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Months of Trial and Error in the ICU Offer Clues on How to Save Covid Patients

Faced with an unmanageable influx of coronavirus patients at Columbia University Irving Medical Center’s step-down unit, an intermediate care ward, Jelic made an unorthodox decision: she asked those struggling to breathe to roll onto their bellies while they waited for intubation to mechanically ventilate their inflamed lungs.

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It wasn’t a random guess. Laying patients in the stomach-down prone position is known to improve oxygenation in sedated, intubated patients with acute respiratory distress syndrome. But there was no guarantee the same would hold true for wakeful Covid patients who were gasping for air.

“We had to buy time,” Jelic, who is also an associate professor of medicine at Columbia University, recalled in an interview. “I remember, the first three patients really had a dramatic improvement in their oxygenation.”

In the absence of a cure, doctors like Jelic were left relying in part on trial and error, but months into the most destructive pandemic in a century, their collective experience is starting to build a framework of how best to cope with coronavirus patients.

As many as 1,000 Covid-related research papers are being released daily ahead of peer review and publication, according to Soumya Swaminathan, the World Health Organization’s chief scientist. “Our goal is to see that the learnings from science are as quickly as possible channeled into impacts for patients and communities,” she told reporters in Geneva on Thursday.

‘How You Do It’

The collective experience may be showing results. U.S. deaths, which often ranged between 2,000 and 3,000 a day in April and May, have mostly remained below 1,000 and in the low hundreds since the beginning of June.

The WHO is collating data from countries to identify crucial elements that reduce mortality. These include how health systems triage Covid-19 patients, how they protect those vulnerable to more serious complications, and the speed with which they provide intensive care.

The goal is to create a tool box that will enable doctors to provide better care for the full range of patients with Covid-19, which has turned out to be more than just a respiratory disease, said Sylvie Briand, the WHO’s director for global infectious hazard preparedness.

“It’s not only what you do — sometimes at this level there is no difference — but it’s how you do it,” Briand said in an interview.

Better Practiced

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, also credits better experience with medicines.

“Whenever you’re in an outbreak, there are two things about treatment that contribute to improvement,” he said. “Not only do you get better in practice, but you get better because of new treatments.”

In April, Gilead Sciences Inc.’s antiviral remdesivir, now approved with the brand name Veklury, was shown to speed recovery time. Last month, the inexpensive corticosteroid dexamethasone was found to reduce deaths by one-third among patients receiving mechanical ventilation. Doctors are also routinely administering heparin and other anticoagulants to prevent dangerous blood clots from forming in the veins of the critically ill.

Although the “awake proning” approach Jelic and colleagues tried hasn’t been properly studied yet in a large clinical trial, it points to a cheap and simple way overwhelmed health centers may be able to help severely ill patients. Their research, published in a June 17 letter to the Journal of the American Medical Association, indicated that it reduced the probability patients would need intubation. The journal also published an invited commentary subtitled “necessity is the mother of invention.”

“I couldn’t agree more with the title,” Jelic said. “I have never seen this much strain on our ICU resources.”

Laying on the stomach improves blood circulation in the upper portion of the lung, she said, increasing the volume of oxygen and carbon dioxide that can be exchanged. It also decreases pressure around the lung, and can help clear secretions from the airways, studies show.

While combination treatments — the HIV medications ritonavir and lopinavir, and the antimalarial drugs hydroxychloroquine and chloroquine with the antibiotic azithromycin — failed to reduce death in hospitalized Covid-19 patients, there’s optimism for others. These include antibody-based therapies and blood products from survivors.

‘Cytokine Storm’

The antiflammatory infusion infliximab, sold by Johnson & Johnson and Merck & Co. as Remicade, is being studied at Tufts Medical Center in Boston as a way of circumventing the major cause of lethal complications in a subset of Covid-19 patients: A damaging immune response, sometimes referred to as a cytokine storm, that usually occurs in the second week of illness.

Infliximab blocks tumor necrosis factor-alpha, a cell-signaling protein or “cytokine” that plays a key role in driving the immune system to exhaustion in response to infections, said Paul Mathew, a Tufts cancer specialist, who’s leading the study. The medicine may also help avert life-threatening blood-clotting problems that can occur in Covid patients.

“Little by little, we discovered new signs and symptoms of the disease,” said the WHO’s Briand. “Now we know that there is really a lot of possibilities for this virus to attack the human body.”

These range from a sudden lack of smell to a multi-system inflammatory syndrome in children — features that have become more apparent with more than 11 million Covid cases worldwide. Others include clotting-related disorders that can be benign skin lesions on the feet, sometimes called “Covid toe,” or potentially lethal strokes.

The more Covid patients Jarrod Mosier sees in his hospital’s intensive care unit in Tucson, Arizona, the more he says he’s convinced that saving lives comes down to protecting the lungs of those with acute respiratory distress syndrome, or ARDS, caused by pulmonary inflammation. Most patients need breathing support, but too little or too much air pressure and volume can damage the lungs further.

“I look at all of those things and tinker with the ventilator for a good while everyday to try to find that balance,” said Mosier, who is also an associate professor of emergency medicine and medicine at the University of Arizona. “To me, that is the thing that will save the most lives in this disease — just excellent critical care management of ARDS.”

Mosier said he’s hoping it results in better patient survival. “I think that’s the case, but it’s very hard to answer that question when you’re in the thick of it,” he said. “Some days I think we’re actually getting pretty good at this. And other days I think, ‘This is demoralizing.’”

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D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

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Company shares shocking model of future remote worker as pandemic continues

Millions of American workers became remote employees overnight when the coronavirus pandemic hit earlier this year, and the future isn’t looking too bright for those who fail to maintain healthy habits while working from home in the long-term, new findings claim.

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Job discovery platform DirectlyApply recently unveiled a visual model for what future remote workers might look like in 25 years if they don’t reform bad habits now, in a figure they’ve named Susan.

Suffering from digital eye strain, poor posture, “tech neck,” obesity, increased stress due to lack of human contact and more, Susan dramatically exemplifies the physical repercussions remote workers may suffer if they fail to prioritize their physical and mental health beyond their 9 to 5.

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Suffering from digital eye strain, poor posture, tech neck, obesity, increased stress due to lack of human contact and more, Susan dramatically exemplifies the physical repercussions remote workers may suffer if they neglect to keep healthy habits.

