Pneumolysis: High Altitude Specialists Explain COVID-19 Lung Destruction

TOPICS: COVID-19 Infectious Diseases Lungs Physiology Pulmonary Virology.

The article by Dr. Gustavo R. Zubieta-Calleja and partners in distributed as open access in Reviews on Recent Clinical Trials, 2020. 

The current COVID-19 pandemic has caused more than 1 million passings which can be ascribed to its serious reformist aspiratory bargain. The need to comprehend this infection has brought about nitty gritty examinations of its transmission and clinical viewpoints distributed around the world. In this new report, specialists in Bolivia give, who live and work at more than 3,600m from above ocean level, a high elevation experts' point of view. At high-height, hypoxemia (low oxygen in the blood), the fundamental entanglement in COVID-19, is each day's beneficial involvement with the High Altitude Pulmonary and Pathology Institute (HAPPI-IPPA) in La Paz, Bolivia, for 50+ years. In contrast to high elevation ailments, as indicated by Prof. Dr. Gustavo Zubieta-Calleja, COVID-19 presents his supernatural new idea: "pneumolysis" (pneumo=lung, lysis=destruction).

Covid-19

At first, all doctors overall accepted that the lung torment in COVID-19 (proved by CAT examines and brought about by SARS-CoV-2) was equivalent to in more established strains SARS-CoV. Notwithstanding, as casualty rates expanded in Intensive Care Units, it became obvious that this pathology was completely new. 

The SARS-CoV-2 infection enters the body through inward breath of the viral burden, and goes through the bronchi to the outside of the alveoli respiratory sacs where pneumocytes (alveolar lung cells), and their vessels are found. The pneumocytes permit the dissemination of oxygen atoms to the vessels where red platelets catch and transport them to all tissues. They additionally permit the entry of carbon dioxide particles (a byproduct of breath) to be breathed out. 

SARS-CoV-2 enters pneumocytes through the ACE2 receptors and starts self-replication of its RNA inside. Pneumocytes are ultimately pulverized freeing all reproduced SARS-CoV-2 RNA that further contaminate other contiguous pneumocytes. The paper created by Prof. Dr. Gustavo Zubieta-Calleja, recommends that different infections may emerge from SARS-CoV-2 entering the vessels. 

The Covid interruption bit by bit lessens the lung's gas trade zone. This outcomes in alveoli irritation and a superimposed change of lung work like High Altitude Pulmonary Edema (HAPE). Both in COVID-19 and HAPE, ocean level patients can't take in enough oxygen as though they were quickly positioned on the culmination of Mt. Everest, without time for variation. All things considered, HAPE is altogether reversible as its system is unique, and there is no pulverization of alveoli. 

The outrageous hypoxemia experienced in COVID-19 patients drives doctors to utilize ventilators (a mechanical method of siphoning air into the lungs) to improve oxygenation. Notwithstanding, utilizing high weights on mostly decimated and delicate lungs can bring about the most noticeably terrible results. While non-obtrusive ventilation brings about better results. 

On the off chance that patients endure the intense pneumolysis with fundamentally low oxygen levels in COVID-19, recuperation brings about irreversible fibrosis (scars) in the lungs. This harmed tissue is not, at this point helpful for gas trade, so pay can be generally accomplished by expanding the quantity of red platelets (hemoglobin oxygen carriers). This poly-erythrocythemia) is a remuneration component found in high-height inhabitants who endure persistent lung infections or other oxygen transport problems, ordinarily known as "Ongoing Mountain Sickness." 

In COVID-19, ocean level hemoglobin can likewise get deficient. The creators hypothesize that a crucial treatment methodology to expand the vehicle of oxygen could be erythropoietin. This hormone normally builds red platelet creation and secures the heart, cerebrum, and vessels from hypoxia's perils. 

Brief organization of oxygen is significant as it can diminish the arrangement of HAPE-type edema and cardiopulmonary exhaust. The utilization of mitigating medicine, being tops Aspirin for its pain relieving, calming, against fever, and hostile to coagulation impacts, are likewise proposed. Opportune utilization of anti-toxins (to shield from super-disease), sufficient oral rehydration, antitussives (advancing a resting lung) and other enemy of coagulation medications should likewise be considered on every individual case. 

To permit individuals to re-visitation of work, Dr. Zubieta-Calleja proposes the utilization of room type earth suits with electric ventilator open circuit enough separated air, diminishing virus hazard. The CoV-2 is a characteristic organic purifying instrument assaulting all the more seriously those with diminished resistance, incendiary cycles, or covering illnesses. "The individual extreme endurance apparatus under COVID-19 presence… " as he clarifies: "is a solid resistant framework." 

Reference: "Coronavirus and Pneumolysis Simulating Extreme High-elevation Exposure with Altered Oxygen Transport Physiology; Multiple Diseases, and Scarce Need of Ventilators: Andean Condor's-eye-see" by Gustavo R. Zubieta-Calleja, Natalia Zubieta-DeUrioste, Thuppil Venkatesh, Kusal K. Das and Jorge Soliz, Reviews on Recent Clinical Trials.