Coronavirus Pandemic Update 46: Can Hot/Cold Therapy Boost Immunity? More on Hydroxychloroquine

Welcome to another COVID-19

update

. We continue to top the charts in terms of infections. If you go to the global meter and sort by deaths per million population, you can still see that the highest concentration of deaths is occurring in Italy right now in terms. of new cases, the US continues to lead in the united states, new york and new jersey, and california is a distant third and of course in new york and now in california we are starting to have problems regarding the saturation of healthcare delivery systems, okay, let's talk about exactly what's going on right now with Kovat Nineteen.

What we have here are three different populations, we have the entire population as a whole and we have those who are going to be infected and we have those who are going to need hospitalization and you may have noticed that. that the situation that we are having right now in New York, especially in other parts of the country as well, is that this population of people who need hospitalization cannot enter our tunnel here, which in fact is the hospital, and that is why we are having problems with the shortage of ventilators in ICU beds, etc., so right now all the work is focused on trying to increase the capacity of the hospital system to allow these types of boluses of patients, if necessary, to pass and are treated. effectively now of course these graphs are not drawn to scale remember there is only a certain amount of the population that will get infected and the way to reduce it further is with isolation but there is a certain percentage of people that get infected that they will need to go to the hospital and based on the data we have now it is around twenty percent, which means that eighty percent of the people who get the infection will not need to go to the hospital and that is almost entirely related to the system that patient's immune system then the immune system is quite complicated and that's why I want to talk a little bit about imagine your immune system is like the armed forces of this country, you have the army, the Navy, the Marines, the Air Force, all of them.

They have specific functions, but we all work together to protect the organism to protect the country, let's face it, there are many threats that can happen to a human being, but in this case the SARS virus affects the human body in a very specific way, so if we can learn which part of the immune system is declining, then we can potentially learn how to fight this virus effectively and reduce the number of people who might need hospitalizations, so go to this article where they actually look at immune responses not only to this crown. virus, but the SARS coven and the MERS

coronavirus

that were there before, so this article was published in the Asian Pacific Journal on allergies and immunology, immune responses in kovat 19 and possible lessons learned from SARS and MERS, as well Let's take a look and see what They found out that they do a comparison in the number of cases between those three viral infections, they also break down the demographics and show the problems here with the SARS bracelet with the current viral infection in terms of the immune actors of the What they mention in this article and what is very interesting is this first point here, which is the delayed or suppressed type 1 interferon response during the initial infection.

In fact, in the article they say here that to generate an antiviral response, innate immune cells need to recognize the invasion of the virus often by molecular patterns associated with pathogens, so remember what the innate immune response is: they are those cells that do not require They are presented with a small part of the virus and therefore it is not T cells or B cells that they are producing. antibodies but innate cells, so they would be like macrophages, monocytes, natural killer cells, this would be like the air force of the Armed Forces and the things that activate them in this case are these parliamentarians of the PA or these molecular patterns that are associated with the path in this case. for the

coronavirus

it would be viral genomic RNA.

They go on to say here that for the SARS MERS Cove coven the response to viral infection by interferon type 1 is suppressed. Both corona viruses employ multiple strategies to interfere with the signaling that leads to the production of interferon type 1. see what else they say here with similar changes in total neutrophils and lymphocytes during kovat 19 SARS cub 2 probably induces a delayed type 1 interferon and loss of viral control early in the infection what they are saying here is that the virus is capable of downregulating its system immunological in the early phase of infection and this may be the reason why most people with this infection are initially asymptomatic until the end, when there is a cytokine storm.

Additionally, no severe cases have been reported in young children when the innate immune response is highly effective, this may explain why young children do not get the disease as severely. These facts clearly indicate that the innate immune response is a critical factor for disease outcome. Analysis of two individuals infected with MERS Cub with different severity found that the type 1 interferon response in the poor outcome patient who died was notably lower than in the recovered patients, so if we go back to our image we see here that the patients who end up in the hospital are about 20% of those who actually get the infection and The reason we can mean is that there is a decrease in innate

