Are we high risk?

[Paleowoman]

Hi Alisbaba - thanks for that useful link.

(I've never heart of the British Heart Valve Society, but see it is basically to support health care professionals.)

 

[Seaton]

Hi @Seaton

Article just popped up in the Guardian which might explain your letter UK government 'giving incorrect information on self-isolation', say GPs:

People across the UK are being given incorrect information from the government about whether or not to isolate, with some wrongly instructed to remain indoors for 12 weeks, GPs have warned.

Doctors fear out-of-date information is being used as they are getting an increasing number of calls from people who do not understand why they have received a text or letter saying they are in the most at risk group. At the same time, some of those who are in priority groups are complaining they have been given no information, they said.

https://www.theguardian.com/world/2...correct-information-on-self-isolation-say-gps

Hello Anne (@Paleowoman)

News just in!

It now appears I’m not in the NHS “extremely vulnerable”/high risk category for Covid-19 as a post AVR patient after all. Seems amidst the confusion, categorisation had been misapplied in my case.

Got a text from my GP this afternoon saying:

You may have received a letter from the government advising that you have been identified as extremely vulnerable to covid 19. We believe this is incorrect. You can follow the usual advice below:​

​

https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/​

Currently only the following patients are considered to be extremely vulnerable: Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19​

So there we are. Free at last! ... Sort of.

 

[tom in MO]

it seems to me that when one is younger its natural to wish to avoid drugs. However as we age its better to accept that some drugs actually do help us live longer. One of my mates (the pharmacist) started taking baby aspirin after he turned 40 because of the evidence from the literature. Clots causing strokes happen in the general population as we age, by being on warfarin early and by being a good ACT dosage manager you stand the best chance of never having a stroke and avoiding the bleed complications associated with warfarin (because of decades of inadequate management practices). That and regular exersize, healthy eating and a moderate alcohol intake will give you the best chances of a long and healthy life

Actually, genetics plays a part in it too. So if you come from a long line of hard drinking, obese sedentary office workers who lived into their eighties... Plus luck, one can always die young when hit by a beer truck When I was a child, the deli man used to say his goal was to live fast, die young and make a good looking corpse.

Per risk if you have valve problems, from Alisbaba's link:

​

Am I high risk?​

​

People with heart disease are at higher risk from Covid-19 but no information specifically for valve disease exists. It is likely that mild or moderate valve disease does not increase the risk. This includes people with bicuspid valves and mitral prolapse with valves that function well. However, it is likely that severe valve disease can increase risk particularly if it is associated with symptoms (usually breathlessness or chest tightness on exertion) or heart failure. You may also be at higher risk if you have had surgery for heart valve disease in the past 3 months. If your surgery was longer ago than this, then you are not expected to be at higher risk unless the repaired or replaced valve is not working normally or your heart is not pumping blood normally (i.e. left ventricular function is reduced).​

I would interpret this to mean that for those of us in the waiting room that have had their surgeries put off due to covid, they need to be extra careful. As those with less than successful valve replacement surgery.

Congrats on your good news Seaton!

 

[pellicle]

Actually, genetics plays a part in it too

always ... but any advantages on top of the hand dealt at conception is one I'll put up my sleeve if I can.
:-D

 

[Paleowoman]

News just in!

It now appears I’m not in the NHS “extremely vulnerable”/high risk category for Covid-19 as a post AVR patient after all. Seems amidst the confusion, categorisation had been misapplied in my case....<snip>...
So there we are. Free at last! ... Sort of. ☀

GP phoned me this morning and reiterated that I should be self isolating and shielded, particularly because of my heart valve problem but also because of respiratory problem. She wants me to be on that 'extremely vulnerable' list and is going to write to cardiologist asking for advice.

Still stay safe Seaton....and everyone else !

 

[Stowegirl]

Hello Anne (@Paleowoman)

News just in!

It now appears I’m not in the NHS “extremely vulnerable”/high risk category for Covid-19 as a post AVR patient after all. Seems amidst the confusion, categorisation had been misapplied in my case.

Got a text from my GP this afternoon saying:

You may have received a letter from the government advising that you have been identified as extremely vulnerable to covid 19. We believe this is incorrect. You can follow the usual advice below:​

​

https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/​

Currently only the following patients are considered to be extremely vulnerable: Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19​

So there we are. Free at last! ... Sort of. ☀

I just wanted to say that being vulnerable TO the virus is not an issue for us. I think that is people who are on immunosuppressants. The effect on some of us is how ill we get if we get it. I don't seem to have been earmarked for that either and I am pre surgery. I don't particularly want to test that out so Im doing my own kind of shielding. It wouldn't do any of us any harm to just be very careful.

 

[user 16827]

My guess is that it is chronic inflammation, in addition to a compromised immune system

 

[Paleowoman]

There is a lot of interest in vitamin D and Covid-19. Dr David Grimes, a gastroenterologist, has been doing research on vitamin D for many years and has written books and papers, and has now written a couple of good posts on his blog about it and Covid-19, one about the importance of vitamin D and immunity and another highlighting the number of black and ethnic minority doctors and health workers who had died of Covid-19 - having darker skin in northern latitudes is a risk factor for low vitamin D as there’s not enough sun in these latitudes to make much vitamin D and the darker your skin the less you make.

http://www.drdavidgrimes.com/2020/04/vitamin-d-and-immunity-important.html
http://www.drdavidgrimes.com/2020/04/vitamin-d-and-doctors-in-uk-dying-from.html
(The illustrations in those links appear broken - I hope Dr Grimes mends them soon)

Something like 85% of people in the UK are deficient in vitamin D (regardless of skin colour) due to not enough sun here and due to people staying out of the sun when it does shine or putting on sunblock due to fear of skin cancer (one only needs 10 to 20 minutes in the sun between 11am and 3pm mid April to mid September to make a good amount of D). Unfortunately the amount of supplemental vitamin D3 recommended by governments is very low and not sufficient to raise blood levels of D to the optimal replete levels.