Susan was created in partnership with a team of clinical psychologists and fitness experts to highlight the effects that isolated working can have on the body, according to DirectlyApply.

“With lockdown having forced people across the globe into what has been the world’s largest remote working experiment, our usual interpretation of the perk has been transformed forever,” a spokesperson for the job-searching site said in a statement shared with Fox News. “Whilst your bed-to-desk commute may allow for more free time and independence, will the physical repercussions to your mind and body be worth it in the future?”

With that being said, the London-based job searching site, which also operates in the U.S. and Canada, shared positive tips for improving physical and mental health while working remotely, amid an uncertain future.

To improve health and wellness during this time, remote workers are encouraged to stick to a routine to optimize productivity, nurture (virtual) social connections with colleagues, exercise outside, clearly delineate between working and living spaces to promote a healthy work-life balance and use free time wisely to support emotional health.

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D’OXYVA is the only fully noninvasive, completely painless over-the-skin microcirculatory and nerve stimulant solution that has been validated to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways, including but not limited to weight loss, recover from injury, improved performance, besides diabetes and heart health.

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FDA says a coronavirus vaccine would have to be at least 50% effective to be approved

The FDA has issued emergency approval for a vaccine only once, for an experimental anthrax vaccine in 2005. The FDA had originally declined to issue an emergency use authorization, but the Department of Defense pushed for one due to concerns over possible anthrax attacks against U.S. military forces. 

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Vaccine-associated enhanced respiratory disease

A clear concern in the FDA’s guidance for the coronavirus vaccine is whether vaccine candidates might cause enhanced respiratory disease —not only failing to decrease the severity of COVID-19, but causing it to get worse. 

While rare, data from animal studies in some vaccine candidates for other coronaviruses, such as SARS-CoV and MERS-CoV, has raised concerns regarding COVID-19, the FDA said.

Infecting healthy people to test a vaccine

The FDA also said challenge trials could be considered to test COVID-19 vaccines. In those trials, healthy people are intentionally infected to see if the vaccine keeps them from getting COVID-19.

That might be necessary if there were so little SARS-CoV-2 virus circulating that it was no longer possible to study whether a vaccine was effective.  If there’s no chance people who’ve gotten test injections could get infected, it wouldn’t be possible to test whether the vaccine works.

US coronavirus map: Tracking the outbreak

The agency made clear in its document that challenge trials are not ideal. “Many issues, including logistical, human subject protection, ethical, and scientific issues, would need to be satisfactorily addressed,” it said. 

Side effects, public trust could undermine vaccine

There are several possible downsides to issuing a vaccine prematurely.

Side effects and bad outcomes may be rare enough that they appear only when many people receive the vaccine, or after enough time has passed for them to appear. That could give fuel to anti-vaccine groups that claim without evidence that vaccines are harmful.

Some people could be scared away from the vaccine if they don’t believe it has been properly and thoroughly tested. If people won’t take the vaccine, it doesn’t matter how soon it’s available.

Paul Offit, a vaccine expert at the University of Pennsylvania, has spoken of the possibility that a vaccine could be unveiled as an “October surprise” and the harm that could cause. The FDA’s guidance made him less concerned, he said.

“I think this is all very reassuring,” he said. “Now all they have to do is follow their own guidelines.

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HOW D'OXYVA CAN HELP?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

physician-recommended easy to use daily

HOW D'OXYVA CAN HELP?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

Reduce unwanted doctor visits, recommended and ranked top by experts!

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This coronavirus mutation has taken over the world. Scientists are trying to understand why.

When the first coronavirus cases in Chicago appeared in January, they bore the same genetic signatures as a germ that emerged in China weeks before. But as Egon Ozer, an infectious-disease specialist at the Northwestern University Feinberg School of Medicine, examined the genetic structure of virus samples from local patients, he noticed something different.

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A change in the virus was appearing again and again. This mutation, associated with outbreaks in Europe and New York, eventually took over the city. By May, it was found in 95 percent of all the genomes Ozer sequenced. 

At a glance, the mutation seemed trivial. About 1,300 amino acids serve as building blocks for a protein on the surface of the virus. In the mutant virus, the genetic instructions for just one of those amino acids — number 614 — switched in the new variant from a “D” (shorthand for aspartic acid) to a “G” (short for glycine).

But the location was significant, because the switch occurred in the part of the genome that codes for the all-important “spike protein” — the protruding structure that gives the coronavirus its crownlike profile and allows it to enter human cells the way a burglar picks a lock.

And its ubiquity is undeniable. Of the approximately 50,000 genomes of the new virus that researchers worldwide have uploaded to a shared database, about 70 percent carry the mutation, officially designated D614G but known more familiarly to scientists as “G.”

“G” hasn’t just dominated the outbreak in Chicago — it has taken over the world. Now scientists are racing to figure out what it means.

At least four laboratory experiments suggest that the mutation makes the virus more infectious, although none of that work has been peer-reviewed. Another unpublished study led by scientists at Los Alamos National Laboratory asserts that patients with the G variant actually have more virus in their bodies, making them more likely to spread it to others.

The mutation doesn’t appear to make people sicker, but a growing number of scientists worry that it has made the virus more contagious.

“The epidemiological study and our data together really explain why the [G variant’s] spread in Europe and the U.S. was really fast,” said Hyeryun Choe, a virologist at Scripps Research and a lead author of an unpublished study on the G variant’s enhanced infectiousness in laboratory cell cultures. “This is not just accidental.”

But there may be other explanations for the G variant’s dominance: biases in where genetic data are being collected, quirks of timing that gave the mutated virus an early foothold in susceptible populations.

“The bottom line is, we haven’t seen anything definitive yet,” said Jeremy Luban, a virologist at the University of Massachusetts Medical School.

The scramble to unravel this mutation mystery embodies the challenges of science during the coronavirus pandemic. With millions of people infected and thousands dying every day around the world, researchers must strike a high-stakes balance between getting information out quickly and making sure that it’s right.

A better lock pick

SARS-CoV-2, the novel coronavirus that causes the disease covid-19, can be thought of as an extremely destructive burglar. Unable to live or reproduce on its own, it breaks into human cells and co-opts their biological machinery to make thousands of copies of itself. That leaves a trail of damaged tissue and triggers an immune system response that for some people can be disastrous.