immunity

, which is the specific problem with this virus and this seems to be confirmed in a recent publication in natural medicine where they observed the immune responses and cells of a patient. who had non-severe kovat 19, in fact this patient never needed to go to the hospital and recovered quite well, of course we will link this article and the previous one in the description below, but what they did look at here was the amount of virus. the symptoms the chest x-ray and then, even

more

important for our evaluation, these monocytes and natural killer cells, so here we have monocytes and natural killer cells and if you look at this triangle here you can see where the patient's monocytes were in Relative to where they should be in a normal healthy patient, monocytes that are part of the innate immune system were much lower than they should have been even though this patient only had mild disease, reaffirming that it is the immune response innate which seems to be suppressed in these kovat 19. patients and even

more

so it seems that monocytes and natural killer cells seem to be the target, so the question is what can we do to increase the number of monocytes and perhaps gamma interferon to raise them in the early stages of the course of this disease. and we've talked before about not treating a viral fever because we know that viral fevers are also involved with the immune response, but I've gotten some interesting comments wondering if a corona virus patient doesn't have a fever, what does inducing a fever improve the outcome? and the immune response, so knowing what we already know about what is happening in Covent 19 in terms of depressed monocytes made this German publication from 2002 even more interesting and here are the authors.

Zelner says that the thermal effect of fever has been associated with better survival and a shorter duration of illness in cases of infection and what they wanted to do was better understand what happened if they subjected 12 healthy volunteers to a hot water bath. at 39.5 degrees Celsius to increase their body temperature and saw what would happen to the expression of monocytes and tumor necrosis factor alpha, which is a cytokine that it releases, and they looked at this both in vitro and in vivo in humans who actually They were put in a hot water bath and what he found was that the in vitro data showed that there was definitely an increase in the Amano sites.

Here they say that the expression of the endotoxin receptor CD14 and the complement receptor CD 11 increased after the hot water bath, in addition, when they looked at healthy subjects after they were placed. In the hot water bath, they said here, after three hours, the response of monocytes to endotoxin improved in an ex vivo lipopolysaccharide stimulation assay, which is basically a stimulant of a bacteria that could have infected a human body when stimulated the immune system they noticed. that there was a greater release of TNF alpha, which was statistically significant, so they concluded that the thermal effect of fever directly activated monocytes, the same cells that curiously are deficient in kovat 19 and that increased their ability to respond, in In this case, to a bacterial challenge, but I'm sure they would also respond just as well to a viral challenge, but this is not the only study that shows that there was an interesting article that was published around the year 2000 titled Immunological changes in humans during exposure to

cold

, effects of warm-up and exercise.

They took subjects and sat them in a warm bath, among other things, and then exposed them to the

cold

to see whether or not that would also improve

immunity

and you can see here the seven subjects in the white boxes sitting at 38 degrees Celsius. The water bath increased their rectal body temperature and then after exposing them to the cold, there was a drop in core body temperature and here when we see the data in this second set of bar graphs, they are the ones where They sat at 38 degrees Celsius. water, you can see here for the leukocytes, which are all the white blood cells, that there was a significant increase in the number of white blood cells here also for the granulocytes it increased well, for the lymphocytes there was an increase and also for the monocytes there was a Remember that Monocytes are the part of the innate immune system that is deficient.

We are discovering in Kovat 19 what they concluded in this report. Despite popular beliefs that cold exposure can precipitate a viral infection, the innate component of the immune system is not negatively affected. for a short period of exposure to the cold, this is exactly the part of the immune system that was discussed with kovat 19. They say, in fact, it appears to be the opposite. The drop in core body temperature resulting from cold exposure led to a consistent and statistically significant decrease. mobilization of circulating cells, an increase in NK cell activity, natural killers, and elevations in circulating IL-6 concentrations.

Furthermore, consistent with one of our hypotheses, prior exercise with a heat clamp significantly increased the leukocyte granula site and the response of monocytes to cold exposure before passive warming and Exercise without a heat clamp also tended to increase the effect of cold exposure alone, but due to the small size of the sample and the internal variability of the subject, these changes were not statistically significant, so the interesting thing they are finding here is that yes, heat can improve the immune system. We've seen it before, but then subjecting them to cold, which goes against popular belief, can actually improve the immune system, especially the innate immune system, which I find very interesting because that's the part that's affected. at Kovat 19, so all this talk about being hot and cold reminded me of the Finnish saunas that are so famous in that part of the world and indeed in most Nordic countries, but not to the extent that we see in Finland, so here is a study that looked at a single blank Finnish sauna session. blood cell profile and cortisol levels in athletes and non-athletes and in this study they only looked at nine people which is a pretty low number so we may not be able to see the statistical significance but let's see what they found for those from you.

