Is it Coro\nna (n Cov-19) or your immune system killing you!

Perhaps it’s not the virus but our own immunological system killing and destroying your lungs through ‘Cytokine storm’.

And if it’s true, a controlled epidemic of number of people would definitely be the right option to create herd immunity till its time of vaccination.

Here the principle of herd immunity lies in the assumptive fact that in case of general exposure most people will have no or mild disease where as rest populace will be effectively controlled through innate immunity hitherto the few uncontrolled would be manage as the nature takes its course in terms of disease severity.

Is in it strange; that some people with Covid takes a long route map to final fate and destiny where as many checkout un-noticing.

How come a virus with same virulence endangers many whereas most wean away unchecked without after effects.

Stats define lethal fatality ratio in limited percentage with variant mean involving ages in almost every facet of milestone.

And again in spite of ruthless turnout of the disease as engraving course from no symptom to critical yet similar toppling and symptom free retaliation by most individuals remains the fate of virus as well.

This twin behavior of the virus or body clearly explains the different reaction of the body or virus and thereafter action and reaction of the body to virus and disease.

Till now and with backup information of previous viral epidemics it has been under observation that body immunological response is creating a pivotal role in disease progression and recovery.

Studies suggest that cytokine storm might explain why disease has different modes of course in different individuals

Same lies with the fact that virus has different strain in different situation hence variant virility and different body response to variant discrete exposure.

As such stats and strategy works needs to quantify cases in terms of all such aspect that predisposes disease and exposes individual with its factors that are calibrated and counted within the contextual support of virus affectivity.

The Pars may be supported by the fact that younger’s are less affected compared to older people and female are less affected than male thus sliding the score to well above when it’s a matter of senior citizen though being a real time study all such findings have minute changes and will remain as such till the graph of disease and epidemic becomes static for studies.

The same goes to body innate response to virus and disease hence body’s immune reaction to the antigen thereby rating a list within questionnaire with the primary melt as why there is a different immunological response of the body to virus or disease exposure?

This Attention to immunological response took flight of interest due to the fact that the virus has close resemblance to the previous counter part responsible in previous epidemic that had similar fatalities of disease process.

Scooping the grave fatality of the course and pattern of Covid- 19 disease process in real time and the previous encountered observation and inference of its epidemic counter parts in 2005; cytokines took the plight of interest hence its role that was being overshadowed by pre-clinical to sub-clinical threat and fear of virus.

Regardless of suggested theories and hypothetical misnomers we must understand that it’s a new virus and is in real time so what we see and hear today can out rightly be disown or rejected tomorrow.

Yet theses minute changes that are brought about actually are the proclamation of remedy as a step up no matter what is added or subtracted during the course and run of pandemic in terms of management modalities.

So far and till now it is said that the fatality and seriousness of the disease and illness is due to the layman fact that immune system goes wild and uncontrolled that makes virus a threat to known destination by an unknown path.

Here my request would be not to take most of this upcoming discussion as a compulsive medical theology and theory where words and manners have ethics of formulary and abbreviations rather explanatory phrases.

Lets not take this extra-curriculum of defining and redefining medical terms in a professional manner but a little in a manner where unprofessional masses at large can assimilate the myth behind disease as beneficiary.

Immune system:

A defense mechanism to fight foreign invader in a body with many physiological and biological component;

Immunity:

Immunity is simply resistance of the body against an invading organism commonly known as antigen.

It’s a balance state of biological defense of an organism or cell to fight against invasion of unrecognized enemy.

Immunity can be

  • Innate and adaptive system
  • Acquired system

Innate system is programmed to recognize and react where as adaptive system is programmed to recognize own substances and not to react.

Inflammation:

The reaction to foreign substance is called inflammation.

Immuno-tolerance:

The non-reaction to own substance is termed immun-otolerance.

Immuno-suppression:

Immuno-Suppression is a reduction in the activation or efficacy of the immune system.

Immuno-Suppressant:

Immuno-suppressant is the method of deliberately induced Immuno-suppression in optimal circumstances.

