Apr 10, 2020
Dr. Pastore shares the science
and latest research behind coronavirus, how it differs from
COVID-19 and what makes it
so dangerous. As he is actively treating those with the virus, he
covers the lesser-known symptoms, the genetic polymorphisms (gene
errors) that put some more at risk than others beyond age and
pre-existing medical conditions, the current status of treatment
for COVID-19 and what you can do to keep you and those around you
safe.
SHOW
NOTES
Review of Dr. Pastore’s
qualifications [0:20]
- PhD
Biomedical informatics, nanomedicine and clinical informatics from
Rutgers University, School of Health Professions
-
- Expertise is understanding biomedical sciences,
human genetics & RNA mechanisms, disease processes & systems,
nanomedicine, drug discovery
- Graduate degree in Human Nutrition, Certified
Nutrition Specialist
All of the information today is
backed by science [3:00]
What is the Coronavirus and what
is COVID-19 and how does this compare to SARS [3:45]
- Coronavirus - simply type of virus, under
microscope has pointed structure looks like it wears a
crown
-
- Been
exposed to coronavirus for a long time - cold, mild upper
respiratory tract infection where bodies fight back - no
cure
- 200+
different types
- “Novel” coronavirus = newly identified
coronavirus type, no resistance against it
- SARS
2003-2004 [6:20]
-
- Severe acute respiratory syndrome, caused by a
novel coronavirus at the time
- Jumped from animal kingdom to humans, which is
what is believed to have happened with the new 2019
coronavirus
- COVID-19 [7:05]
-
- The
upper respiratory infection some people develop after contracting
the novel 2019 coronavirus (hence the name COVID-19)
- You can be exposed to the
coronavirus, be a carrier of the
coronavirus, potentially
exhibiting zero symptoms ever,
transmit the virus to someone else and they can develop COVID-19
symptoms [7:30]
- Coronavirus is spreading faster than SARS in
2003 [8:00]
-
- Less
severe of an illness in the majority of those infected when
compared to SARS
- Those
with strong immune systems may only ever feel incredibly mild
cold/flu symptoms or nothing at all, yet are giving the coronavirus
to others with weaker immune systems [9:40]
-
- There
are some individuals who do not feel sick, infect others, and
then develop COVID-19 symptoms
What makes the coronavirus so
dangerous? [10:50]
- Spreading faster than any other virus in
history
- Those
that have passed away from COVID-19 experienced a “cytokine storm”
[11:30]
-
- Mutli-factorial hyper-inflammatory
process
- Over-stimulates the immune system factors,
causing the lungs to shut down the normal process of
breathing
- Genetic polymorphism (genetic expression) in
gene ACE2 can allow COVID-19 to get deeper into the
lungs, greater chance of developing cytokine storm requiring
hospitalization & ventilation [13:25]
- As of
April 9, 2020, 25% of people walk around asymptomatic (constantly
changing) [17:00]
-
- was
17.3% March 20th, 2020
- People need to behave like they have the
infection
Less-known/more rare symptoms of
the coronavirus beyond cough/fever/chills [18:00]
- 3% of
carriers present with pink-eye, can be the only symptom
- Diarrhea & other gastrointestinal/digestive
complaints can be your only symptoms, don’t assume it’s a stomach
bug or bad food
- Loss
of taste or smell
- Sudden confusion - potentially caused by
reduced blood-oxygen levels
What causes the more common
symptoms [22:05]
- Dry
“barking” cough, fever, chills, body aches, headache, shortness of
breath, congestion
- Virus
interacting with immune system
- Virus
is replicating within body [22:45]
-
- Virus
is RNA strands that fool your own cells into reproducing the virus
(making your body “photocopy” the virus to take over more of your
body) and then bust out of cells & take over nearby healthy
cells
- Replication of virus + immune system response
causes the common symptoms
Immediately notify your
physician if these symptoms arise, get immediate medical help if
you have trouble breathing or pale/bluish skin [24:30]
How long does it take to show
symptoms? [25:15]
- 2-14
days from time of exposure, if at all
- Some
reports of people being sick/developing symptoms beyond
that
- Learning more about how long virus can
survive.
-
- can
live 3 days on stainless steel, 24 hours on package delivered to
your door [26:25]
Who’s most at risk?
[27:00]
- Those
with pre-existing conditions like diabetes, heart disease, lung
diseases
- Immuno-compromised individuals - HIV,
autoimmune diseases, undiagnosed or newly diagnosed celiac disease
patients that are sIgA deficient
Recovery [29:15]
- Some
feel fine after 3 days, some passing away - why?
