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Old 26 March 2020, 08:12 PM   #3927
Zakalwe
"TRF" Member
 
Join Date: Jun 2017
Real Name: Sal
Location: London
Posts: 2,496
Quote:
Originally Posted by Uggi View Post
I've got a question for Joey and the other doctors on here who are seeing this first hand.

One of the peculiar aspects of this virus is how is affects different people so differently. One of my employees has a wife with chronic Crohns disease and she is so full of steroids that she has virtually no immune system at all: he always says that when she gets a mild cold is lasts a month. We found out last week that him, his wife and his two daughters (one also with Crohns) had tested positive. Naturally we were very worried. I spoke to him yesterday and they have all thankfully fully recovered and he is back at work (working remotely). He said the symptoms were bad while the fever lasted but otherwise like normal flu. Even for his wife. There are many similar stories.

But alongside the stories of vulnerable or elderly people shrugging it off quite easily there are many horror stories (some in this thread) of young, healthy, fit people ending up in ICU, or worse.

My question is.... how common is it that one virus can show such widely ranging symptoms in different patients or is there a scary prospect that the virus is already showing in different forms or different strains? At the start of this crisis there seemed to be an expected pattern - it will be very bad for elderly or immuno compromised people but not bad for younger, healthy people. That pattern seems to be changing. Do we know why?
The answer to this is undoubtedly complex and probably not completely understood for what is a new pathogen. I’m certainly no expert in immunology or virology but it’s likely that the variation in severity (which is also seen with seasonal influenza) relates more to the host response than to the virus itself.

When you get an infection you generally feel ill because of the response mounted by your immune system. Some people’s immune systems over-react to the presence of a pathogen and it causes collateral damage and it’s these people that can become seriously unwell. Why do a minority react this way whilst most don’t? Genetics almost certainly plays a part. Certain environmental factors may be at play e.g. smoking. Advanced age degrades every system in your body, including response to infections.

The observation about more young people being affected is related to the increasing number of cases over time. It was never the case that young people could not become seriously unwell (the first notable death of the entire pandemic was a young, healthy Chinese doctor) but simply that their odds are much, much better than older people. Again to analogise with ‘flu - it’s known as a disease that seriously afflicts older people but it certainly does also kill young people - 674 annually in the U.K. in the 15-44 age group according to this:

https://www.sciencedirect.com/scienc...63445313003733

It’s just that you never hear about them.
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