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    Evaluation of the Relationship Between Serum levels of Zinc, Vitamin B12, Vitamin D and Clinical outcomes in Patients with COVID-19


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    Abstract

    Due to the known anti-inflammatory and antiviral effects of zinc, 25(OH)D, and vitamin B12, in this study, we explored the association between serum levels of these micronutrients in COVID-19 patients at the time of admission and clinical outcomes. This study carried out on 293 patients with COVID-19 who were hospitalized at Imam Hassan hospital (Bojnourd, Iran). We collected demographic data, clinical characteristics, values of serum biochemical parameters in the first week of admission, and clinical outcomes from electronic medical records. We also measured serum levels of zinc, 25(OH)D, and vitamin B12 within three days of admission. Of 293 hospitalized, the median age was 53 years, and 147 (50.17%) were female. Thirty-seven patients (12.62%) admitted to the ICU, and forty-two (14.32%) died. We found that serum levels of zinc, vitamin B12, and 25(OH)D are lower in patients who died than those who admitted to ICU or non-ICU and survived; however, these differences were not statistically significant for vitamin B12 and 25(OH)D (P>0.05). The serum concentrations of zinc, vitamin B12, and 25(OH)D at the time of admission did not affect the length of hospital stay in COVID-19 patients. In general, it seems that serum levels of 25(OH)D, vitamin B12, and especially zinc at the time of admission can affect clinical outcomes in COVID-19 patients.

    Quote from THHuxleynew

    One anecdote does not a good drug make. You know, that is why they have patients in hospital, even in a coma - quite a lot do recover...


    Anyway, which is it? ivermectin works in all stages, or only early stage... Those suggesting it need to have a consistent hypothesis and collect evidence - not cherry pick.


    THH

    You suggested early treatment, I just showed you were wrong in that assumption. FLCCC I -MASK +protocol has been very consistent as well as evolving

    FM1 - you know the last sentence here is a not necessarily true conclusion.


    they have shown a correlation, not a causal relationship.


    Since there are many confounders here it could be those with poorer initial health (comborbidities) had lower levels.


    or, it could be that there is some causal relationship.


    Zinc deficiency (10% of US popn) has been proposed as causative element on oxidative DNA damage and hence cancer.


    But then patients with cancer might have lower zinc and also be more vulnerable to severe COVID.


    Good not to be zinc deficient though.

    THH FUD alert


    Quote from THHuxleynew

    Shane - you know well that it is not about that. Ivermectin has had quite a few high quality studies - showing no results.

    Your are an outraging XXXX. May be you once could link one of your claimed high quality studies?!


    The biggest study I know to date is Uttar Pradesh. 205 Millions participants. after 6 weeks CoV-19 is gone!

    Quote from THHuxleynew

    Since COVID only kills 2% that will not be such a big deal.

    This explains your mediocre understanding of teh situation. CoV-19 kills 0.1% of the PCR+. If we exclude age >75 < 0.005% ..


    Quote from THHuxleynew

    One anecdote does not a good drug make.

    One pig make only one ham.


    Free from Marx. Today's pigs are tomorrow Salami!

    Quote from Fm1

    You suggested early treatment, I just showed you were wrong in that assumption. FLCCC I -MASK +protocol has been very consistent as well as evolving

    I have heard different things at different times. Could you clarify this for me? Then I can note it when evidence here supports or the opposite that hypothesis.


    Otherwise we find negative results are always excused. I need a specific hypothesis for which stages of COVID ivermectin is effective.

    Quote from Wyttenbach

    May be you once could link one of your claimed high quality studies?!

    Repurposing Medication for Treatment of Covid-19 | Together Trial
    An Adaptive Clinical Trial. Covid-19 reseach determining the efficacy of treating SARS-CoV-2 with repurposed, widely availiable, economically feasible…
    www.togethertrial.com


    The interim results were posted by me from a powerpoint a few pages ago. Also discussed on TSN, linked by somone else.


    Randomised, placebo, large group.

    Quote from Wyttenbach

    The biggest study I know to date is Uttar Pradesh. 205 Millions participants. after 6 weeks CoV-19 is gone!

    You were very silent after I posted in great detail all the reasons for UP being better than Kerala in India.


    If you can't distinguish between a population experience, with many confounders not considered by you, and a study, you will be permanently misinformed.

    Quote from Wyttenbach

    This explains your mediocre understanding of teh situation. CoV-19 kills 0.1% of the PCR+.

    That statement is false. It is well known that IFR depends on population age structure, and that at age 60-70 the risk is significant (> 1%). Look at UK results alpha variant where infections and deaths are accurately tracked, before vaccination.