This replication process is messy. Even though it has a “proofreading” mechanism for copying its genome, the coronavirus frequently makes mistakes, or mutations. The vast majority of mutations have no effect on the behavior of the virus.

But since the virus’s genome was first sequenced in January, scientists have been on the lookout for changes that are meaningful. And few genetic mutations could be more significant than ones that affect the spike protein — the virus’s most powerful tool.

This protein attaches to a receptor on respiratory cells called ACE2, which opens the cell and lets the virus slip inside. The more effective the spike protein, the more easily the virus can break into the bodies of its hosts. Even when the original variant of the virus emerged in Wuhan, China, it was obvious that the spike protein on SARS-CoV-2 was already quite effective.

But it could have been even better, said Choe, who has studied spike proteins and the way they bind to the ACE2 receptor since the severe acute respiratory syndrome outbreak in 2003.

The spike protein for SARS-CoV-2 has two parts that don’t always hold together well. In the version of the virus that arose in China, Choe said, the outer part — which the virus needs to attach to a human receptor — frequently broke off. Equipped with this faulty lock pick, the virus had a harder time invading host cells.

“I think this mutation happened to compensate,” Choe said.

Studying both versions of the gene using a proxy virus in a petri dish of human cells, Choe and her colleagues found that viruses with the G variant had more spike proteins, and the outer parts of those proteins were less likely to break off. This made the virus approximately 10 times more infectious in the lab experiment.

The mutation does not seem to lead to worse outcomes in patients. Nor did it alter the virus’s response to antibodies from patients who had the D variant, Choe said, suggesting that vaccines being developed based on the original version of the virus will be effective against the new strain.

Choe has uploaded a manuscript describing this study to the website BioRxiv, where scientists can post “preprint” research that has not yet been peer reviewed. She has also submitted the paper to an academic journal, which has not yet published it.

The distinctive infectiousness of the G strain is so strong that scientists have been drawn to the mutation even when they weren’t looking for it.

Neville Sanjana, a geneticist at the New York Genome Center and New York University, was trying to figure out which genes enable SARS-CoV-2 to infiltrate human cells. But in experiments based on a gene sequence taken from an early case of the virus in Wuhan, he struggled to get that form of the virus to infect cells. Then the team switched to a model virus based on the G variant.

“We were shocked,” Sanjana said. “Voilà! It was just this huge increase in viral transduction.” They repeated the experiment in many types of cells, and every time the variant was many times more infectious.

Their findings, published as a preprint on BioRxiv, generally matched what Choe and other laboratory scientists were seeing.

But the New York team offers a different explanation as to why the variant is so infectious. Whereas Choe’s study proposes that the mutation made the spike protein more stable, Sanjana said experiments in the past two weeks, not yet made public, suggest that the improvement is actually in the infection process. He hypothesized that the G variant is more efficient at beginning the process of invading the human cell and taking over its reproductive machinery.

Luban, who has also been experimenting with the D614G mutation, has been drawn to a third possibility: His experiments suggest that the mutation allows the spike protein to change shape as it attaches to the ACE2 receptor, improving its ability to fuse to the host cell.

Different approaches to making their model virus might explain these discrepancies, Luban said. “But it’s quite clear that something is going on.”

Unanswered questions

Although these experiments are compelling, they’re not conclusive, said Kristian Andersen, a Scripps virologist not involved in any of the studies. The scientists need to figure out why they’ve identified different mechanisms for the same effect. All the studies still have to pass peer review, and they have to be reproduced using the real version of the virus.

Even then, Andersen said, it will be too soon to say that the G variant transmits faster among people.

Cell culture experiments have been wrong before, noted Anderson Brito, a computational biologist at Yale University. Early experiments with hydroxychloroquine, a malaria drug, hinted that it was effective at fighting the coronavirus in a petri dish. The drug was touted by President Trump, and the Food and Drug Administration authorized it for emergency use in hospitalized covid-19 patients. But that authorization was withdrawn this month after evidence showed that the drug was “unlikely to be effective” against the virus and posed potential safety risks.

So far, the biggest study of transmission has come from Bette Korber, a computational biologist at Los Alamos National Laboratory who built one of the world’s biggest viral genome databases for tracking HIV. In late April, she and colleagues at Duke University and the University of Sheffield in Britain released a draft of their work arguing that the mutation boosts transmission of the virus.

Analyzing sequences from more than two dozen regions across the world, they found that most places where the original virus was dominant before March were eventually taken over by the mutated version. This switch was especially apparent in the United States: Ninety-six percent of early sequences here belonged to the D variant, but by the end of March, almost 70 percent of sequences carried the G amino acid instead.

The British researchers also found evidence that people with the G variant had more viral particles in their bodies. Although this higher viral load didn’t seem to make people sicker, it might explain the G variant’s rapid spread, the scientists wrote. People with more virus to shed are more likely to infect others.

The Los Alamos draft drew intense scrutiny when it was released in the spring, and many researchers remain skeptical of its conclusions.

“There are so many biases in the data set here that you can’t control for and you might not know exist,” Andersen said. In a time when as many as 90 percent of U.S. infections are still undetected and countries with limited public health infrastructure are struggling to keep up with surging cases, a shortage of data means “we can’t answer all the questions we want to answer.”

Pardis Sabeti, a computational biologist at Harvard University and the Broad Institute, noted that the vast majority of sequenced genomes come from Europe, where the G variant first emerged, and the United States, where infections thought to have been introduced by travelers from Europe spread undetected for weeks before the country shut down. This could at least partly explain why it appears so dominant.

The mutation’s success might also be a “founder effect,” she said. Arriving in a place like Northern Italy — where the vast majority of sequenced infections are caused by the G variant — it found easy purchase in an older and largely unprepared population, which then unwittingly spread it far and wide.

Scientists may be able to rule out these alternative explanations with more rigorous statistical analyses or a controlled experiment in an animal population. And as studies on the D614G mutation accumulate, researchers are starting to be convinced of its significance.

“I think that slowly we’re beginning to come to a consensus,” said Judd Hultquist, a virologist at Northwestern University.

Solving the mystery of the D614G mutation won’t make much of a difference in the short term, Andersen said. “We were unable to deal with D,” he said. “If G transmits even better, we’re going to be unable to deal with that one.”

