Question

Research the Internet for information about one specific respiratory disease that is new to you

1. Write a report describing a respiratory disease that is new to you.
2. Remember to Cite your sources
3. Please Add personal comments (this makes discussions more interesting)

Answer 1

The new Respiratory virus which is Nobel Coronavirus originated from Wuhan city of china, is the cause of Pandemic in the world. It causes ARDS like Illness. Coronaviruses are increasingly recognized as important human pathogens.

Coronavirus is an enveloped virus largest known single-stranded positive-sense RNA genomes.

Pathophysiology :::

COVID -19 may not cause pneumonia either typical or atypical or classical ARDs . It seems like we are dealing with a presumed wrong diseases.

The Key pathogenic molecular step of SARS-Cov2 is to attack the 1-Beta Chain of Hemoglobin and hunting the porphyrins dissociating the iron form it and releasing iron into the circulation.

Thus Hb looses its capacity to bind with oxygen , so oxygen is not supplied to major organs. That is why we see resistant hypoxia coupled with very rapid multi-organ failures.

Moreover The free iron released into the circulation is so toxic as it causes a powerful oxidative damage to the lungs .

Free iron toxicity causes inflammation of alveolar macrophages- leads to CT scan characteristic changes.

The body try to compensate this by elevating the rate of Hb synthesis which explains why Hb is high in those patients.

Other compensatory mechanisms to deal with such iron load is increasing ferritin production ( iron store ) which explains the very high ferritin levels observed in those patients.

Therefore the cause of monocytosis is the body needs to excess macrophages to engulf the excess iron load .

And the cause of Lymphopenia is the WBCs differentiation favored twards monocytes line rather than lymphocytes line.

This makes ferritin a bad prognostic marker (too much iron means too much Hb lost its O2 carrying capacity) .

Also this iron load and increased Hb production lead to increased blood viscosity with recurrent and diffuse micro and macro circulatory thrombosis that is why there is high levels of DDimer in those patients and this explains the cause of sudden deterioration and death in some sporadic cases

This disseminated thrombosis is proved by postmortem examinations of ARDS victims ( it is not a real ARDS) .

This theory could explain why we are loosing patients so rapidly and why mechanical ventilation is not so much effective in treatment and using ARDS mechanical ventilation protocol is not causing any benefit. actually it could be futile and causing more lung damage.

On the other hand this is crucially explains the very rapid and good response of those patients to full therapeutic anti coagulation.   

Chloroquine as antimalarial drugs is working by protecting Hb against invasion by malaria parasites .It is doing the same here but just protecting the Hb against invasion by the virus.

The chemical components in chloroquine phosphate compete with the porphyrin and bind to the viral protein, thereby inhibiting the viral protein's attack on heme or binding to the porphyrin.