COVID-19 | Govt warns against use of N-95 masks with valved respirators

COVID-19 mostly kills through an overreaction of the immune system, whose function is precisely to fight infections, say scientists who have decoded the mechanisms, symptoms, and diagnosis of the disease caused by the SARS-Cov-2 coronavirus.

In a study published in the journal Frontiers in Public Health, the researchers explained step-by-step how the virus infects the airways, multiplies inside cells, and in severe cases causes the immune defences to overshoot with a "cytokine storm".

This storm is an over-activation of white blood cells, which release too-great amounts of cytokines -- inflammation-stimulating molecules --into the blood, they said.

"Similar to what happens after infection with SARS and MERS, data show that patients with severe COVID-19 may have a cytokine storm syndrome," said study author Daishun Liu, Professor at Zunyi Medical University in China.

"The rapidly increased cytokines attract an excess of immune cells such as lymphocytes and neutrophils, resulting in an infiltration of these cells into lung tissue and thus cause lung injury," Liu said.

The researchers explained that the cytokine storm ultimately causes high fever, excessive leakiness of blood vessels, and blood clotting inside the body.

It also causes extremely low blood pressure, lack of oxygen and excess acidity of the blood, and build-up of fluids in the lungs, they said.

The researchers noted that white blood cells are misdirected to attack and inflame even healthy tissue, leading to failure of the lungs, heart, liver, intestines, kidneys, and genitals.

This multiple organ dysfunction syndrome (MODS) may worsen and shutdown the lungs, a condition called acute respiratory distress syndrome, (ARDS), they said.

This, the researchers explained, happens due to the formation of a so-called hyaline membrane -- composed of debris of proteins and dead cells -- lining the lungs, which makes absorption of oxygen difficult.

Most deaths due to COVID-19 are therefore due to respiratory failure, they said.

The researchers explained that in the absence of a specific antiviral cure for COVID-19, the goal of treatment must be to the fight the symptoms, and lowering the mortality rate through intensive maintenance of organ function.

For example, an artificial liver blood purification system or renal replacement therapy can be used to filter the blood through mechanical means, they said.

The team noted that especially important are methods to supplement or replace lung function, for example with non-invasive mechanical ventilation through a mask, ventilation through a tube into the windpipe, the administration of heated and humidified oxygen via a tube in the nose, or a heart-lung bypass.

The researchers stressed the importance of preventing secondary infections.

They noted that SARS-Cov-2 also invades the intestines, where it causes inflammation and leakiness of the gut lining, allowing the opportunistic entry of other disease-causing microorganisms.

The researchers advocate that this should be prevented with nutritional support, for example with probiotics -- beneficial bacteria that protect against the establishment of harmful ones -- and nutrients and amino acids to improve the immune defences and function of the intestine.

"Because treatment for now relies on aggressive treatment of symptoms, preventative protection against secondary infections, such as bacteria and fungi, is particularly important to support organ function, especially in the heart, kidneys, and liver, to try and avoid further deterioration of their condition," Liu added.

New Delhi, Feb 24: The shared values between India and the US are "discrimination, bigotry, and hostility towards refugees and asylum seekers", Amnesty International USA said in a joint statement with Amnesty International India ahead of US President Donald Trump's visit to India on Monday.

Trump, accompanied by his wife Melania, daughter Ivanka and son-in-law Jared Kushner as well as senior officials of his administration, landed in Ahmedabad on the first leg of his two-day visit to India.

"Anti-Muslim sentiment permeates the policies of both U.S. and Indian leaders. For decades, the U.S.-India relationship was anchored by claims of shared values of human rights and human dignity. Now, those shared values are discrimination, bigotry, and hostility towards refugees and asylum seekers,” Margaret Huang, Amnesty International USA’s executive director, was quoted as saying in the statement.

It was a reference to the anti-CAA protests in India, the internet lockdown in Jammu and Kashmir and the Muslim ban expansion by President Trump affecting Nigeria, Eritrea, Myanmar, Kyrgyzstan, Sudan and Tanzania, the statement said.

It added that Amnesty International USA’s researchers travelled to Lebanon and Jordan to conduct nearly 50 interviews with refugees that as a result of the previous version of the ban have been stranded in countries where they face restrictive policies, increasingly hostile environments, and lack the same rights as permanent residents or citizens.

The statement also came down hard on the Indian government, hitting out at the Citizenship (Amendment) Act (CAA) 2019 and saying it legitimises discrimination based on religious grounds.

It criticised statements such as “identify them (the protestors) by their clothes” or “shoot the traitors” by Prime Minister Modi and his party workers. Such remarks "peddled the narrative of fear and division that has fuelled further violence", it said.

“The internet and political lockdown in Kashmir has lasted for months and the enactment of CAA and the crackdown on protests has shown a leadership that is lacking empathy and a willingness to engage. We call on President Trump and Prime Minister Modi to work with the international community and address our concerns in their bilateral conversations,” Avinash Kumar, executive director, Amnesty International India said in the statement.

Patna, Jun 25: At least 83 people died due to thunderstorms in Bihar in the last 24 hours, according to Chief Minister's Office.

Bihar Chief Minister Nitish Kumar announced Rs 4 lakhs each for the families of deceased.

Thirteen people died in Gopalganj, 8 each in Madhubani and Nawada, 6 each in Baghalpur and Siwan, 5 each in Darbhanga, Banka, East Champaran and 3 each in Khagaria and Aurangabad.

Due to thunderstorms, two people each lost their lives in West Champaran, Kishanganj, Jamui, Jahanabad, Purnia, Supaul, Buxar, Kaimur while one death each was reported in Samastipur, Shivhar, Saran, Sitamarhi and Madhepura.