But it’s still essential to understand how the genome influences the behavior of the virus, scientists say. Identifying emerging mutations allows researchers to track their spread. Knowing what genes affect how the virus transmits enables public health officials to tailor their efforts to contain it. Once therapeutics and vaccines are distributed on a large scale, having a baseline understanding of the genome will help pinpoint when drug resistance starts to evolve.

“Understanding how transmissions are happening won’t be a magic bullet, but it will help us respond better,” Sabeti said. “This is a race against time.”

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Why Use D'OXYVA?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

physician-recommended easy to use daily

Why Use D'OXYVA?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

Reduce unwanted doctor visits, recommended and ranked top by experts!

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Scientists just beginning to understand the many health problems caused by COVID-19

CHICAGO – Scientists are only starting to grasp the vast array of health problems caused by the novel coronavirus, some of which may have lingering effects on patients and health systems for years to come, according to doctors and infectious disease experts.

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Besides the respiratory issues that leave patients gasping for breath, the virus that causes COVID-19 attacks many organ systems, in some cases causing catastrophic damage.

“We thought this was only a respiratory virus. Turns out, it goes after the pancreas. It goes after the heart. It goes after the liver, the brain, the kidney and other organs. We didn’t appreciate that in the beginning,” said Dr. Eric Topol, a cardiologist and director of the Scripps Research Translational Institute in La Jolla, California.

In addition to respiratory distress, patients with COVID-19 can experience blood clotting disorders that can lead to strokes, and extreme inflammation that attacks multiple organ systems. The virus can also cause neurological complications that range from headache, dizziness and loss of taste or smell to seizures and confusion.

And recovery can be slow, incomplete and costly, with a huge impact on quality of life.

The broad and diverse manifestations of COVID-19 are somewhat unique, said Dr. Sadiya Khan, a cardiologist at Northwestern Medicine in Chicago.

With influenza, people with underlying heart conditions are also at higher risk of complications, Khan said. What is surprising about this virus is the extent of the complications occurring outside the lungs.

Khan believes there will be a huge healthcare expenditure and burden for individuals who have survived COVID-19.

LENGTHY REHAB FOR MANY

Patients who were in the intensive care unit or on a ventilator for weeks will need to spend extensive time in rehab to regain mobility and strength.

“It can take up to seven days for every one day that you’re hospitalized to recover that type of strength,” Khan said. “It’s harder the older you are, and you may never get back to the same level of function.”

While much of the focus has been on the minority of patients who experience severe disease, doctors increasingly are looking to the needs of patients who were not sick enough to require hospitalization, but are still suffering months after first becoming infected.

Studies are just getting underway to understand the long-term effects of infection, Jay Butler, deputy director of infectious diseases at the U.S. Centers for Disease Control and Prevention, told reporters in a telephone briefing on Thursday.

“We hear anecdotal reports of people who have persistent fatigue, shortness of breath,” Butler said. “How long that will last is hard to say.”

While coronavirus symptoms typically resolve in two or three weeks, an estimated 1 in 10 experience prolonged symptoms, Dr. Helen Salisbury of the University of Oxford wrote in the British Medical Journal on Tuesday.

Salisbury said many of her patients have normal chest X-rays and no sign of inflammation, but they are still not back to normal.

“If you previously ran 5k three times a week and now feel breathless after a single flight of stairs, or if you cough incessantly and are too exhausted to return to work, then the fear that you may never regain your previous health is very real,” she wrote.

Dr. Igor Koralnik, chief of neuro-infectious diseases at Northwestern Medicine, reviewed current scientific literature and found about half of patients hospitalized with COVID-19 had neurological complications, such as dizziness, decreased alertness, difficulty concentrating, disorders of smell and taste, seizures, strokes, weakness and muscle pain.

Koralnik, whose findings were published in the Annals of Neurology, has started an outpatient clinic for COVID-19 patients to study whether these neurological problems are temporary or permanent.

Khan sees parallels with HIV, the virus that causes AIDS. Much of the early focus was on deaths.

“In recent years, we’ve been very focused on the cardiovascular complications of HIV survivorship,” Khan said.

physician-recommended easy to use daily

HOW D'OXYVA CAN HELP?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

physician-recommended easy to use daily

HOW D'OXYVA CAN HELP?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

Reduce unwanted doctor visits, recommended and ranked top by experts!

Posted on Leave a comment

Why COVID-19 kills some people and spares others. Here’s what scientists are finding

The novel coronavirus causing COVID-19 seems to hit some people harder than others, with some people experiencing only mild symptoms and others being hospitalized and requiring ventilation. Though scientists at first thought age was the dominant factor, with young people avoiding the worst outcomes, new research has revealed a suite of features impacting disease severity. These influences could explain why some perfectly healthy 20-year-old with the disease is in dire straits, while an older 70-year-old dodges the need for critical interventions.

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Underlying health conditions are thought to be an important factor influencing disease severity. Indeed, a study of more than 1.3 million COVID-19 cases in the United States, published June 15 in the journal Morbidity and Mortality Weekly Report, found that rates of hospitalizations were six times higher and rates of death were 12 times higher among COVID-19 patients with underlying conditions, compared with patients without underlying conditions. The most commonly reported underlying conditions were heart disease, diabetes and chronic lung disease.

In general, risk factors for more severe COVID-19 outcomes include:

About 8 out of 10 deaths associated with COVID-19 in the U.S. have occurred in adults ages 65 and older, according to the U.S. Centers for Disease Control and Prevention (CDC). The risk of dying from the infection, and the likelihood of requiring hospitalization or intensive medical care, increases significantly with age. For instance, adults ages 65-84 make up an estimated 4-11% of COVID-19 deaths in the U.S, while adults ages 85 and above make up 10-27%.

The trend may be due, in part, to the fact that many elderly people have chronic medical conditions, such as heart disease and diabetes, that can exacerbate the symptoms of COVID-19, according to the CDC. The ability of the immune system to fight off pathogens also declines with age, leaving elderly people vulnerable to severe viral infections, Stat News reported.

Diabetes mellitus — a group of diseases that result in harmful high blood sugar levels — also seems to be linked to risk of more severe COVID-19 infections.

The most common form in the U.S. is type 2 diabetes, which occurs when the body’s cells don’t respond to the hormone insulin. As a result, the sugar that would otherwise move from the bloodstream into cells to be used as energy just builds up in the bloodstream. (When the pancreas makes little to no insulin in the first place, the condition is called type 1 diabetes.)