    Or look at a study working out age specific factors in German infection and death rates:

    Estimating effective infection fatality rates during the course of the COVID-19 pandemic in Germany - BMC Public Health
    Background The infection fatality rate (IFR) of the Coronavirus Disease 2019 (COVID-19) is one of the most discussed figures in the context of this pandemic.…
    bmcpublichealth.biomedcentral.com


    Your statement might be true after vaccination.


    THH

    Quote from THHuxleynew

    Mark U's guy in that link says very clearly that HCQ and ivermectin do not work - only his magic ClO2!

    Not so! You're reading into it. Parse his words rightly. He is referring to certain people who did not respond well to Ivermectin, hydroxychloroquine, etc, and who subsequently did respond well to chlorine dioxide. He is not saying that ivermectin does not work as a general rule! There will always be some people who for one reason or another did not respond well to ivermectin, for instance because of dosage, because they were not treated soon enough, because there was no synergistic additions such as zinc, and so on. Chlorine dioxide seems to have an advantage in that it works well as a stand alone treatment and even in later stages of disease.

    Quote from Mark U

    Not so! You're reading into it. Parse his words rightly. He is referring to certain people who did not respond well to Ivermectin, hydroxychloroquine, etc, and who subsequently did respond well to chlorine dioxide. He is not saying that ivermectin does not work as a general rule! There will always be some people who for one reason or another did not respond well to ivermectin, for instance because of dosage, because they were not treated soon enough, because there was no synergistic additions such as zinc, and so on. Chlorine dioxide seems to have an advantage in that it works well as a stand alone treatment and even in later stages of disease.

    Yon will need something better than seems for the developed world to follow Latin America.


    Pseudoscience in the Times of Crisis: How and Why Chlorine Dioxide Consumption Became Popular in Latin America During the COVID-19 Pandemic
    INTRODUCTIONThe COVID-19 pandemic has affected the economic and political landscape of the world (Blofield et al., 2020; Greer et al., 2020). Low- and…
    www.frontiersin.org


    While the world was horrified by President Donald Trump's suggestion of drinking household disinfectants to prevent COVID-19 (Litman et al., 2020), less has been mentioned about the extensive use of chlorine dioxide as treatment in Latin America. Chlorine dioxide is a disinfectant commonly used to clean medical equipment and treat residual waters (Smith et al., 2001). At high concentrations and non-physiological pH, chlorine dioxide effectively inhibits microbial and viral activity (Hauchman et al., 1986; Zoffoli et al., 2005). Exposure to high doses of chlorine dioxide has been shown to cause thyroid suppression, DNA damage and neurotoxicity in several animal models (Bercz et al., 1982; Abdel-Rahman et al., 1984; Orme et al., 1985; Harrington et al., 1986; Toth et al., 1990). It is therefore understood that chlorine dioxide is not safe for human consumption.

    At the global scale, the dissemination of pseudoscience and post-truth phenomena is often associated with income inequalities (Rijs and Fenter, 2020). Interestingly, however, while Latin American countries often have similar levels of inequality, the use of chlorine dioxide as COVID-19 treatment varied significantly across countries (Table 1). In this article, I use chlorine dioxide consumption to further dissect the contribution of additional variables to pseudoscience dissemination, including scientific literacy and the democratic state of internal politics.

    Quote from THHuxleynew

    I need a specific hypothesis for which stages of COVID ivermectin is effective.

    I had to try out 3 different BP meds before finding the one that worked for me. Others do well with what didn't work for me. Same goes for chemo drugs. Each case calls for a different drug. Sometimes the drug works fine at first, then it may stop working and they change to another.


    The body is a complicated biochemical organism, and each body reacts differently to the same drug regimen. IVM+ may work only in one disease stage for me, and another stage for you. That is no reason to dismiss it out of hand.

    Quote from Shane D.

    I had to try out 3 different BP meds before finding the one that worked for me. Others do well with what didn't work for me. Same goes for chemo drugs. Each case calls for a different drug. Sometimes the drug works fine at first, then it may stop working and they change to another.


    The body is a complicated biochemical organism, and each body reacts differently to the same drug regimen. IVM+ may work only in one disease stage for me, and another stage for you. That is no reason to dismiss it out of hand.

    I'm not. There have been high quality studies showing no effect. Maybe they don't cover all cases. What I do know is the claimed evidence for it posted here is not sound - for obvious reasons I have repeatedly and in detail posted.


    You should remember that patients often recover (99% from COVID or more in young countries), so you can't use evidence of a drug that sometimes works to say it does any good at all without very careful analysis. That is why RCTs are valuable.


    If ivermectin had helped in 30% or more of early COVID cases the TOGETHER trial would have picked it up from early (powerpointed but not published yet) results.

