"You can never have too many knives." --Joe Ambercrombie
Shabbat shalom, motherf***ers! --Mordechai Jefferson Carver
No, I wasn't referring to that post but I presume that it is the same data set and it has already been mentioned in this thread earlier
https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e5.htm
Doesn't read posts longer than two paragraphs.
From YVK's link:
vs
So it would appear Covid19 increases the risk of myocarditis somewhere between 5.5x and 9.2x in 16-24 year-olds while the Pfizer vaccine increases the risk between 4.5x and 17.8x in 16-19 year-old boys and between 3.2x and 11.9x in 20-24 year-old boys.
Those 95% confidence intervals are huge and we're comparing boys & girls with covid vs boys with the vaccine so we can't say for certain which carries the higher risk, but I'd lean toward covid being the greater risk. Again, myocarditis is a tiny risk overall and young men appear to be the only demographic where it could be close.
We probably need to differentiate between COVID myocarditis and the right heart failure that frequently occurs with prolonged, severe ARDS. Many patients with prolonged ARDS will develop RV dysfunction that is largely mediated by increased pulmonary vascular resistance from the hypoxia, hypercarbia, acidemia, high mean airway pressures on the ventilator, and inflammatory mediators that constrict the pulmonary vasculature. The RV is a thin-walled, weak pus that does not tolerate sudden increases in pressure from increased pulmonary vascular resistance associated with ARDS from any cause.
Unless these patients are getting cardiac biopsies or cardiac MRIs, this is going to be hard to tease out. I suppose that the timing of symptoms may be a clue in some cases such as heart failure that occurs after recovering from COVID or near the end of an otherwise mild respiratory course.
This is probably why some of the best COVID outcomes on ECMO are coming out of the groups using a V-PA cannulation approach (Protek Duo) rather than traditional VV ECMO. In VV ECMO, the cannulas drain deoxygenated blood from the vena cava, send it to an oxygenator, and then pumps it back to the right atrium where the oxygenated blood circulates through the poorly functioning lungs that do very little before going back to the left heart to be sent to the rest of the body. This provides some measure of indirect RV support by minimizing hypoxia, hypercarbia, acidemia, and the need for high ventilators pressures. In V-PA cannulation, the blood return catheter tip is advanced into the pulmonary artery and the pump provides direct RV support and functions like an oxygenating right ventricular assist device (RVAD). I’ve got 1 patient with COVID lung destruction (now clear of the virus but horribly trashed lungs) on a Protek and is trach’ed, awake, and participating in bedside physical therapy with a goal of getting a lung transplant before Halloween. Our goal is to protect his right heart as a heart-lung transplant is a bridge too far…
I like my rifles like my women - short, light, fast, brown, and suppressed.
I just want to take a moment to again thank all the doctors, scientists, and health care folks who have been posting here. In a world where it's often hard to figure out WTF the true story is on any given issue, we are extremely fortunate to have the benefit of your observations and insights.
Also a big shout out to @0ddl0t. The studies and graphs and charts and all the other good shit you post are often Greek to me, but then you pithily summarize things so that an 8th grader can understand. As one of the many lawyers who went to law school because we were told there would be no math, I'm very appreciative.
I just popped positive on the binaxnow home test.
Have been feeling fatigue since Thursday night. Today woke up with headache, congestion, very noticeable joint and body ache, mild diarrhea, and sore throat. No temperature.
I was vaccinated with Pfizer in March (both doses). I Honestly did not expect to feel this sick when I eventually got exposed.
Anyhow I’m upping my vitamins and etc:
-36mg of prescription ivermectin (5days)
-5000 IU vitD
-325mg aspirin
-1000mg vitC
-Melatonin
-500 mg quercetin
-1000 mg zinc
Hoping for the best!
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