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#16
03-08-2022, 05:02 PM
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#17
03-08-2022, 05:31 PM
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OP,
Just something to consider: OPINION GUEST ESSAY Why Do Some People Never Get Covid? March 8, 2022 Credit...La Tigre Daniela J. Lamas By Daniela J. Lamas Dr. Lamas, a contributing Opinion writer, is a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston. Leer en español This article is part of Times Opinion’s reflection on the two year mark of the coronavirus pandemic. Read more in a note from Alexandra Sifferlin, Opinion’s health and science editor, in our Opinion Today newsletter. As an intensive care unit doctor, I often find myself thinking about the apparent randomness of infectious disease. Two people go out to dinner and have the same meal; one ends up in the emergency room with food poisoning, but the other does not. The seasonal flu runs through an entire family, except for one individual who remains healthy. A case of mono can be a bad memory for one person and turn into a death sentence for another. Doctors look for the vulnerabilities that we can see to explain these outcomes, like age, vaccination status and underlying conditions, but we are often left without answers. The unpredictability of the coronavirus has made clear just how much we don’t know. Standing at the bedside in the Covid intensive care unit during the first wave, I wondered why young men without identifiable risk factors had become critically ill while their spouses and children were able to manage their symptoms at home. More recently, Omicron has swept through cities, infecting people at a far greater rate than before, and yet some continued to test negative — even if a roommate was positive. Now physicians and researchers throughout the globe are asking, and attempting to answer, similar questions. Dr. Mayana Zatz was taking her usual stroll near her home in São Paulo, Brazil, when she realized she hadn’t seen one of her neighbors for several weeks. When she ran into his wife, Dr. Zatz learned that he had been sick at home with a high fever, a cough and flulike symptoms. Even then, in February 2020, these were telltale signs of Covid. The woman was caring for him by herself, without a mask, and though she had expected to fall ill, too, she was feeling just fine. In the weeks that followed, Dr. Zatz, a geneticist at the University of São Paulo, could not stop thinking about her neighbors. Why had the woman not gotten sick? Could it be that she had avoided infection altogether? Or was she simply less severely affected by the coronavirus? Both her neighbors took coronavirus antibody tests and shared the results with Dr. Zatz; as expected, the man showed evidence of prior infection, but the woman did not. Dr. Zatz spread the word that she wanted to study more discordant couples like her neighbors. She appeared on Brazilian television asking to hear from people who had shared a home and a bed with an infected partner but did not get sick. And to her great surprise, she was inundated with thousands of emails. Her neighbor’s story wasn’t so unusual, after all. Did you know you can share 10 gift articles a month, even with nonsubscribers? Share this article. Since the World Health Organization declared Covid-19 a pandemic in March of 2020, almost exactly two years ago, scientists and health workers have learned a tremendous amount about the coronavirus. The uncertainty and fear of that first spring have given way to clear evidence for how best to treat those who fall ill. We understand routes of transmission, and in the United States we are lucky to have access to effective vaccines and testing. Many of us are fortunate to lead lives that are no longer so limited by this virus. But why some people do not become sick despite significant exposure remains a mystery — one of the most important of the pandemic. A global network of scientists, Zatz prominent among them, believes crucial clues may lie in our genes. * Dr. Zatz has long suspected that genetics might be at play in why people have dissimilar reactions to the same disease. Early on in her training, she found herself drawn to studying muscular dystrophy — asking how two boys with the same genetic mutation could have such different degrees of disease, one ending up in a wheelchair at a young age, the other remaining highly mobile. Before the pandemic, she was also focused on the divergent effects of the Zika virus on twins. After observing sets of fraternal twins who had been exposed to Zika in the womb (one born with severe birth defects and the other somehow unimpaired), her lab was able to show that this difference was also likely driven by genetics. Now as the pandemic tore through Brazil, Dr. Zatz once again set out to discover whether there were genes that protect people from illness and its effects and whether there are individuals who are naturally resistant to this virus. Her lab got to work collecting blood samples from 100 of the couples that reached out to her after her television appearance. The researchers found that the infected and uninfected members of the couple were similar in terms of age and ancestry, though men were more likely to have fallen ill with the virus. Editors’ Picks Beyond Beyoncé Fame, Awol Erizku Expands What Black Art Can Be The Hidden Story of the North’s Victory in the Civil War Once Obscured in the U.S., Lao Cooks Share and Celebrate Their Cuisine Dr. Zatz and her colleagues believe that no single gene mutation could affect the response to the coronavirus, and so they instead looked for combinations of genes that could be at play. They ultimately found variants in genes of infected people, as compared to those of their asymptomatic partners, that influence the activity of natural killer cells, a key component of the immune system. Partners who showed no sign of infection were more likely to have a robust natural killer cell response, which could result in a stronger defense