COVID why do suffers have such different outcomes

Yes, I have just seen on TV news a young man fighting for his life with COVID, whilst an old lady has come through it and is celebrating her 105 th birthday today.

If we knew that we would be on the way to beating it.

We still don’t know how long or how severe Long Covid will be on those who survived.

It’s a very clever Virus........you could almost say that it was made so that it couldn’t be cured, a bit like Novachok (scuse spelling )

Yes, it’s puzzling. I am also puzzled by families where several members have died of Covid. Given that statistically the vast majority of people survive CV, you’d have thought it was very unlikely that more than one family member would lose their life to it, but you seem to read stories where several family members pass away.

Do they have a genetic issue that makes survival less likely, (although that wouldn’t account for couples dying, as they aren’t reacted) or do they get a particularly virulent strain?

Oopsadaisy1 Now that’s a scary thought that it was made rather than an occurrence of nature

Rosie: I don’t understand that either. I did think at the start of the pandemic that some people would have some sort of immunity to it but no matter how much I listen to or read I can’t totally understand the range of symptoms. Especially when someone in a household has it but no one else catches it.

rosie1959

Oopsadaisy1 Now that’s a scary thought that it was made rather than an occurrence of nature

... and the stuff of conspiracy theorists.

I have no doubt scientists will come up with some solutions one day. It could be something genetic or it could be that some people receive a higher viral load when they're infected or that they have more ACE2 receptors (overweight people do) or that people are infected with slightly different variants or or or ...

MayBee70

Rosie: I don’t understand that either. I did think at the start of the pandemic that some people would have some sort of immunity to it but no matter how much I listen to or read I can’t totally understand the range of symptoms. Especially when someone in a household has it but no one else catches it.

The range of symptoms is because it causes clots, which block off supplies of oxygen etc to a multitude of organs. It's systemic rather than just respiratory.

sueDonim re. family members. Could it be something to do with lifestyle.
Families tend to have a similar diet, may smoke, etc. My family eat quite healthily, exercise regularly, don’t smoke. That gives us a head start.

Smoking is a contentious one some studies were surprised to find that smokers were less likely to catch it in the first place but would tend to struggle more if they did
In fact at one point they were giving nicotine patches out in France
Being a smoker I am rarely unwell I visit the doctor every 20 years or so

There's nothing "magic" about why some people suffer more than others. There will be a logical, scientific reason. It's just that it hasn't been discovered yet.

Smoking affects many organs in the body, including arteries and the heart. It's not just that it causes cancer. It depends on the combination of lifestyle factors. Both my parents were heavy smokers and both died from lung cancer, as did one of my grandfathers. My mother also had COPD.

It could be that smokers already have "sticky" blood, which makes the effects of Covid-19 worse. They certainly have lower oxygen levels.

I seem to remember reading that the longer you were in contact with someone with Covid the more of the virus you absorbed and the worse the effect was. It would follow that family members in close contact could make each other quite ill.

I thought it was due to viral load, a small amount of the virus would make the body start an anti-viral response and stop it spreading to other cells but a large amount at once, long contact or very close contact, would be overwhelming.

I cannot remember where I read this but was in the early days of the virus so thinking may have changed.

Certain ethnic minority groups seem to be very badly affected - but that could just be lifestyle factors rather than genetic - the experts aren’t sure.

Deedaa and cornishpasty I've read that's it thought it's to do with viral load too. It would certainly be consistent with households and educational settings (including schools and halls of residence) being the main places where infection takes place.

Some people are more susceptible for various reasons, such as age and underlying health conditions, but if they haven't been exposed to a high viral load, they're less likely to be badly affected. There's still a lot of research to be done.

Kandinsky It's scandalous that there seems to be little research into why certain ethnic groups are badly affected. It doesn't help the the Equalities Minister, Kemi Badenoch, has even denied that they are disproportionately affected.

My understanding is that it depends on how the body responds to the initial infection so in part at least it's down to the immune system. Vitamin d is key and people can be low at this time of year which is why the government have offered it free to those who are shielding. Professor Tim Spector of the Zoe App mentioned the importance of gut health last week, I can remember that he mentioned dark chocolate which is ok with me! The other issue people talk about is viral load, so health workers who get a lot of exposure may be more at risk of severe illness. This is how I interpret what I've read at the moment. But it is a really puzzling aspect of this awful disease.

rosie1959, we just don't know enough yet.