    Pseudoscience in the Times of Crisis: How and Why Chlorine Dioxide Consumption Became Popular in Latin America During the COVID-19 Pandemic
    INTRODUCTIONThe COVID-19 pandemic has affected the economic and political landscape of the world (Blofield et al., 2020; Greer et al., 2020). Low- and…
    www.frontiersin.org


    There are several documented cases, both in the scientific literature and in the popular media, of strong side effects caused by chlorine dioxide intoxication (Montoya and Rocha, 2020). According to court documents, in the United States alone, poison control centers have handled over 16,000 cases of chlorine dioxide intoxication since 2014 (Braga, 2020; Orshan, 2020). Some of the common symptoms of intoxication include severe vomiting and diarrhea, anemia, severe liver failure, low blood pressure, arrythmia and methemoglobinemia (US Food and Drug Administration, 2020).

    During the COVID-19 pandemic, proponents of chlorine dioxide resurfaced, claiming that this compound could prevent and treat SARS-CoV-2 infections (Karnik-Henry, 2020). While no evidence was presented to support those claims, one observational clinical trial was registered in clinicaltrials.gov which aimed to determine the effectiveness of oral chlorine dioxide administration to treat COVID-19 in 20 volunteers. This study, which was to take place in Colombia, was sponsored by the Genesis Foundation. Yet, to date, no results have been reported (US National Library of Medicine, 2020).


    In Latin America, the biggest proponent of chlorine dioxide is the “Coalicion Mundial Salud y Vida” (translated to “Global Health and Life Coalition” - COMUSAV). Created in 2020, this coalition has over 3,500 members and chapters in 16 Latin American countries, although it is not formally registered in any country (Gonzalez, 2020). COMUSAV defines itself as a coalition that encompasses “open-minded” physicians, researchers, health professionals and enthusiasts promoting integral health approaches and homeopathic practices (Lammoglia, 2020). The leaders of COMUSAV are practicing physicians who treat thousands of patients with chlorine dioxide (Gonzalez, 2020). Several of its members have been outspoken at promoting unproven therapies, such as the use of scorpion venom to treat cancer (Musacchio, 2020), as well as rejecting the application of vaccines against the SARS-CoV-2 virus (Molina, 2020). COMUSAV claims to have done chlorine dioxide toxicology studies in chicken embryos infected with avian coronavirus, although those results have not been published in a peer-reviewed journal (La Red, 2020). Moreover, COMUSAV falsely claimed that these results demonstrate chlorine dioxide is safe to administer to other animals, including humans and that the results are extrapolatable to other coronaviruses, such as SARS-CoV-2 (La Red, 2020).

    Many Latin American countries debated the use of chlorine dioxide to treat COVID-19. For example, in Peru congressman and physician Posemoscrowte Chagua requested the congress to create a “neutral” special commission to evaluate the effects of chlorine dioxide in the treatment of COVID-19 (Redaccion Gestion, 2020). The health commission of the congress evaluated the proposal and proponents of chlorine dioxide were invited to present their viewpoints to lawmakers (Loayza, 2020). The commission eventually suspended the investigation and did not approve the use of chlorine dioxide in Peru (El Universo, 2020). In Argentina, congresswoman Monica Frade requested the central government to authorize the chlorine dioxide as a medication, although the request was unsuccessful and the topic was not further discussed in congress (El Intransigente, 2020). In Chile, congressman Florcita Alarcon presented a similar request (Dote, 2020), which was also rejected (Camara de Diputados de Chile, 2020). In Costa Rica, the main proponent was former presidential candidate Rolando Araya who claimed he “didn't need to be a doctor to know it works” (Roque, 2020). While these motions were particularly effective at promoting the public image of specific political figures, they failed to gain formal authorization to commercialize chlorine dioxide as a medication. However, this compound was extensively sold in illegal markets and promoted in social media (Oliveira et al., 2020).

    Within Latin America, Bolivia represents a particularly interesting case, as it is the only country in which congress approved the use of chlorine dioxide in the prevention and treatment of COVID-19 (Porter and Moynihan, 2020; Trigo et al., 2020). Bolivia has a complicated political landscape. Until November 2019, President Evo Morales and his political party “Movimiento al Socialismo”(translates to “Movement toward socialism” —MAS) governed the country for almost 14 years. Yet, after the Organization for American States (OAS) found indictments of fraud in the October 2019 presidential elections, Morales and his closest allies resigned and fled the country amid massive protests and loss of support from the police and the armed forces (Escobari and Hoover, 2019). Through constitutional succession, Jeanine Añez assumed the interim presidency of Bolivia (Sohr, 2019). However, the members “Plurinational legislative assembly” (PLA), the majority of which were from MAS, did not resign. In the mist of the presidential elections, MAS-dominated PLA approved a bill to “exceptionally elaborate, commercialize and supply chlorine dioxide for COVID-19” (Porter and Moynihan, 2020; Trigo et al., 2020). While President Añez never signed the bill to legalize the use of chlorine dioxide as a drug (King, 2020), several governors, majors and political candidates, most of which were from MAS, distributed this compound in their respective regions (Associated Press, 2020).