 

[rich01]

Just wanted to add that low vitamin d can also be genetic. I get lots of sun, but my vitamin d level stayed low. I started supplementing and had to take 15,000 IU of D3 a day to get my vitamin d to top of range. I found in the summer, I could drop down to 10,000 IU a day.

When you look at what most doctors recommend, I take way more than they recommend, yet that's what it took to get my vitamin d up. I later learned I had a SNP that indicates a likely problem converting sunlight to vitamin d, which is why I have to supplement at such a high level.

Some other things that may help with covid-19 are zinc plus a zinc ionophore, which gets zinc inside the cell. That is thought to be part of the reason that chloroquine, which is a ionophore, works. EGCG found in green tea and quercetin are ionophores, so possibly taking zinc and one of these might help.

I have seen vitamin C recommended, 1 g twice a day or to tolerance. Elderberry extract is an anti-viral that I have also seen recommended. Start when symptoms of viral infection are first noticed.

 

[Alisbaba]

I have to take vitamin D now for life

 

[Paleowoman]

I'm prescribed 20,000 IUs of vitamin D3 per week in winter, that's just over 2,500IUs per day, and 20,000 IUs every other week in summer, by my GP, and my blood levels of D are tested every six months when I have my regular blood tests. This is because twelve years ago I took 4,000 IUs of vitamin D3 per day for a couple of months in winter and then had a blood test - it was too high at 384nmol/L (153 ng/mL) - made my GP really panic. No harm was done as I didn't have hypercalcaemia, I just had to stop take the D for two months and my level fell to half that amount (half life of D is two months). My endocrinologist and I thought that the reason my level of D went too high was that the supplement I was taking had more D3 in it than it was meant to, hence me getting prescription D3 which is better regulated. The dose was arrived at by repeated testing at the end of summer and end of winter which my GP keeps doing, average around 150 nmol/L (60ng/mL) which is optimal replete. Everyone is very different in the amount of D3 they need to take.

 

[coffeelover]

Hi Valvers! Very Interesting info and post about Vitamin D. Thank you everyone for sharing... From my own experience, you can be deficient in Vitamin D and not know it. Several years my Vitamin D level was checked when I was in the hospital for my AVR surgery ...and the blood tests revealed I was very low. I eat a balanced diet, exercise outdoors in the winter( cross country ski, run, walk) but I just cannot get enough Vitamin D in the winter without a supplement. So now I supplement in the winter and I'm definitely remembering to take my Vitamin D during this pandemic period.

 

[Protimenow]

A few things:

My doctors prescribed a D3 supplement when I was discharged from the hospital two weeks ago. I already have supplements. (A few years ago, a prescription for a D supplement was sent to a pharmacy which took a bottle of a generic D3 supplement and sold it to me).

Recent news about the effects of COVID-19 show, in some people, that a clot can form. This cost one person his leg because of a clot in his name, and may cause pulmonary embolism, stroke, and other nice things that those of use who are already taking warfarin can avoid.

Given this information, we may conclude that we are at LOWER risk of these reactions than other patients.

 

[Paleowoman]

In the UK press today articles reporting that Public Health England (PHE) is recommending people take a supplement of vitamin D. As usual it is completely carp advice. PHE says people should take 10mcg, that’s just 400IU of vitamin D3 per day. That amount of D will take no one out of deficiency and not keep anyone in sufficiency even if they are at sufficient levels to begin with. In addition PHE say if people go out in the sun they should cover up or put on sunscreen - those both stop the skin making vitamin D. PHE also say that vitamin D has nothing to do with immunity. Huge sigh of frustration here.

 

[Agian]

Paleo, you state 85% in the UK are vitamin D deficient. Interesting tidbit. It's 50% in South Australia. That fits well with the different climates.

 

[Protimenow]

Do ANY of us go outside, in full sunlight, for more than a few minutes any more? I take Vitamin D supplements, but even without a living dog to walk, I may just build my stamina by walking around the block.

 

[rich01]

Do ANY of us go outside, in full sunlight, for more than a few minutes any more? I take Vitamin D supplements, but even without a living dog to walk, I may just build my stamina by walking around the block.

From April thru November, I probably average at lest 4 hours a day in the sun. I find that sunlight energizes me. Even in the summer, I spend several hours outside in the hottest part of the day.

 

[tom in MO]

Per the use of ACE inhibitors, looks like it helps:

Hospitalized COVID-19 patients with hypertension and on treatment with an renin-angiotensin system inhibiting drug had significantly better survival, compared with similar hypertensive patients not on these drugs, in observational, propensity score–matched analyses that drew from a pool of more than 3,430 patients hospitalized at any of nine Chinese hospitals during December 2019–February 2020. ACEI/ARBs Linked With Survival in Hypertensive, Chinese COVID-19 Patients​

 

[hx77]

I believe endocarditis and strep are both bacterial, not viral, so not sure how to relate those to covid-19.

It's hard to find specific information, but what I have put together from listening to several interviews is the main problems are age, obesity, diabetes, hypertension, and weak immune system, not necessarily in that order. I think some people with heart disease are high risk and others not as much.

Attached please find the leading COVID19 comorbidities in New York State deaths as of April 24, 2020.

 

[ddwheeler]

Attached please find the leading COVID19 comorbidities in New York State deaths as of April 24, 2020.

View attachment 887361

Those are very interesting stats. May I ask for the source? I would like to check in on this, going forward, as well as see if similar data is available, per state.

*** Edit. I found it. Thanks for the initial post.