study (https://jamanetwork.com/journals/ja...ccessKey=58760460-df0f-4790-9257-8f3682dca39b) :

"52 of 241 patients (21.6%) in the ivermectin group and 43 of 249 patients (17.3%) in the control group progressed to severe disease"

"In 2021, 2 randomized clinical trials from Colombia and Argentina found no significant effect of ivermectin on symptom resolution and hospitalization rates for patients with COVID-19. A Cochrane meta-analysis18 also found insufficient evidence to support the use of ivermectin for the treatment or prevention of COVID-19."

That vent number is surprising though isn't it? So more people in the group ivermectin group got what's called severe Covid but less ended up on vents? BTW I'm triple vaxxed and don't have a dog in this fight. Also ivermectin is a weight based drug and all people in trial got the same dose so that might make a difference.

 

[ivinsfan]

I think those numbers are too small to be considered statistically significant. Relying on those numbers would be kind of like saying "Well, they gave my brother-in-law ivermectin when he was hospitalized with COVID, and he didn't have to go an a ventilator... so I guess it works."

The total number of participants in the study was 490. Out of those, 52 in the ivermectin group and 43 in the control group went on to develop severe COVID. That seems to be the statistically significant finding here, and it shows that ivermectin did not reduce the odds of developing severe COVID.

but again if I stayed off a vent that's a big deal to me and my family.



so it was 10 of 43 in the non iv severe Covid on a vent



and 4 of 52 in the ivermectin group.


Remember there is no long term bad results of taking a short course of ivermectin.


It seems to be a mixed bag as far as results, a bigger study might have yielded more info.


As far as treatments it's grim as they are saying the Mono antibodies are not very good against Omicron

 

[sengsational]

let's see... 10 went on vents in non ivermectin group and 4 went on vents in the ivermectin group and yet "it does not help with disease progression".. yadayadayada yes I read beyond the headline.. I dunno if I managed to stay off a vent due to ivermectin I'd consider that a win.

Wise of you to read beyond the headline! I've talked with people who have seen such a headline and concluded "they proved it doesn't work", which is not at all what the study says. It says they didn't prove it did or didn't "work" for their weird primary endpoint of progressing to "severe disease", but they should have called it "kind of not so severe disease" (see below). If you look at the studies for Remdesivir (which got EUA despite no studies showing significance), at the time, with limited information, they thought they saw a trend toward protection, so they gave them the EUA. And if the risk of taking it was low enough, and there was limited, but directionally appropriate effect, I'd have given it a try. Repurposed drugs don't seem to be getting the same acknowledgement of non-statistically significant trends.

But back to the JAMA paper, right in the "limitations" section, they say that the study wasn't designed to nail down going on a vent or dying. It looks to me like everybody except 1 person who went on a vent ended-up dying, so the two clinical endpoints are about the same. No one can say for sure what would have happened if the population for the study was 1000 people vs 490, but if you look at the risk ratio (I think it was 0.31 with a p value of 0.09) one might conclude that that would have shown a statistically significant benefit for treatment with N=1000. RR of 1 would show no effect, and greater than 1 would show harm. This was 0.31. So obviously, the intervention was farther away from harming and closer to benefiting, but no conclusions can be made because it could have been chance.

The total number of participants in the study was 490. Out of those, 52 in the ivermectin group and 43 in the control group went on to develop severe COVID. That seems to be the statistically significant finding here, and it shows that ivermectin did not reduce the odds of developing severe COVID.

The primary endpoint selection of this trial seems strange to me: 95% SpO2. Shoot, I've measured my SpO2 and occasionally seen 95%, and I've never had Covid (as far as I know). The WHO uses 93% for it's definition. Its interesting that in this study they selected this less severe definition as their endpoint. I wonder if they collected data on other endpoints, such as number of days in the hospital, but didn't include those in the paper. Of course, I don't think I've ever read a paper where I wasn't left wondering about something

 

[W2R]

I think there is still so much to learn about COVID and its lingering effects.

Never has a truer statement been posted on the internet, IMO. There is so much left to learn about it.

