What it's like to experience the dreaded COVID-19 "cytokine storm"

Originally published at: https://boingboing.net/2020/04/06/what-its-like-to-experience.html

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A very good read indeed.

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“cytokine storm”

With my compromised lungs from a life of asthma, this scares the hell out’a me. A simple chest cold sends me to the ER, this would bury me for sure…

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“Necrotic Lung” is my Nordic Death Metal band’s name.

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But I was coughing up jet black sputum — obsidian black, as black as your cell phone. I thought about it for a moment and then I turned to a physician, whomever was there at the moment and I said, “It’s necrotic lung.”

COVID-19 just didn’t seem like a proper pandemic without a bubo-grade horror symptom. And there we have it.

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You might be a bit relieved on this front, at least personally.

Cytokine storm is part of why the 1918 flu was so deadly, and it’s theorized that it’s why it was disproportionately young adults that died.

It’s essentially an autoimmune reaction and those with strong immune systems are more at risk. Like significantly.

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“Baby its COVID outside”

I have spoken.

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He’s not the only one!

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For me, the horrific moment came as when I was reading about a doctor watching the ventilator’s exhaust tube carrying pink, bubbling foam out of the patient’s lungs. Memories of childhood pneumonia and all the other horrors hit me all at once.

And at that moment I wanted to grab everyone who said “it’s just like the flu” and shove their faces in it. (Not literally, of course, but shoving their faces into pictures of the dying.)

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Ferritin is a protein that binds iron but it also spikes when there is infection, forget “below 400” normally people are around 50, measuring ferritin is a cheaper way for a lab to determine your iron levels.

Not sure how someone could be alive with 18,000 but obviously it’s possible.

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Me just reading the summary:

dead (3)

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I hate to admit it, but this was my first reaction when I read that sentence…
Screen Shot 2020-04-06 at 4.16.05 PM

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God punches down.

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Yeah, drowning in a bloody froth of destroyed lung tissue, gasping for air, was bad enough for me.

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It isn’t autoimmune. You’re right that those with strong immune systems are more at risk, but autoimmunity specifically means immune reactivity against self-antigens (you). In this case, immune activation by coronavirus (or positive feedback loops) spins out of control and gets stuck in an escalating loop that starts to cause widespread collateral damage to tissue. Many immune cells are packed with various offensive weapons and there are endogenous regulatory mechanisms to limit the use of those weapons so that normal tissue isn’t caught in the crossfire. In a cytokine storm, those endogenous regulatory elements get overwhelmed and the immune system starts getting more and more indiscriminate in its use of weapons, which in turn leads to more damage in non-immune tissues. So, yes, bad for most organ systems and worse in patients with a greater overall capacity for immune reactions, but not autoimmunity. Let me know if anything in the above is too jargon-y.

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Isn’t there a Depeche Mode song that describes this perfectly?

Similar, I suppose, to people being killed by high temperatures, in response to an infection.

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Reach out and touch me.

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more horrifying than the story was the ad selling a $28 bottle of hand sanitizer, a $12 (Hey it’s on sale) canister of 88 sanitizing wipes, $33 for ten rolls of toilet paper (also on sale)… and so on.

I found this disquieting. Maybe SPD is completely unrelated though?

Conclusions
Like asthma, other atopic conditions, particularly atopic dermatitis, are also associated with an increased risk of SPD. There may be a common immunogenetic mechanism underlying increased risk of SPD among individuals with either asthma or other atopic conditions. Our study findings need to be further studied.