In a review of 13 relevant studies, scientists found that people with diabetes were nearly 3.7 times more likely to have a critical case of COVID-19 or to die from the disease compared with COVID-19 patients without any underlying health conditions (including diabetes, hypertension, heart disease or respiratory disease), they reported online April 23 in the Journal of Infection.

Even so, scientists don’t know whether diabetes is directly increasing severity or whether other health conditions that seem to tag along with diabetes, including cardiovascular and kidney conditions, are to blame.

That fits with what researchers have seen with other infections and diabetes. For instance, flu and pneumonia are more common and more serious in older individuals with type 2 diabetes, scientists reported online April 9 in the journal Diabetes Research and Clinical Practice. In a literature search of relevant studies looking at the link between COVID-19 and diabetes, the authors of that paper found a few possible mechanisms to explain why a person with diabetes might fare worse when infected with COVID-19. These mechanisms include: “Chronic inflammation, increased coagulation activity, immune response impairment and potential direct pancreatic damage by SARS-CoV-2.”

Related: 13 coronavirus myths busted by science

Mounting research has shown the progression of type 2 diabetes is tied to changes in the body’s immune system. This link could also play a role in poorer outcomes in a person with diabetes exposed to SARS-CoV-2, the virus that causes COVID-19.

No research has looked at this particular virus and immune response in patients with diabetes; however, in a study published in 2018 in the Journal of Diabetes Research, scientists found through a review of past research that patients with obesity or diabetes showed immune systems that were out of whack, with an impairment of white blood cells called Natural Killer (NK) cells and B cells, both of which help the body fight off infections. The research also showed that these patients had an increase in the production of inflammatory molecules called cytokines. When the immune system secretes too many cytokines,a so-called “cytokine storm” can erupt and damage the body’s organs. Some research has suggested that cytokine storms may be responsible for causing serious complications in people with COVID-19, Live Science previously reported. Overall, type 2 diabetes has been linked with impairment of the very system in the body that helps to fight off infections like COVID-19 and could explain why a person with diabetes is at high risk for a severe infection.

Not all people with type 2 diabetes are at the same risk, though: A study published May 1 in the journal Cell Metabolism found that people with diabetes who keep their blood sugar levels in a tighter range were much less likely to have a severe disease course than those with more fluctuations in their blood sugar levels.

People with type 1 diabetes (T1D) are also at elevated risk of adverse outcomes, a small study published in Diabetes Care suggests. The study, coordinated by T1D Exchange — a nonprofit research organization focused on therapies for those with type 1 diabetes — found that of 64 people with either COVID-19 or COVID-19-like symptoms, two died. Nearly 4 in 10 people had to be treated in a hospital. And nearly a third experienced diabetic ketoacidosis — a potentially deadly condition in which the body experiences a shortage of insulin and blood sugar levels rise dangerously high. The average patient was about 21 years old, suggesting that risks could be potentially higher for older age groups.

People with conditions that affect the cardiovascular system, such as heart disease and hypertension, generally suffer worse complications from COVID-19 than those with no preexisting conditions, according to the American Heart Association. That said, historically healthy people can also suffer heart damage from the viral infection.

The first reported coronavirus death in the U.S., for instance, occurred when the virus somehow damaged a woman’s heart muscle, eventually causing it to burst, Live Science reported. The 57-year-old maintained good health and exercised regularly before becoming infected, and she reportedly had a healthy heart of “normal size and weight.” A study of COVID-19 patients in Wuhan, China, found that more than 1 in 5 patients developed heart damage — some of the sampled patients had existing heart conditions, and some did not.

In seeing these patterns emerge, scientists developed several theories as to why COVID-19 might hurt both damaged hearts and healthy ones, according to a Live Science report.

In one scenario, by attacking the lungs directly, the virus might deplete the body’s supply of oxygen to the point that the heart must work harder to pump oxygenated blood through the body. The virus might also attack the heart directly, as cardiac tissue contains angiotensin-converting enzyme 2 (ACE2) — a molecule that the virus plugs into to infect cells. In some individuals, COVID-19 can also kickstart an overblown immune response known as a cytokine storm, wherein the body becomes severely inflamed and the heart could suffer damage as a result.

People who smoke cigarettes may be prone to severe COVID-19 infections, meaning they face a heightened risk of developing pneumonia, suffering organ damage and requiring breathing support. A study of more than 1,000 patients in China, published in the New England Journal of Medicine, illustrates this trend: 12.3% of current smokers included in the study were admitted to an ICU, were placed on a ventilator or died, as compared with 4.7% of nonsmokers. Cigarette smoke might render the body vulnerable to the coronavirus in several ways, according to a recent Live Science report. At baseline, smokers may be vulnerable to catching viral infections because smoke exposure dampens the immune system over time, damages tissues of the respiratory tract and triggers chronic inflammation. Smoking is also associated with a multitude of medical conditions, such as emphysema and atherosclerosis, which could exacerbate the symptoms of COVID-19. A recent study, posted March 31 to the preprint database bioRxiv, proposed a more speculative explanation as to why COVID-19 hits smokers harder. The preliminary research has not yet been peer-reviewed, but early interpretations of the data suggest that smoke exposure increases the number of ACE2 receptors in the lungs — the receptor that SARS-CoV-2 plugs into to infect cells. Many of the receptors appear on so-called goblet and club cells, which secrete a mucus-like fluid to protect respiratory tissues from pathogens, debris and toxins. It’s well-established that these cells grow in number the longer a person smokes, but scientists don’t know whether the subsequent boost in ACE2 receptors directly translates to worse COVID-19 symptoms. What’s more, it’s unknown whether high ACE2 levels are relatively unique to smokers, or common among people with chronic lung conditions.
Several early studies have suggested a link between obesity and more severe COVID-19 disease in people. One study, which analyzed a group of COVID-19 patients who were younger than the age of 60 in New York City, found that those who were obese were twice as likely as non-obese individuals to be hospitalized and were 1.8 times as likely to be admitted into critical care. “This has important and practical implications” in a country like the U.S. where nearly 40% of adults are obese, the authors wrote in the study, which was accepted into the journal Clinical Infectious Diseases but not yet peer-reviewed or published. Similarly, another preliminary study that hasn’t yet been peer-reviewed found that the two biggest risk factors for being hospitalized from the coronavirus are age and obesity. This study, published in medRxiv looked at data from thousands of COVID-19 patients in New York City, but studies from other cities around the world found similar results, as reported by The New York Times. A preliminary study from Shenzhen, China, which also hasn’t been peer-reviewed, found that obese COVID-19 patients were more than twice as likely to develop severe pneumonia as compared with patients who were normal weight, according to the report published as a preprint online in the journal The Lancet Infectious Diseases. Those who were overweight, but not obese, had an 86% higher risk of developing severe pneumonia than did people of “normal” weight, the authors reported. Another study, accepted into the journal Obesity and peer-reviewed, found that nearly half of 124 COVID-19 patients admitted to an intensive care unit in Lille, France, were obese. It’s not clear why obesity is linked to more hospitalizations and more severe COVID-19 disease, but there are several possibilities, the authors wrote in the study. Obesity is generally thought of as a risk factor for severe infection. For example, those who are obese had longer and more severe disease during the swine flu epidemic, the authors wrote. Obese patients might also have reduced lung capacity or increased inflammation in the body. A greater number of inflammatory molecules circulating in the body might cause harmful immune responses and lead to severe disease.

