re: Covid: outside the box thinking - hemoglobin/ Vit D/ “host-centric” (and why that matters)

I think that’s the main reason for use. We don’t really use other macrolides much in America and azithromycin is the least likely of all of them to cause Tdp anyway.

Probably the main hesitation from a hospitalist with this is simply a lack of known risk/benefit ratio.

I personally think the hcq is fine but the combo with azithromycin is a little shaky.

Doesn't hcq have a risk of Tdp too?

The case studies from this pandemic are going to be really interesting. I wish I was out in the field doing something instead of studying.

It’s certainly an interesting new way of looking at things. And it might explain why African Americans are handling this much worse. Sickle Cell doesn’t exist as an all-or-none, there are varying degrees. It would be helpful to know if the patients who passed away from COVID had any underlying hemoglobinopathies. Italy has considerable rates of thalassemias which have similar issues as sickle cell.

My hemoglobin doesn’t allow Covid to effect it

Shrug. I believe zinc works best as a preventative, I don’t think it helps too much once you’re a few days into an illness.

But taking it for a week probably won’t hurt you so if someone wanted it I wouldn’t recommend against it

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I’ve had a very strong suspicion for awhile now that anemic patients do very poorly with this. I thought it was primarily due to the severe pneumonia impairing oxygen delivery but this makes sense

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My only question is why aren’t we seeing a rash of this in kids with sickle cell disease. If that is the issue, shouldn’t you be seeing it there?

I would be interested to see all hospitalizations. The retrospective studies after all this is over will be interesting

I didn't read the whole article and maybe this was in but it didn't read it because I saw a similar one posted on here Sunday which I did read in its entirety. But to put in perspective the seriousness of this is if true and maybe the writers didn't include because they assumed the readers would understand the impact, so at the risk of insulting some in hopes of enlightening others, lets talk about oxygen carrying capacity and what this does. Normally an adult has a hemoglobin in the 15gr/100 ml oxygen ranging from about 12 to 20. Let's use 15.
Hgb has the carrying capacity of 1.34 ml of oxygen per gram. So in 100 ml of blood, Hgb can carry 20.1 ml of oxgen. But at a normal SPo2 that would be .97x20.1 OR 19.5. The other transport is oxygen dissolved in plasma. Henry's Law states the dissolved oxygen is equal to .003 ml per mmHg partial pressure of PaO2. Normal PaO2 being 100 so or about 0.3 ml of oxygen per 100 ml. So we have 19.5 +0.3 = 19.8. Assuming a total obliteration of the Hgb's abilty to transport you essentially reduce the body's oxygen carry ability by around 98.5%. Pretty scary if this is the pathology behind serious cases of corona.
DISCLAIMER - it has been 25+ years since I did these calculations so math might be off a tad but the concept is correct,

Man that’s nothing I know it’s out of range but I see people walk in the ER all the time with >170 like it’s nothing

The question seems to be is it working by way of decreasing viral load via it’s action on toll
like receptors 7/8/9, hemoglobin metabolism, changing the PH of endosomes or some
other MOA remains to be seen. The amount of data, research and understanding that will come from this pandemic is going to be an incredible benefit to mankind for many years to come.