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Comment by rimliu | Hacker News Reader

Yes, but this time its viral pneumonia.

Not only viral pneumonia though.

According to a professor, specializing in pandemics, I heard interviewed while the outbreak was still focused mainly in Wuhan, many ultimately get killed off by bacterial secondary infection. Encouraging in some ways, under the horrifying circumstances, with the catch that in many parts of the world that secondary infection will be caused by multiple resistance bacteria.

I'd say this pandemic is going to be by far the biggest single consequence post to date for the antibiotic resistance problem, despite being driven by a pathogen that was never sensitive to the antibiotics.

Yes, and isn't this cause for some optimism since many people have now received vaccines such as Prevnar-13 and Pneumovax-23?

The CDC still isn't recommending them for all adults. At this point I probably won't go to the doctor's office due to transmission risks.

I heard (from a doctor who just received an e-mail summarizing clinical results from Wuhan and Seattle) that actually the primary killer is cardiac arrest.

"This virus is way smarter than I'd imagined. Apparently people don't mostly die of respiratory failure, but of cardiac arrest. Doctors have noted that right as patients begin to recover from their ARDS (severe respiraotry failure requiring intubation), they suddenly develop acute heart failure (dilated cardiomyopathy with EF going from normal to <10% acutely, for the doctors on here) and go into VF/VT or asystole."

The mechanism for that is unknown, but apparently the virus is attacking the heart directly.

I heard that the virus isn't attacking the lungs or the heart, rather it's the immune systems response after the main infection has done it's business? Probably makes it more bizarre.

That's the "cytokine storm" theory, right? I've heard that but also heard conflicting and inconclusive evidence about it. Some evidence against it is that lymphopenia (abnormally low white blood cell count) is seen in 83% of patients and that patients with lymphopenia have significantly worse prognosis as far as death rates are concerned; this would seem to indicate that it's not the immune system doing the damage. It doesn't conclusively rule it out - you can develop cytokine storms with a depressed immune system, and Spanish Flu was another disease that also caused both lymphopenia and cytokine storms - but it does waggle its eyes suggestively in favor of looking for other causes.

Thanks!

Cardiac arrest was also reported for SARS (SARS-CoV-1): https://www.ncbi.nlm.nih.gov/pubmed/14633442

So much is still unknown about SARS and MERS that I wouldn't hold my breath waiting for credible answers regarding SARS-CoV-2/COVID-19. And MERS is still circulating (see https://www.who.int/emergencies/mers-cov/en/), so it's not like nobody is interested.

When I learned diaphragmic breathing years ago, there were some studies around suggesting that it helped clear the lungs, especially the lower lungs, of debris and fluid, which can help prevent bacterial pneumonia.

Anecdotes != data, but I've had 1 'chest cold' in the intervening years, whereas as a child and teen most of my colds were chest colds and clearing my lungs was a major step in every recovery.

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