-
- Genetic ACE2 polymorphism
-
- Some
have the ACE2 polymorphism that better prevents the coronavirus
from infecting the body
- Pre-existing conditions, those with poor
health
- Body
produces surfactant chemical that makes lungs sponge-like
[31:05]
-
- Genetic polymorphism that lowers surfactant
production, makes lungs less sponge-like and makes breathing more
challenging with COVID-19
What can we do?
[32:15]
- Pretend you have the
coronavirus
- Social distancing - use technology to virtually
connect with others
- REALLY wash your hands - scrub & sing “Happy
Birthday” twice
- Hand
sanitizer - minimum 60% alcohol
-
- Other
types are NOT designed to kill novel/new viruses
- Stay
home as much as possible - 6 feet from others is not
enough
- Wear
a mask when going out
-
- To
protect others from
you
- Don’t
touch your face before washing your hands
-
- Study
showed even trained, educated medical professionals touch their
face 23 times per hour
- Clean
& disinfect all surfaces that could have been exposed (groceries,
counter where you rested groceries, car surfaces)
-
- Alcohol-based surface cleaners need to have at
least 70% alcohol
- Strip
off & wash your clothing in hot water, warm shower with soap as
soon possible
-
- So
far, we know virus can live on cloth for 3 days
How is COVID-19 treated? Current
research shows…. [45:00]
- No
FDA/CDC/WHO approved medical treatment
- Hospitals are practicing palliative care,
symptom treatment
- Ongoing experimental medical trials around the
world (approx. 60 so far)
-
- NYU
hyperbaric oxygen therapy - putting COVID-19 patients in more
oxygen-rich environment, previously used to treat lung
damage
- Repurposing FDA-approved drugs to treat
COVID-19 [47:15]
-
- Scientists are using drugs that have already
been approved for other conditions and are currently being studied
on effect to combat COVID-19 & slowing the spread within the
body
- Limits the virus spread so your own immune
system can battle it
- DRUG
TRIAL: Remdesivir
-
- Believed to inhibit the action of RNA
polymerase, intravenous delivery
- Targets how coronavirus replicates
- DRUG
TRIAL: Galidesivir
-
- Viral
RNA-polymerase binder, intravenous delivery
- DRUG
TRIAL: Camostat
-
- Transmembrane protease, serine 2
inhibitor
- Blocks penetration of coronavirus to get into
cell
- DRUG
TRIAL: Favipiravir
-
- Selective viral RNA-polymerase inhibitor,
delivered orally
- Two
HIV drugs being studied right now
-
- DRUG
TRIAL: Darunavir and
Cobicistat,
delivered orally
- DRUG
TRIAL: Fingolimod
-
- Sphingosine 1-phosphate receptor modulator,
delivered orally
- Class
of drugs used as immunomodulators and are used in conditions such
as multiple sclerosis.
- Calms
the immune system/cytokine storm to prevent it from attacking your
own cells
- DRUG
TRIAL: Plaquenil, better known as
hydroxychloroquine
-
- May
inhibit the terminal glycosylation of ACE2 of this
virus
These drugs SHOULD NOT be taken
as a prophylactic / to “prevent” the coronavirus [51:00]
- All
medications have side effects
- Pharmacogenetics - study of genetic reaction to
drugs (99.999% accurate)
-
- Based
on an individual’s genetics and polymorphisms, some may have
opposite reaction and worsen health
- Can
not respond to a drug
- Won’t
be one specific drug to treat it
- Instead, a polypharmacy - multiple options to
treat based on genetics and other pre-existing medical
conditions
Testing accuracy & false
negatives [57:25]
- NIH
estimates weeks away from a finger-prick test with almost 100%
coronavirus diagnosis accuracy
- Current testing of throat swabs 87.3% accurate,
at best
-
- 13 of
every 100 people that have been tested are given a false negative
and are out in public infecting others
Vaccination? [60:00]
- Over
a year out, but trials are underway
- Using
plasma of those that have recovered from the virus
- Cell-surface receptor to suppress cytokine
storm (keep immune system calm to prevent degrading of lung
function)
- When
vaccine is available, celiacs should get tested to ensure vaccine
is effective (often times they do not)
The future evolution of the
coronavirus [63:20]
- Hard
to determine next 6 months, constantly changing
- Hoping to flatten curve - signs are showing
improvement
-
- Less
infected, more time to react
- The
faster everyone does their part, the faster the curve will
flatten
- Drug
trials to conclude in a few months - more answers to what drugs
work for certain categories of people
Conclusion [66:30]
LINKS:
EPA Disinfectants for Use
Against SARS-CoV-2
https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
CDC Cleaning and Disinfection
for Households
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html