Who doesn't know what a Finnish sauna is, it's quite extreme. The sauna can reach more than two hundred degrees Fahrenheit, which is very close to the boiling point of water. During the sauna session, the human body is alternately exposed to hot and cold stimuli. Hot air in The sauna room affects the skin and respiratory system, this leads to an increase in the core temperature of the body up to thirty-nine degrees Celsius, while the skin temperature can reach forty-two degrees Celsius and then once This done, there is a quick cool down and then they return to the sauna to warm up once more, so what happened to the white blood cells in this situation?

Here they found that there was a statistically significant increase in the number of white blood cells, particularly more notable in the athletes than among the non-athletes, some of these were statistically significant and some of them were not possibly related to the low number of subjects in this study. . Here they found that a significant increase in monocyte count was accompanied by an increasesignificant in the number of neutrophils. and eosinophils only in the athletes, which could have been caused by reduced cortisol secretion compared to untrained subjects. Remember this is only after a sauna session, so let's break down what's going on.

We have the infection that occurs here. Right now and then we have right now some of those around 20% will end up in the hospital with pneumonia secondary to the cytokine storm, as it's often called, why are people asymptomatic to begin with? and it may be that the immune system is being suppressed well if we inflame the immune system if we augment the immune system with thermal regulation and hyperthermia, is it possible that we can precipitate a storm situation and get patients to the hospital sooner without helping them well? that's a good question and it's a possibility and that's why I found this post so interesting.

They talked about this interleukin il-6 that has been implicated in the cytokine storm that pneumonia patients suffer when they had kovat 19:00 the article is long but I found this paragraph very enlightening, although febrile temperatures initially increase cytokine production proinflammatory reactions by macrophages at sites of inflammation, there is also evidence that heat stress dampens cytokine synthesis. Once macrophages have been activated, this sequence of events is analogous to a natural fever that often occurs after that Nate's macrophages and other immune cells initially encounter the PMPs. Remember PA and Peas from that first article we discussed in this regard.

Human monocyte-derived macrophages produce less TNF (less IL-6 and less IL-1 beta) when exposed to febrile temperatures and then heat in cells experienced heat reduces the transcription of proinflammatory cytokines and also reduces the stability of cytokine mRNA. Heat treatment of LPS-activated macrophages also appears to reduce inflammation, so what? What they're showing here is that fever can actually reduce the cytokine storm and improve the innate immune system. Now they have a model of this with mice that have arthritis, collagen-induced arthritis. When they exposed the mice to hyperthermia in the fever range, they had significantly fewer joints. damage, so they say that together these findings suggest that strategic temperature changes contribute to a negative biochemical feedback loop that actually protects tissues against damage caused by the excessive release of cytokines after infection.

It is interesting that in this period of time between the time when the infection is documented and the hospitalization, if there was a higher temperature, it could improve the immune system, which seems to be high. I'm already nervous, and it would potentially reduce the cytokine storm that's causing pneumonia that requires hospitalization. Well, up to this point we've looked at real people. However, I have looked at cells as substitutes for a good immune system against viruses. Let's put it to the test and here we have an article that asks the same question: do regular healthy baths reduce the incidence of common colds?

They took 50 people who had never been in a sauna before this was an Austrian study and 25 of them stayed out of the sauna and were used as controls, the other 25 bathed in the sauna to see if they could reduce the incidence of the common colds and what they found was this in the six months that both groups recorded how many common colds they had, there were significantly fewer common cold episodes in the sauna group, this was particularly found during the last three months of the study period, when the incidence was reduced by about half compared to controls and then they concluded that regular sauna bathing probably reduces the incidence of common colds, but they felt that more studies were needed to prove this and they always are needed more studies to make sure what you're seeing is real here in an editorial by dr.