Immunodeficiency:

Immunodeficiency is a state in which the immunity to fight against infection, disease and invader is compromised to subnormal level of immune system or entirely absent.

Most cases of immunodeficiency are acquired secondary due to extrinsic factors that affect the patient’s immune system.

Opportunistic infection

Opportunistic infection is an infection caused by pathogens (bacteria, viruses, fungi, or protozoa) resident or non-resident that take advantage of an opportunity not normally available.

Many of these pathogens do not cause disease in a healthy indivisual that has a normal immune system.

However, a compromised diseased immune system, in a debilitated individual with lowered resistance to infection becomes disease by it s own commensals.

Commensals:

Commensals are Organism that resides normally on individual with symbiotic or mutualism based biological interaction with or without benefit.

Auto Immune disease:

When immune system reacts against it own substance or cell. This self inflicted injury is due to the abnormal behavior of the own immune system.

Health:

Health is a state of well being, with no infirmity or disease.

Technically when self substance is immunologically spared and foreign invader is immunologically eliminated state of equilibrium is called the health.

Disease:

A disrupted state of well being

Technically as per context a disease is when foreign invader cannot be eliminated or when what is self is not spared.

  • Innate immunity:

Innate immunity is a natural immunity acquired through genetic make-up without an external stimulation or exposure to previous infection.

It is divided into two types:

  • Non-Specific innate immunity

It offers a degree of resistance to all infections in general.

  • Specific innate immunity

It offers resistance to a particular kind of microorganism only.

  • Adaptive (Acquired) immunity:

It is divided in to two;

(a)Naturally acquired

It is acquired through chance contact with the organism.

(b)Artificially acquired

It is through deliberate action such as Vaccination

Immunity (Organogram of divisions)

  • Innate immunity

(Natural vide genetic material)

  • Adaptive (acquired )Immunity
  • Natural
  • Passive vide (Maternal)
  • Active vide (Infection)
  • Artificial
  • Passive vide (Antibody Transfer)
  • Active vide (Immunization)

It is still debatable whether a person is completely immune for life after exposure and recovery for immunity after any infection can range from life-long and complete to nearly non-existent.

Corona viruses, a large group of viruses that jump from animal hosts to humans

Much of our understanding of corona virus immunity is not from SARS or MERS but from the seasonal corona viruses that spread every year causing respiratory infections ranging from a common cold to pneumonia.

In two separate studies, researchers infected human volunteers with a seasonal corona virus and about a year later inoculated them with the same or a similar virus to observe whether they had acquired immunity.

Multiple assumptions with predicted theories are in run for this family of virus where a slight change in viral strain or number of years results in loss of immunity from partial to no immunity.

Same goes to the SARS and MERS virus where number of passing years reduces immunity to the virus replication on re exposure.

Corona Virus:

Corona viruses in general are family of viruses that targets and affects mammal’s respiratory system.

There are four main genera of corona virus which are called

  • Alpha
  • Beta
  • Gamma
  • Delta

Most of these viruses affect animals but few can also cross the barrier to human thus transmit disease to human.

The genera that crosses barrier are alpha and beta genera and the common carrier are bats, civet cats, pangolin, and dromedaries or camel through intermediary animal.

The sequence genomic DNA structure of corona SARS-COV- 2 has resemblance to two bat viruses with 88 % resemblance in genomic sequence.

  • SL-CoVZC45
  • SL-CoVZX21

It is also suggested that new virus DNA is about 79 % similar to SARS Corona Virus and 50% similar to MERS Virus

Recently it is suggested that pangolin is the initial propagator as its genomic DNA sequence is 99% of corona virus specific to these animal

Its incubation is 5-6 (any where up to 14 days new WHO advisory) days that is the virus takes 5-6 days to give rise to symptom.

It has been observed that symptoms of Covid -19 with other respiratory ailment are very difficult to distinguish until it is done by a specific specialist test that discloses and matches the viral DNA SARS- Cov-2.

As such we shall keep this in mind that not all symptoms are viral and not all diseases are viral.