 

[anethum]

Also ivermectin is a weight based drug and all people in trial got the same dose so that might make a difference.

The dose each patient received varied based on their body weight.

"Patients were randomized in a 1:1 ratio to receive either oral ivermectin, 0.4 mg/kg body weight daily for 5 days, plus standard of care (n = 241) or standard of care alone (n = 249). The standard of care consisted of symptomatic therapy and monitoring for signs of early deterioration based on clinical findings, laboratory test results, and chest imaging."


The References in the paper has links to two other randomized studies cited which also "found no significant effect of ivermectin on symptom resolution and hospitalization rates for patients with COVID-19"

https://jamanetwork.com/journals/jama/fullarticle/2777389

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769369

 

[harllee]

I too read the above cited ivermectin study. Hard to tell if ivermectin helped but I guess there is no harm in a vaccinated person taking it except for the risk of diarrhea. However, the study did say that vaccination significantly reduced severe disease. To me, the main issue with ivermectin is that people who refuse the vaccine often say they don't need the vaccine because they take ivermectin. This is so wrong--this study shows that the vaccine is clearly reduces severe disease, much more so than ivermectin.

 

[sengsational]

We've been quoting these numbers from the paper where the intervention group had 52 severe with 3 that died, and the non-intervention group that had 43 severe with 10 that died. These are values from the paper. I didn't think of this, but someone asked:

"What if the study inclusion criteria had been severe disease?"

It wasn't, and the paper didn't go there. But if it was, there would have been 95 participants and 13 deaths. 6% of the intervention group died and 23% of the non-intervention group died. A relative risk reduction of 75% with a p value of 0.015 (statistically significant). Call me crazy, but I'd rather be in the intervention group!

I'm probably running afoul of some logic here, but if so, I can't see it.

 

[ivinsfan]

I too read the above cited ivermectin study. Hard to tell if ivermectin helped but I guess there is no harm in a vaccinated person taking it except for the risk of diarrhea. However, the study did say that vaccination significantly reduced severe disease. To me, the main issue with ivermectin is that people who refuse the vaccine often say they don't need the vaccine because they take ivermectin. This is so wrong--this study shows that the vaccine is clearly reduces severe disease, much more so than ivermectin.

harllee 52% of the people in this study were double vaxxed...I don't know if they consider any of that when they did the control study as to who got the ivermectin certainly the vaxxed people should have better protection from severe outcomes.

 

[harllee]

harllee 52% of the people in this study were double vaxxed...I don't know if they consider any of that when they did the control study as to who got the ivermectin certainly the vaxxed people should have better protection from severe outcomes.

It is kind of buried in the report but it states that "fully vaccinated patients had a significant lower rate of severe disease" and refers to a table (I have not looked at the attached tables). I assume that vaccinated peopled were distributed in both groups and whether they received ivermectin or not, vaccinated people had a significant lower rate of severe disease.

 

[Koolau]

We've been quoting these numbers from the paper where the intervention group had 52 severe with 3 that died, and the non-intervention group that had 43 severe with 10 that died. These are values from the paper. I didn't think of this, but someone asked:

"What if the study inclusion criteria had been severe disease?"

It wasn't, and the paper didn't go there. But if it was, there would have been 95 participants and 13 deaths. 6% of the intervention group died and 23% of the non-intervention group died. A relative risk reduction of 75% with a p value of 0.015 (statistically significant). Call me crazy, but I'd rather be in the intervention group!

I'm probably running afoul of some logic here, but if so, I can't see it.

It sounds as if they may have chosen the wrong hypothesis to test. Or perhaps more pointedly, they may have limited their hypothesis too much. I'm no expert so, once again, I've told you way more than I know so YMMV.

