[conspire] 45's treatment oddities and why men are dying at much higher rates

[Deirdre Saoirse Moen]

A great blog post about 45’s stated treatment:

https://blogs.sciencemag.org/pipeline/archives/2020/10/05/the-presidents-coronavirus-treatment

tl;dr: two of the treatments (monoclonal antibodies and remdesivir) are early stage to prevent viral replication; dexamethasone is late stage to prevent damage from already replicated virus cells signaling cytokines like a Wagnerian soprano. So, last only useful if the first two have failed and the front line has fallen, as it were.

Now, my comment on that blog entry:

If you check out the table on p. 35 of the supplementary appendix of the RECOVERY paper, there was no benefit in Trump’s age group for dexamethasone over standard of care.

https://www.nejm.org/doi/full/10.1056/NEJMoa2021436?query=featured_coronavirus

Now, I’m not a physician, so understanding some of the nuances of how these things interact is beyond my training. But I do have *experience* being on steroids long term, and they often make you feel enough better that you think you can do things that, frankly, you can’t.

Stanford professor Michele Dauber tweeted about her experience (in the context of neuro surgery):

> I think the drive by thing he just did is potentially a symptom of Dexamethasone. In addition to warning of mood changes my surgeon told me it makes you feel like I could bike up Mt. Tam or run a marathon right after brain surgery when I still had staples in my head.

Yes, steroids definitely make you feel like you *can* do more than you *should* do. Which no doubt explains his just-now statement that he will be released tonight. No doubt AMA (against medical advice).


Part 2 is an article I mentioned to Rick, which is that men are dying of the severe form of COVID in hospitals at a MUCH greater rate than in other illnesses like the flu, and the reasons hadn't been clear. Given that conspire is a largely male audience:

https://blogs.sciencemag.org/pipeline/archives/2020/09/28/interferon-and-the-coronavirus

tl;dr: some people have antibodies against interferon, and it seems to happen more frequently in men.

> But in 987 severely ill patients, at least 101 of them had such antibodies against at least one of the Type I interferons (!)  [...] 37% of the 101 patients in this group ended up dying of the disease, which is also an extreme statistical red flag.


Deirdre