Blood type seems to be a predictor of how susceptible a person is to contracting SARS-CoV-2, though scientists haven’t found a link between blood type per se and severity of disease.

Jiao Zhao, of The Southern University of Science and Technology, Shenzhen, and colleagues looked at blood types of 2,173 patients with COVID-19 in three hospitals in Wuhan, China, as well as blood types of more than 23,000 non-COVID-19 individuals in Wuhan and Shenzhen. They found that individuals with blood types in the A group (A-positive, A-negative and AB-positive, AB-negative) were at a higher risk of contracting the disease compared with non-A-group types. People with O blood types (O-negative and O-positive) had a lower risk of getting the infection compared with non-O blood types, the scientists wrote in the preprint database medRxiv on March 27; the study has yet to be reviewed by peers in the field.

In a more recent study of blood type and COVID-19, published online April 11 to medRxiv, scientists looked at 1,559 people tested for SARS-CoV-2 at New York Presbyterian hospital; of those, 682 tested positive. Individuals with A blood types (A-positive and A-negative) were 33% more likely to test positive than other blood types and both O-negative and O-positive blood types were less likely to test positive than other blood groups. (There’s a 95% chance that the increase in risk ranges from 7% to 67% more likely.) Though only 68 individuals with an AB blood type were included, the results showed this group was also less likely than others to test positive for COVID-19.
The researchers considered associations between blood type and risk factors for COVID-19, including age, sex, whether a person was overweight, other underlying health conditions such as diabetes mellitus, hypertension, pulmonary diseases and cardiovascular diseases. Some of these factors are linked to blood type, they found, with a link between diabetes and B and A-negative blood types, between overweight status and O-positive blood groups, for instance, among others. When they accounted for these links, the researchers still found an association between blood type and COVID-19 susceptibility. When the researchers pooled their data with the research by Zhao and colleagues out of China, they found similar results as well as a significant drop in positive COVID-19 cases among blood type B individuals.

Why blood type might increase or decrease a person’s risk of getting SARS-CoV-2 is not known. A person’s blood type indicates what kind of certain antigens cover the surfaces of their blood cells; These antigens produce certain antibodies to help fight off a pathogen. Past research has suggested that at least in the SARS coronavirus (SARS-CoV), anti-A antibodies helped to inhibit the virus; that could be the same mechanism with SARS-CoV-2, helping blood group O individuals to keep out the virus, according to Zhao’s team.

Many medical conditions can worsen the symptoms of COVID-19, but why do historically healthy people sometimes fall dangerously ill or die from the virus? Scientists suspect that certain genetic factors may leave some people especially susceptible to the disease, and many research groups aim to pinpoint exactly where those vulnerabilities lie in our genetic code.

In one scenario, the genes that instruct cells to build ACE2 receptors may differ between people who contract severe infections and those who hardly develop any symptoms at all, Science magazine reported. Alternatively, differences may lie in genes that help rally the immune system against invasive pathogens, according to a recent Live Science report.

For instance, a study published April 17 in the Journal of Virology suggests that specific combinations of human leukocyte antigen (HLA) genes, which train immune cells to recognize germs, may be protective against SARS-CoV-2, while other combinations leave the body open to attack. HLAs represent just one cog in our immune system machinery, though, so their relative influence over COVID-19 infection remains unclear. Additionally, the Journal of Virology study only used computer models to simulate HLA activity against the coronavirus; clinical and genetic data from COVID-19 patients would be needed to flesh out the role of HLAs in real-life immune responses.

physician-recommended easy to use daily

Why Use D'OXYVA?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

physician-recommended easy to use daily

Why Use D'OXYVA?

Expert say D’OXYVA can help COVID-19 patients find relief. Preliminary medical data shows people with pre-existing conditions including diabetes may experience serious complications from COVID-19.

D’OXYVA helps by delivering transdermal ultra-purified medical gas directly to the blood stream delivering major outcomes for well over 90% of users.

Experts call D’OXYVA a gamechanger.

“Studies with D’OXYVA have shown unmatched results in noninvasive woundcare,” Dr. Michael McGlamry.

Anyone with an underlying condition should know this option is available.

Reduce unwanted doctor visits, recommended and ranked top by experts!

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Circularity in collaboration with EndPandemics

As the pandemic spreads worldwide, companies must plan ahead and make steps that will help them protect their employees, keep their business on track, and even prepare for the worst – business disruption. Most have revisited policies, considered new innovations and platforms, and canceling events that requires mass gatherings. 

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As shops, restaurants and bars across the nation and around the world shut down to at least help flatten the curve and slow the spread of coronavirus, many workers were sent home. For most of them if not all, that means uncertainty as to when they’ll see a paycheck again.

For those who want to help, it can be hard to know where and how to start.

“There are so many ways to help and sometimes it gets very confusing as there are so many charities to choose from, but during these hard times, all kinds of giving makes a difference”, says Jennifer Rose Boadilla-Pelaez, Circularity Healthcare’s Senior Sales and Marketing Manager, Creative Director.

Circularity announced a long-term collaboration with EndPandemics on June 16th, 2020.