It's a new (to us) virus and a changing picture as well, with the newer variants seeming to be far more contagious and some younger people becoming more seriously ill.

We do know of some influencing factors, like age (diminishing T cells), low Vitamin D levels, weight/obesity - but there must be many more.

Deedaa

I seem to remember reading that the longer you were in contact with someone with Covid the more of the virus you absorbed and the worse the effect was. It would follow that family members in close contact could make each other quite ill.

But what I don’t understand is that quite often family members don’t catch it at all even asymptotically. David Davis did a web chat with Dr John the other day and he’s adamant that most people are deficient in VitD and that the amount given to people in care homes is insufficient. (can’t believe I’m listening to David Davis!).

An over active immune system for one. Our daughter had (has) long Covid. Doctor told her this. She’s back at work now full time as a teacher since the NY and has just text ‘tired mum, which is to be expected but bit anxious again as chest ache back. Going to bed before 9pm’.

MayBee70

Deedaa

I seem to remember reading that the longer you were in contact with someone with Covid the more of the virus you absorbed and the worse the effect was. It would follow that family members in close contact could make each other quite ill.

But what I don’t understand is that quite often family members don’t catch it at all even asymptotically. David Davis did a web chat with Dr John the other day and he’s adamant that most people are deficient in VitD and that the amount given to people in care homes is insufficient. (can’t believe I’m listening to David Davis!).

I'm not denying that, but there's more to it than lack of Vitamin D.

ACE2 receptors play an important part.

"Does everyone have the same number of ACE2 on their cells?
No. ACE2 is present in all people but the quantity can vary among individuals and in different tissues and cells. Some evidence suggests that ACE2 may be higher in patients with hypertension, diabetes and coronary heart disease. Studies have found that a lack of ACE2 (in mice) is associated with severe tissue injury in the heart, lungs and other tissue types."

Extract above, but read the whole article:

theconversation.com/what-is-the-ace2-receptor-how-is-it-connected-to-coronavirus-and-why-might-it-be-key-to-treating-covid-19-the-experts-explain-136928#:~:text=ACE2%20acts%20as%20the%20receptor,regulate%20functions%20in%20the%20cell.

Urmstongran

An over active immune system for one. Our daughter had (has) long Covid. Doctor told her this. She’s back at work now full time as a teacher since the NY and has just text ‘tired mum, which is to be expected but bit anxious again as chest ache back. Going to bed before 9pm’.

I hope she's had full blood tests to check that all her organs are functioning properly. If not, she should ask for them. Liver, heart and kidney damage can all cause fatigue and are manageable if diagnosed early enough.

There is nothing unusual about that, Every illness has people getting it seriously and others lightly, even in the same family.

In the days before the measles jab, My slightly younger sister had measles far more severely than I did, while I had chicken pox far worse than she did.

Yes, there are major structural social and life style issues that affect large groups, but mainly it is just subtle changes in immune systems, genes, trivia.

There are two issues with BAME communities.

1 Are they being infected more frequently than others? If so, why? Is it their jobs, their living conditions, reluctance to take precautions or something else?

2 Are their outcomes worse than others? Again, why? Is it something genetic? Do they receive worse treatment? Are they in poorer health to start with? Or something else?

Whatever it is, the fact is that a disproportionate number from many ethnic backgrounds have died and it shouldn't be ignored. Policies might need to be adjusted to take them into account (despite the howls from those objecting to positive discrimination).

Yes growstuff, that has happened in the NHS and local authorities, there are individual risk assessments done, and ethnicity is taken into account in the scoring so that staff are protected. In the first wave it was an unpredicted consequence, and it was tragic that so many staff lost their lives.

Casdon

Yes growstuff, that has happened in the NHS and local authorities, there are individual risk assessments done, and ethnicity is taken into account in the scoring so that staff are protected. In the first wave it was an unpredicted consequence, and it was tragic that so many staff lost their lives.

That's good to hear. I wonder if all organisations are so conscientious.

I know that it's been an issue in schools (not just with BAME people, but others with identifiable risk factors) and I'm not sure it was ever resolved.