 

[Chuckanut]

I've been listening to a discussion between Joe Rogan and Dr. Michael Osterhold. IMHO, it shows both men at their best. Forget the stuff you may have heard about either on social media. This is good stuff if you are interested in Covid in particular and how medical research works in general.

https://open.spotify.com/episode/5VSukFrMYGae1ILd0e4HuR

#1779-Michael Osterholm

 

[sengsational]

Nitric Oxide Nasal Spray

Nitric oxide nasal spray is available OTC in many countries for the treatment of Covid-19. Not mentioned by the US agencies or media, that I can find. But they did a prospective, double blind, placebo controlled trial that showed reduction of viral load by 99% after 48 hours. The placebo was just saline. They've apparently got another trial with a disease prevention endpoint going on. Of course this is the manufacturer doing these studies, so there's that. But a lot of countries have approved nitric oxide for Covid.

I couldn't find the details of the study, but found this Forbes India media piece https://www.fortuneindia.com/people...ention-in-future-sanotizes-gilly-regev/107182 that describes a business venture between the Canadian company and Glenmark (30B generics, OTC business with revenues in US, Europe, and India).

SaNOtize’s NONS FabiSpray, launched in India last week in partnership with Glenmark, was approved by the drug regulator, Drugs Controller General of India, for the treatment of adult Covid-19 patients with a risk of progression of the disease. In its phase III trials, the spray demonstrated it reduced Covid-19 viral load by 94% in 24 hours and by 99% in 48 hours. The trial confirmed NONS was an effective antiviral treatment that shortens the course of Covid-19 and could prevent its transmission, SaNOtize said in a statement.

 

[Koolau]

Nitric oxide nasal spray is available OTC in many countries for the treatment of Covid-19. Not mentioned by the US agencies or media, that I can find. But they did a prospective, double blind, placebo controlled trial that showed reduction of viral load by 99% after 48 hours. The placebo was just saline. They've apparently got another trial with a disease prevention endpoint going on. Of course this is the manufacturer doing these studies, so there's that. But a lot of countries have approved nitric oxide for Covid.

I couldn't find the details of the study, but found this Forbes India media piece https://www.fortuneindia.com/people...ention-in-future-sanotizes-gilly-regev/107182 that describes a business venture between the Canadian company and Glenmark (30B generics, OTC business with revenues in US, Europe, and India).

Wow! That does sound encouraging.

By the way, most drug research IS conducted by the manufacturer or it's clinical partners. Gummints, for the most part depend upon this clinical work when granting approvals. Up their sleeve, of course, is the big hammer that "if you cheat, you'll never work in this town again!" YMMV

 

[ExFlyBoy5]

Nitric oxide nasal spray is available OTC in many countries for the treatment of Covid-19. Not mentioned by the US agencies or media, that I can find. But they did a prospective, double blind, placebo controlled trial that showed reduction of viral load by 99% after 48 hours. The placebo was just saline. They've apparently got another trial with a disease prevention endpoint going on. Of course this is the manufacturer doing these studies, so there's that. But a lot of countries have approved nitric oxide for Covid.

I couldn't find the details of the study, but found this Forbes India media piece https://www.fortuneindia.com/people...ention-in-future-sanotizes-gilly-regev/107182 that describes a business venture between the Canadian company and Glenmark (30B generics, OTC business with revenues in US, Europe, and India).

Here is a little more information on the current trial.

https://clinicaltrials.gov/ct2/show/NCT05109611

 

[oiseux]

Nitric oxide nasal spray is available OTC in many countries for the treatment of Covid-19. Not mentioned by the US agencies or media, that I can find. But they did a prospective, double blind, placebo controlled trial that showed reduction of viral load by 99% after 48 hours. The placebo was just saline. They've apparently got another trial with a disease prevention endpoint going on. Of course this is the manufacturer doing these studies, so there's that. But a lot of countries have approved nitric oxide for Covid.

I couldn't find the details of the study, but found this Forbes India media piece https://www.fortuneindia.com/people...ention-in-future-sanotizes-gilly-regev/107182 that describes a business venture between the Canadian company and Glenmark (30B generics, OTC business with revenues in US, Europe, and India).

That is really interesting. Here's the company press release
https://www.businesswire.com/news/h...OVID-19-Receives-Regulatory-Approval-in-India

The results of the study don't seem to be released, but they reference a Phase 2 study in the UK
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117664/

Although the clinical end point was not prevention of disease progression, there is no indication of any outcomes.