PROTECT AND REGENERATE

End Pandemics

In line with Circularity Healthcare’s mission to provide real and affordable healthcare, we have partnered with #Endpandemics, a global alliance to protect and regenerate nature, to help prevent future pandemics by ending the commercial trade in wild animals, expanding wild habitat, and protecting livelihoods. Your contribution will not only protect our global health and save wildlife, it will also safeguard global biodiversity, enhance sustainable agriculture, and mitigate climate change. Circularity Healthcare will also be donating its products to every member of the network of this charity to help them stay healthy.

About EndPandemics

EndPandemics is  a dynamic, global alliance of organizations—representing conservation, climate, health, finance, security, agroforestry, business, technology, and communications—who have launched this global campaign to reduce the risks of pandemics by addressing the root cause of all zoonotic outbreaks—rampant wildlife trade and the destruction of wild habitat.

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How a New OTC Medical Device Backed by Nobel Prize-winning Science Can Protect You by Targeting Underlying Conditions

treat underlying condition in covid patients

Patients dealing with underlying health issues, including diabetes and chronic heart conditions, as well as COVID-19, may find fast and painless relief from an over the counter (OTC) device.

An easy-to-use , commercially-available device, D’OXYVA (deoxyhemoglobin vasodilator) by Circularity Healthcare, LLC, delivers transdermal ultra-purified medical gas directly to the blood stream and body tissues that are low in oxygen-rich blood flow.

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The handheld, lightweight device – which promotes  the rest and digest functions of the autonomic nervous system  and the circulation of the blood in the smallest blood vessels, known as microcirculation – has demonstrated over years of studies and user feedback great efficacy in treating a number of health issues, including treating and closing so-called non-healing diabetic wounds. 

D’OXYVA has shown significant promise for severe cases of diabetic foot ulcers,” says Dr. Michael McGlamry, a podiatrist in Georgia.

He says the device helps increase oxygen-rich blood flow in the local microcirculatory system, leading to better blood perfusion and tissue oxygenation.  

“Improved microcirculation leads to better tissue oxygenation and better heart function, as the heart does not need to exert extra force to bring the blood to all the organs of the body,” says Dr. McGlamry.

Wound healing

Foot wounds are a significant concern for diabetics: 15% will develop a foot ulcer, and 14-24% of individuals with a foot ulcer, will need amputation.  

Dr. Felix Sigal, a Los Angeles podiatrist, says this device is a game changer.

“Transdermal delivery of carbon dioxide has therapeutic effects on both the microcirculation and tissue oxygenation,” he says. “By improving tissue oxygenation and microcirculation, studies have shown greater progress in wound healing with respect to wound size and area of injury.”

The device was evaluated over eight years and three dozen human studies where zero adverse effects were reported. The CO₂ is approved by the FDA for anesthesia and oxygen therapy as a non-toxic, simple molecule under the Medical Gas Safety Act of 2012. It’s in the final phase of getting a combination device-drug approval. 

“D’OXYVA has recorded significant results, delivering major outcomes for well over 90% of users,” says Dr. McGlamry. 

Applications for COVID-19 patients

The device may help improved blood flow and tissue oxygenation for people with COVID-19 . Patients most at risk for the novel coronavirus include those over 65 who have heart disease, liver disorders, diabetes or other underlying health issues.

“Because it affects the immune system and compromises the body’s natural defenses fight off infections, it is critical for a person with diabetes to have good blood flow circulation, reducing the chance of infection, ulcers and at worst case amputations,” says Dr. Geoffrey Watson, who specializes in chronic care management in Oakland, California.

He says while the heart is a far distance from the foot, the foot relies on the heart for consistent blood flow, requiring open pathways. Often those pathways are constricted in diabetics, resulting in poor blood circulation

Dr. Watson says vasodilation is essential, “to promote microcirculatory blood flow to supply adequate oxygenation the feet, thereby likely helping to prevent infections, ulcers and wounds.” 

Clinical Trial

Circularity Healthcare’s Phase 3 clinical trial — which involves the use of an FDA-approved drug in addition to IDE device D’OXYVA® (deoxyhemoglobin vasodilator), a non-toxic, non-invasive  transdermal drug delivery device — is poised to help the most at-risk coronavirus patients experiencing complications due to diabetes, poor circulation, hypertension, high blood pressure, and cardiovascular disease. 

“Further studies are needed but this device has the potential to prevent symmetrical peripheral gangrene, a limb threatening complication of COVID-19,” says Dr. Sigal, who is helping conduct the D’OXYVA Phase 3 diabetic foot ulcer clinical trials.

This clinical trial represents the first biotech solution to improve a patient’s overall oxygen-rich blood flow. 

For more information: https://doxyva.com/covid-19/

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Medical Gas Market Size & Share | Global Industry Report, 2014-2024

The global medical gas market size was valued at USD 7.5 billion in 2016 and is expected to witness a CAGR of 9.0% during the forecast period. Rising incidence of chronic diseases, growing number of industry-friendly safety initiatives undertaken by the government, implementation of U.S. FDA safety and innovation act, growing base of geriatric population, and increasing demand for home Health care and point of care products are some of the major factors propelling the growth of the medical gases market. 

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Medical gases are labeled as medical products and subsequently the related equipment are termed as medical devices. They are frequently used by Health care professionals for diagnostic and treatment purposes. Additionally, it has varied usage in pharmaceutical and biotechnology industry, such as, pharmaceutical manufacturing, cell culture studies, and drug discovery and development.

Chronic diseases such as asthma, diabetes, cancer, respiratory diseases, cardiovascular diseases, and other non-communicable disease have become a global burden, crippling nations. According to the Centers for Disease Control and Prevention, 1 out of 2 adults in the U.S. suffers from a chronic disease and 1 in 4 adults suffer from more than two chronic diseases.

Data from the same source indicate that 86% of the national Health care expenditure amounting to 2.7 trillion USD were spent on the treatment of chronic and mental health conditions in the U.S. According to American Public Health Association, seven out of ten deaths in the U.S. is a result of chronic disease. These facts are indicative of the alarming rise in chronic diseases which is expected to fuel the market growth of medical gases as they are used very commonly in diagnostic and therapeutic settings.