    This study, which was to take place in Colombia, was sponsored by the Genesis Foundation. Yet, to date, no results have been reported (US National Library of Medicine, 2020).


    You may remember Genesis. They were a fraudulent cult-like organisation that made money selling ClO2 cure-alls. They registered a trial to try to avoid FDA prosecution.


    Coronavirus (COVID-19) Update: Federal judge enters temporary injunction against Genesis II Church of Health and Healing, preventing sale of Chlorine Dioxide Products Equivalent to Industrial Bleach to Treat COVID-19
    Federal court enters temporary injunction against Genesis II Church
    www.fda.gov

    Bacterial Superinfection Pneumonia in Patients Mechanically Ventilated for COVID-19 Pneumonia


    Potential overuse of antibiotics found in patients with severe COVID-19 pneumonia
    Only 21 percent of patients with severe pneumonia caused by SARS-CoV-2 (the virus that causes COVID-19) have a documented bacterial superinfection at the time…
    medicalxpress.com


    Abstract

    Rationale: Current guidelines recommend patients with SARS-CoV-2 pneumonia receive empirical antibiotics for suspected bacterial superinfection based on weak evidence. Rates of ventilator-associated pneumonia (VAP) in clinical trials of patients with SARS-CoV-2 pneumonia are unexpectedly low. Objectives: We conducted an observational single center study to determine the prevalence and etiology of bacterial superinfection at the time of initial intubation and the incidence and etiology of subsequent bacterial VAP in patients with severe SARS-CoV-2 pneumonia. Methods: Bronchoscopic bronchoalveolar lavage (BAL) fluid samples from all patients with SARS-CoV-2 pneumonia requiring mechanical ventilation were analyzed using quantitative cultures and a multiplex polymerase chain reaction panel. Actual antibiotic use was compared with guideline-recommended therapy. Measurements and Main Results: We analyzed 386 BAL samples from 179 patients with SARS-CoV-2 pneumonia requiring mechanical ventilation. Bacterial superinfection within 48 hours of intubation was detected in 21% of patients. 72 patients (44.4%) developed at least one VAP episode (VAP incidence rate 45.2/1000 ventilator days); 15 (20.8%) of initial VAPs were caused by difficult-to-treat pathogens. Clinical criteria did not distinguish between patients with or without bacterial superinfection. BAL-based management was associated with significantly reduced antibiotic use compared with guideline recommendations. Conclusions: In patients with SARS-CoV-2 pneumonia requiring mechanical ventilation, bacterial superinfection at the time of intubation occurs in less than 25% of patients. Guideline-based empirical antibiotic management at the time of intubation results in antibiotic overuse. Bacterial VAP developed in 44% of patients and could not be accurately identified in the absence of microbiologic analysis of BAL fluid. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).

    Quote from Mark U

    Not so! You're reading into it. Parse his words rightly

    I suspect macular degeneration..


    Quote from Mark U

    There will always be some people who for one reason or another did not respond well to ivermectin, for instance because of dosage, because they were not treated soon enough, because there was no synergistic additions such as zinc, and so on.

    some unfortunates don't respond well to Covid vaccines..

    breakthroughs deaths etc..perhap this could be assigned to "don't work" FUD trash.. :)

    As regards the dosage

    the majority of those treated with IVM have not been obese

    ..poor Africans...leaner Uttar Pradeshians


    however as long as the loading dose is raised for obese persons

    the lower maintenance dose based on lean weight

    should be used... based on experiments with some happy overfed chiens..

    A Large Impact of Obesity on the Disposition of Ivermectin, Moxidectin and Eprinomectin in a Canine Model: Relevance for COVID-19 Patients
    Ivermectin (IVM) and moxidectin (MOX) are used extensively as parasiticides in veterinary medicine. Based on in vitro data, IVM has recently been proposed for…
    www.frontiersin.org

    in practice it a doctor might double the dose on the first two days for a very obese individual

    to counter the dilution effect by a large volume of distribution.

    https://www.nps.org.au/assets/d3729c552388657c-42487cfa0f2f-drug-dosing-in-obese-adults-40-189.pdf

    Quote from THHuxleynew

    There are several documented cases, both in the scientific literature and in the popular media, of strong side effects caused by chlorine dioxide intoxication (Montoya and Rocha, 2020).

    As there are for just about any chemical, especially in excessive dosages. Hello?

    Just another typical elitist hit piece with no substantive evidence.

    Why no mention that Bolivia, with about the highest indigenous and lowest income demographic - both of which are strikes against it for success against coronavirus - has a relatively low death per capita for SA.


    Here's the study you didn't link to:


    https://www.hilarispublisher.com/open-access/determination-of-the-effectiveness-of-chlorine-dioxide-in-the-treatment-of-covid-19.pdf

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