against infection. This does not mean that all who avoided disease did so by virtue of these genes, and Dr. Zatz’s team chose to focus on this one aspect of the immune response when there are likely many others at play. But the findings offered one piece of a puzzle. Today Dr. Zatz’s lab, which has become well known for its research on Covid resistance, is also looking for answers from a population that would, on the face of it, seem the most vulnerable to the coronavirus: centenarians. Her team has collected blood samples from 100 individuals older than 90, including 15 centenarians, one of them a remarkably healthy 114-year-old. All of these people made it through infection relatively unscathed or were exposed to the virus but were never symptomatic. Focusing on this population, which would normally be considered extremely high risk because of their advanced age, could help isolate a genetic factor that explains Covid-19 outcomes. Dr. Zatz’s team will infect some of their cells in a lab with the Delta and Omicron variants to see if they can identify which mechanisms — including perhaps the function of natural killer cells — might offer this powerful protection. “If we really can find out what the resistant genes are and what they do, I think we can find new treatments,” Dr. Zatz told me. “But that will take some time.” One of the other key figures studying why some people seem resistant to Covid is the pediatric immunologist and geneticist Dr. Jean-Laurent Casanova of Rockefeller University. He is also on the hunt for genetic markers for Covid resistance at his lab in New York and Paris. Along with an international team of scientists, he recently published a worldwide call for individuals with protracted coronavirus exposure who never tested positive. He has already fielded more than 10,000 emails from people around the globe, including from Siberia, Patagonia and Indonesia, all willing to have their genomes sequenced. “We’re sending saliva kits to the four corners of the world,” he told me. Dr. Casanova is also working on the same question in reverse: How is it that otherwise healthy people can develop life-threatening disease? Since his pediatric residency in Paris, where he became fascinated by children who grew critically ill after what should have been a mild illness, he has studied genetic mutations — what he terms “inborn errors of immunity” — that are associated with severe versions of otherwise relatively harmless infections. In 2015 his lab demonstrated that some cases of severe influenza pneumonia might be due to mutations in a gene that controls the immune system’s production of interferons, which are proteins that work to keep viruses in check. This work, he said, was the “base camp” for his study of the coronavirus. So far, Dr. Casanova and his colleagues have identified a small percentage of patients with severe Covid-19 who have mutations in genes involved in interferon, resulting in a hole in the body’s ability to defend itself against infection. These people were all healthy before becoming infected with the coronavirus. He went on to find that at least 15 percent have misguided antibodies that attack interferon and impair its function in the immune response. While Dr. Casanova’s research team is used to findings like these, it is unusual that they account for such a large proportion of cases, he said. “It’s a surprise for everyone in my field,” he told me. It suggests that perhaps scientists could test for these antibodies among people with other vulnerabilities, such as the elderly, in order to understand who is particularly at risk of severe disease. Drs. Zatz and Casanova approached this work with specific hypotheses, ideas about what steps of the immune system might explain susceptibility or resistance to the coronavirus. But that is not the only way to investigate the role of genetics in disease. Dr. Casanova, along with other scientists, also takes a different approach to the same question, using biobanks of genetic data from large swaths of the population to search entire genomes for links between genes and disease. This method is called genomewide association studies. “We let the data teach us what they’re going to teach us,” said Dr. Benjamin Neale, a co-director of the program in medical and population genetics at the Broad Institute in Boston. In March 2020, he and colleagues established the Covid-19 Host Genetics Initiative, bringing together academics and direct-to-consumer companies with genetic databases like Ancestry.com and 23andMe. Knowing that time was of the essence as the virus spread worldwide, the researchers were gratified to find “robust data,” said Dr. Mark Daly, who is the director of the Institute of Molecular Medicine Finland and one of the leaders of the initiative. They described associations between severe coronavirus infection and genetic variants related to how the immune system responds to infection, including genes involved in the function of interferon. They also found associations between severe illness and genetic variants that are associated with other lung diseases, like interstitial lung disease and lung cancer. Finding connections like these does not definitely prove that the variants play a role in a person’s response to Covid, but they suggest a possible connection for further exploration. * The work of this network of researchers has drawn attention to a field of study that has not often found itself in the spotlight. Though researchers have studied genetic susceptibility and resistance to H.I.V., tuberculosis and malaria, there has never been such a large-scale effort to understand the role genetics might play in the response to one specific infection, with multiple studies and results at one time. Of course, there has never been a novel virus that has so thoroughly shut down and reshaped society at a time when scientists have had gene sequencing tools at their disposal. “The host response to infectious agents has not nearly gotten the attention from genetics that rare diseases, common