Recent studies suggest that variant strains of corona viruses have spread in different parts of the globe and theses are;

  • Type A

Type A is closest to virus found in bats and pangolin

It was the root cause of the outbreak.

Two sub Cluster of the viruses have been found with one linking to Wuhan while other to America and Australia Spain, Chile

  • Type B

Derived from type “A” mutation that mutates slowly in china and rapidly outside china such as UK, Belgium, France, Japan, Brazil, Canada, Germany, Finland, Denmark

  • Type C

Its daughter to Type “B” and mutation spread to Europe, Singapore, and Hongkong, Italy

Patho-Physiology of Covid -19:

Cytokine Storm:

Practically specking cytokines are the signaling molecule that alert immune system and an immune system that go wild create a cytokine storm or precisely the immune system starts harming rather helping.

Normal structured and signature stand of the immune system is to encounter any germ entering the body in an orderly and controlled environment and cascade.

However sometimes reaction to the invader takes the plight of hit and hammer without the torch test or testament thus like an uncontrolled mob with heavy weaponry as if coup against its own orderly fashion creating a messy war of sludge without flush.

As such plea to recognize own is sacrificed rather butchered and none among shall it be an invader or its own are ruined and run thus destroying own self and own tissue taking them as enemy, as well.

This is a devastating immune response with auto immune activation under the umbrella of dozens of small protein herd broadly known as cytokine storm.

Cytokines are protein made by certain immune and non immune cells which has an effect on immune system.

They can be made in lab as well and are used in grave and lethal diseases as immune modulators.

Examples of cytokines are interleukin, interferon and colony stimulating factors and are immune modulator that can cause flue like symptom matchable and almost similar to what can be predicted and isolated in this pandemic Covid -19 infections.

Increase activity of cytokine increases immune response sluddging and crossing the limit of affected area thereby destroying the unaffected vessel as well by a vicious cycle of torn and tear without fear.

Resultant is clotting cascade and sluddging, choking, decrease blood flow organ failure.

Containment and curtailing cytokine storm is the current chapter of biblical verses of the doctors at the moment.

All efforts are being prayed and exhumed to isolate alert sign of undergoing cascade before a irreversible chain of event takes its start.

Many factors have been isolated that alerts such ruthless process as has been signature and signed since they are found in high quantity as indicator. Among them are;

  • Ferritin
  • CRP
  • IL- 6
  • IL-2R

Cytokine storm has been linked to pandemics since early and is said that there may a genetic mutation variant that had made immune system to overreact.

One must bear it’s hard to fight when immune system is compromise.

Person carrying mutated gene have mutated protein that react differently from normal and perhaps the same explains different percentage of severity in different individuals inflicted with Covid-19.

Such mutations serve the function of destruction from distracted recognition to impediment of flow or trafficking.

It is said that women’s have inherent genetic superiority on corona pandemic with her dual X-chromosome this is by a TLR -7, a specific gene that helps to recognize single stranded viruses and as such women bearing 2-X has advantage over man in early recognizing.

One of the genetic superiority of female over male is because testosterone inhibits immune system where as estrogen enhances immune system.

A Covid -19 uses its spike protein to enter in to the cell by unlocking protein on the surface of the cell known as ACE 2 protein that is found on the surface of X chromosomes.

.

As such if a man encounter Covid -19 with a spike protein it unlock the ACE2 thus entering cell there by more susceptible to female which has better advantage of recognition with 2X.

Thus an immune system is typically body’s personal army that works from cellular to macro level playing a pivotal role in warding off invading organism hence guarding against internal or external threat.

It is to be elaborated here that being a RNA virus it has high mutation rate which when combine with natural selection quickly adapt to changes in host.

Such enhanced level of mutation and transfer of genes in offspring also makes development of vaccination as unwanted problem with often resistance in drug prescription.

Presently there is a proposed story that stray dogs intestine might have contributed to the origin of pandemic where as animals like snakes and pangolin have all been put forth as intermediate host in spreading of disease.

It is said that Ancestor of SARS Cov-@ infected the intestine of the Canid(A closely resemble mammal in dog family) resulting in evolution of the virus and jump in to human(Dr Raza)