Ernst, who was responsible for publishing the Austrian study on the sauna, says here, however, it seems unwise to recommend the sauna indiscriminately, so if in doubt a medical check-up is mandatory once done, the sauna can be fun and relaxing, so we took dr. Ernst claims literally, but the question goes deeper: does this heat and then the cold help prevent and treat coronavirus 19? Of course, the answer to that question is that we don't know at this time because there hasn't been a randomized controlled study. trial looking at that specifically, but there also hasn't been a randomized, placebo-controlled trial on anything we're using for Cova 19 right now.

I know this is a long video but I needed to include more here because it's Very interesting, this was a paper published in 2016 by the Salk Institute and a very interesting review of all the data pertinent to their study that looked at this idea of ​​hyperthermia and hypothermia , this initial proposal made by Kluger in the 1970s only considered the fever response to be beneficial for host defenses; however, we suggest that both fever and hypothermic responses are host strategies to optimize their defenses during infection. In fact, there is evidence to suggest that both fever and hypothermic responses are beneficial to the host in the context. from a variety of illnesses, so the more I thought about this, the more I started thinking about the Finnish sauna.

Here there is a population of people who use the sauna extensively, so here you have the scan in countries of Denmark, Norway and Sweden. Finland is not technically a Scandinavian country, but they are all considered Nordic countries, so they are all in the same place, but while Finns use saunas a lot on a regular basis, maybe even two or three times a week, not so much in Sweden, Norway and Denmark. Although they are used to some extent, there are around 5.5 million people in Finland and it is estimated that there are around 2 million saunas, so I got the idea to look up some of these Nordic countries about wool domitor and I I realized, of course, that although they are very similar in nature there could be some confounding variables that differentiate them, but whether this type of heat and cold that is being experienced could help the innate immune system and whether it is in fact the innate immune system which is deficient in a case of Kovat 19, so we would expect to see some kind of improvement if it was worth it, so let's look at some of the numbers and again, this type of study doesn't really prove anything that can be seen affected when the virus began in each of these respective countries. and where they are throughout the process, but it will be interesting to see what happens, so what I decided to do was take the different countries, Denmark, Norway, Sweden and Finland, and I put here approximately the population of each of these countries, so Denmark is 5.6. million and then you can pull these numbers directly from the world meter.

What about the total deaths? This is an interesting question because maybe if the immune system is amplified by sauna and cold baths maybe it wouldn't prevent you from getting the infection, but it could prevent you from getting a cytokine storm and getting pneumonia, so we could see a difference in total deaths. Let's take a look and in Finland there are 11 interesting ones. What about the total deaths per million? What about the new deaths for today? It will be interesting to keep track of this data as things progress. There is another culture that also likes to take very hot baths and then cool off afterwards, and that is the Japanese, and looking at their numbers, going back to Bali might cause confusion, but we have to look.

In this, from the microscopic level and the macroscopic level, as well as changing the subject, I also wanted to talk to you about a new publication that just appeared online about

hydroxychloroquine

and it is by the same author who published the study that showed that the combination of a zero, myosin and

hydroxychloroquine

were effective there was some criticism due to the low number of patients in that group well now they

update

d their results with 80 patients and basically the results are very similar in conclusion we confirmed the effectiveness of hydroxychloroquine associated with azithromycin in the treatment of Cova 19:00 and its potential effectiveness in the early deterioration of contagion, given the urgent therapeutic need to control this disease with effective and safe drugs and given the insignificant cost of both hydroxychloroquine and myosin, we believe that other teams should urgently evaluate this

therapy

strategy both to prevent the spread of the disease and to treat patients before serious and irreversible respiratory complications occur.

You can see here that the black bar is the number of patients tested and the tan bar here is the number of patients with a lower CT value. 34 is the number of cycles you have to do with reverse transcriptase PCR to really get a signal, so what you really want here is a high, high number, which means the RNA is undetectable, so when you have less than 34, that's a The bad thing is that you want the number of patients with that to decrease and that's exactly what you're seeing here: it's decreasing and it actually hits zero around day 11 and then you can easily see it with this bar green which is the percentage of patients with a CT value less than 34 and you can see that it is a good result.

There are many things today that we will continue tomorrow. Thanks for joining us.