chronic diseases and cancer have,” Dr. Daly noted. “The knowledge gained here, the understanding of both susceptibility and severity, has opened my eyes to how much more genetics can teach us about infectious disease biology.” Genetics is complicated. Often there’s a lot of noise, especially as a pandemic evolves. For one, understanding why someone might not get Covid-19 becomes more difficult as factors like vaccinations, boosters and prior infections now play a role in how people fare against the virus. Even the question of whether something as simple as blood type is related to Covid-19 outcomes — a focus early on in the pandemic — has been fraught with conflicting science and is still not something that we doctors view as meaningful at the bedside. To make things more challenging, people’s behaviors and environment can affect the way their genes work. “As geneticists, we’re exceptionally practiced at identifying areas of the genome that matter somehow, but we have a long way before we can turn that ‘somehow’ into an understanding of the consequence to a particular illness,” said Dr. Neale. “That is simply where we are with genetics. It’s amazing, but it’s also very frustrating.” And even the deepest understanding of the genetics of a disease does not guarantee that scientists can develop a drug that works. To make matters more complicated, genetic mutations can have positive and negative effects simultaneously: The same genetic variant that can lead to H.I.V. resistance might also increase susceptibility to West Nile virus. But if there was ever a time to move a field forward through worldwide collaboration and tens of thousands of people willing to offer their genetic information to help spur research, this is it. Just as a Covid vaccine was developed on a time scale many felt impossible, so, too, might genetic research into disease be advancing in huge bounds that in normal times might seem implausible. “I think that this pandemic has bridged two communities that haven’t worked closely enough together,” Dr. Daly told me, referring to the fields of genetics and infectious disease. And this is just the beginning. When I started to think about genetics playing a role in this disease, I worried that in telling a story about our genes, we would shift our attention away from the social failures that have exacerbated the virus’s toll. Any scientist will tell you that observable factors like underlying conditions and age and environmental contributions that determine exposure play a major part. People who don’t have access to health care or are living in crowded, underserved nursing homes are likely at far greater risk than those with certain genetic markers who have the luxury of being able to keep themselves safe. But that is not the only way to tell this story. Instead, the power of genetics is about making sense of randomness and understanding biology and in doing so, removing blame from the individual. I recently spoke with a former Covid-19 patient who had nearly died from the disease while her parents remained largely healthy despite living with her in the days before she became symptomatic and tending to her. She said that people who learn what happened to her are always searching for an explanation, for some clue as to why a young and healthy woman nearly died from this virus. There must have been something that she did that put her at risk. “I think people are so uncomfortable with randomness that they victim-blame. They remove themselves from the tragedy,” she said. “I have lost control of my life, essentially. And people do not want to believe there’s randomness in that, because it frightens the living hell out of them.” It is unlikely that we will ever have a complete explanation for every individual who grew severely ill and everyone who did not. But perhaps what this work on genetics can offer us is a way to come to terms with the truth that any of us might be vulnerable. There are the vulnerabilities that we can see, like age and underlying medical conditions. And there is also vulnerability that is less visible, that is maybe even encoded in our genes. But our genetic code is just where it all starts. Dr. Zatz’s neighbors both did well, ultimately. The man recovered while the woman still has not been infected, at least not symptomatically. Was this because of their genes? Scientists might never know. Ultimately, our genes are just one piece of the impossibly complex story of this virus, a story that we will tell and retell in the years to come. Last edited by bironi; 03-08-2022 at 06:58 PM. Reason: stupidity
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#18
03-08-2022, 06:37 PM
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#19
03-08-2022, 07:08 PM
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#20
03-08-2022, 07:14 PM
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Thanks for the shares so far. Please keep them coming. I’m seeing a wide variety of experiences. Thankfully, most of you have recovered quickly and very well. I feel terrible for those who have not and wish you the best. Again, please post your experiences if you are comfortable sharing.
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#21
03-08-2022, 07:28 PM
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Got Covid April of 2021. The week I was supposed to get my vaccine.
Mild symptoms. Fatigue for a few days. Fairly fast recovery. But plateaued around 90% at around 4-5 months in and have been that way since. At 11 months in. My heart feels ok, but feel pressure in my chest when I breathe in. Like one of my kids is sitting on me. Used to run 10-12 miles at a decent pace. But now I’m done at 5-6 miles at a slightly slower pace. Similar with cycling.
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#22
03-08-2022, 07:30 PM
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Not sure this thread is going to reveal much other than that individual responses to the virus vary greatly. Last edited by parallelfish; 03-08-2022 at 07:36 PM.
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#23
03-08-2022, 08:15 PM
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#24
03-08-2022, 08:23 PM
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Recently they removed the "you must wear a mask" requirement at work.
All these folks who've been vaccinated but still got a moderately bad case are leading me to wonder about that. I guess the moral of the story is that you still need to be careful, and consider wearing your mask if you're in say, a conference room with lots of other people.
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#25
03-08-2022, 08:30 PM
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I'm 61, I got sick on 2/7 with it, I'm simply amazed that I avoided it for so long. It came on very fast, at 3am I woke up with a scratchy throat, assumed I had been sleeping with my mouth open. My alarm went off at 5:30, full on sore throat, by 7 I felt like I had been beaten with a 2x4 for an hour. I had severe body aches and slept all day and all night. By afternoon the next day I was getting antsy so I putzed around in the shop making a piece of furniture for the 5 day quarantine. I do have a long term effect with some inflammation in my back giving pinched nerve symptoms.
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#26
03-08-2022, 10:39 PM
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Had COVID over this past new years. Age 40, vaxxed. 1 night with mild fever, then the following 4 days hellish back aches, muscle aches, mild headaches, sore throat at the very end of it all. Was back on the bike just a few days later. Felt pretty normal. Eased back into my training. Was able to hit my workout targets a week after symptoms were completely gone. Nothing since. No long term issues. Will get my booster next week.
Last edited by CAAD; 03-08-2022 at 10:41 PM.
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#27
03-08-2022, 11:06 PM
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I've had it 3 times, mild each time, but long covid after
March 2020, sick for 3 days, day one temp 104, day two-three 101 and super tired, no sense of taste. "recovered" just as quickly, but a few weeks later experienced HR of 165 trimming roses or walking upstairs plus shortness of breath/air hunger when I tried exertion like jogging/biking. I saw doc, passed "stress test" that would have been a joke the year prior, but since nothing scary on ECG or stress test, he didn't care and had nothing to offer.
I did get vaccinated when the VA offered, and boosted when that was allowed and I could get an appt. I VERY Slowly got better and was backing to running 1 hour at a 9-10 min mile pace when I broke my ankle in Feb '21. Recovered from that and was back to decent shape when I went to Big Bear CA in August '21 and got a breakthrough. Very mild, just headache and fatigue for 2 days, but again unable to do any exertion again with HR 160-200. That took until the week of Dec 18th 2021 to get better, but got better more rapidly. Then in January 2022 my wife got Omicron, I had only a day or 2 of mild cold symptoms but then once again now have the same shortness of breath and high HR. I hope it resolves, and faster than before. Bottomline, I'm thankful it isn't worse, but it is frustrating. I forget stuff, like I've gone on errands a few times with no wallet, and forget what I was about to look up or why I entered a room or have no memory of certain conversations, but that was worse the 1st bout, and it was never so bad it bothered me like the inability to jog or ride hard. I am much worse when not well hydrated or when it is hot: direct radiant heat from the sun is worse than the absolute temp, and being in san diego county has tested that too many times good luck
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#28
03-08-2022, 11:16 PM
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I’ve read quite a few stories about athletes and post COVID issues, people seem to be coming to a general consensus to take it quite easy for something like 6 weeks after getting Covid to help prevent problems. Haven’t seen any actual studies that back this up.
Sent from my iPad using Tapatalk
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#29
03-08-2022, 11:26 PM
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If I feel good after getting covid I will continue "as normal" other then stopping group rides and such, but will go solo. I'm vax'd and boosted, but I prefer to stay away from it as long as possible, as I've recently lost someone to covid so I'm going to go on protecting myself.
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#30
03-08-2022, 11:37 PM
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I had COVID October 2020 at age 54. I wasn’t hospitalized, but had trouble breathing for a week, passed out at urgent care then had a bad headache for a week. Lost six weeks of riding time, but slowly ramped up through 2021. Got vaxxed with phizer in March/April of 2021, first dose lost a week of riding. Felt like a mild case of COVID. Second dose wasn’t as bad but still didn’t ride for a week, no energy.
In mid January this year got COVID again, but it was mild. Fatigue and body ache with the sniffles were my symptoms. Lost two weeks of riding, got my booster and lost another week with fatigue. I have days here and there since my first bout where I have no energy and while I get through my work day fine I have no desire to exercise. Since December I have also developed some heart/chest discomfort, but never while riding. I have seen a doctor and they did some labs on my blood, which were all normal. Had an ekg which was normal. Was referred to a cardiologist and he said he thought I was fine, but I have a echocardiogram next week and a stress test in May to rule anything out.
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