In addition, increasing geriatric population susceptible to chronic conditions is also expected to boost demand for technologically advanced equipment that aid in the management and treatment of various such conditions. Old age heightens the need for Health care by making individuals more susceptible to diseases especially pertaining to the respiratory system thus triggering patient hospitalization rates. Statistics suggest that 55% – 60% of patients admitted in hospitals are administered with medical gases. Thus, with a rise in geriatric population globally, the demand for medical gases is expected to rise considerably.

Growing demand for home healthcare and point of care markets is expected to boost the medical gases and equipment market by triggering a rise in demand for packaged medical grade gases (such as oxygen). In July, 2012, the U.S. Congress passed a bill putting into effect the Food and Drug Safety and Innovation Act. This act is expected to serve this market as a driver during the forecast period owing to elimination of drug user fees for medical gas manufacturers and establishment of a standard certification process for medical gas and equipment products among others.

Application Insights

Based on application, the market is segmented into therapeutic, diagnostic, and others. The other applications taken into consideration are pharmaceutical manufacturing, biotechnology, and other research activities. The therapeutic application held the largest market revenue in 2016 owing to a broad range of medical gases used to treat and manage various disease conditions. Medical gases used for diagnostics are also expected to gain a lucrative market share with the highest CAGR of 10% during the forecast period.

Medical gases are needed to standardize and maintain medical devices used for the delivery of anesthetic gases. They are usually used for patient diagnostics such as blood gas analysis and lung function testing. For instance, liquid helium is required in MRI to cool down superconductive magnets coil scanners. Thus, varied usage of these gases is expected to propel their market growth.

Equipment Insights

Medical gas equipment involves various types of products including manifolds, vacuum systems, alarm systems, flow meters, medical air compressors, cylinders, hose assemblies and valves, outlets, regulators and masks. Medical gas vacuum systems are used to provide safe and sufficient flows at desired pressure levels to the medical gas outlets or vacuum inlet terminals. This product held the largest share in 2016 and is expected to continue to maintain its dominancy throughout the forecast period owing to its rapidly increasing penetration rates and relatively higher prices.

Masks showcased the highest CAGR of 10.9% during the forecast period owing to its frequent usage for medical gas administration. Since medical gas outlets play an important role in the distribution of medical gases, they are also expected to gain a lucrative market share in the near future. Medical air compressors which are mechanical devices that store air by compression and later used in air driven medical equipment such as dental tools, ventilators and nebulizers are also expected to gain a significant share in the market.

Regional Insights

The key regions considered in the medical gases market are North America, Europe, Asia Pacific, Latin America, Middle East and Africa. The U.S. is the estimated to dominate the overall market with the largest market share. In addition, the increasing geriatric population along with increasing prevalence of chronic diseases is expected to further enhance the sector growth in the North American region.

The European region followed closely after the North American region in terms of market share.  Some of the major factors attributing to the growth of this region is the presence of various associations such as the EIGA (European Industrial Gases Association) and MGA (Medical Gas Association) which aid in providing standard rules and regulations for medical gas manufacturers.

On the other hand, Asia Pacific is anticipated to be the fastest growing segment, owing to densely populated nations such as China and India and an increase in Health care spending in the respective nations.

Medical Gases Market Share Insights

The major players leading the market are The Linde Group; Airgas, Inc.; BeaconMedaes; Medical Gas Solutions Ltd.; Air Products and Chemicals; Praxair, Inc.; Air Liquide; and Matheson Tri-Gas among others. The medical gases market is highly fragmented with many local and few global players.

Key strategies adopted by the major players, such as collaborations, acquisitions and mergers, new product launches are estimated to fuel the market growth of the companies and subsequently the market. Strategies such as these aids companies in strengthening their global existence for long-term sustained growth in the industry. For instance, in June 2015, Air Liquide announced acquisition of Baywater Health care Ireland Ltd, to expand its home Health care business in Europe. This acquisition is expected father add to the company’s existing product portfolio allowing it to deliver more to their clients. Various collaborations are also expected to benefit the market players in strengthening their position in the market. For instance, in July 2016, Praxair expands its Helium supply in Central Europe by signing a long-term agreement for the purchase of helium (liquid) from PGNiG, the only producer of helium in Central Europe.

Report Scope

Attribute

Details

Base year for estimation

2015

Actual estimates/Historical data

2012 – 2015

Forecast period

2016 – 2024

Market representation                                   

Revenue in USD Million and CAGR from 2016 to 2024

Regional scope

North America, Europe, Asia Pacific, Latin America, Middle East & Africa

Country scope

U.S., Canada, UK, Germany, India, China, Brazil, Mexico, South Africa

Report coverage        

Revenue forecast, company share, competitive landscape, growth factors and trends

15% free customization scope (equivalent to 5 analyst working days)

If you need specific information, which is not currently within the scope of the report, we will provide it to you as a part of customization

Segments covered in the report

This report forecasts revenue growth at global, regional & country levels and provides an analysis of the industry trends in each of the sub-segments from 2013 to 2024. For the purpose of this study, Grand View Research has segmented the global medical gases market report on the basis of gas type equipment, application, and region:

  • Gas Type Outlook (Revenue, USD Million, 2013 – 2024)

    • Pure Gases

      • Medical Air

      • Carbon Dioxide

      • Oxygen

      • Nitrogen

      • Nitrous Oxide

      • Helium

    • Gas Mixtures

      • Carbon Dioxide Oxygen Mixtures

      • Oxygen-Nitrous Oxide Mixtures

      • Ethylene Oxide

      • Oxyfume 2000

      • Helium Oxygen Mixtures

      • Aerobic Mixtures

      • Anaerobic Mixtures

      • Blood Gas Mixtures

      • Laser Gas Mixtures

      • Lung Mixtures

  • Equipment Outlook (Revenue, USD Million, 2013 – 2024)

    • Manifolds

    • Vacuum Systems

    • Alarm Systems

    • Flow meters

    • Medical Air Compressors

    • Cylinders

    • Hose Assemblies and Valves

    • Outlets

    • Regulators

    • Masks

  • Application Outlook (Revenue, USD Million, 2013 – 2024)

    • Therapeutic

    • Diagnostic

    • Others

  • Regional Outlook (Revenue, USD Million, 2013 – 2024)

    • North America

      • U.S.

      • Canada

    • Europe

      • UK

      • Germany

    • Asia Pacific

      • China

      • India

    • Latin America

      • Brazil

      • Mexico

    • The Middle East and Africa

      • South Africa

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless over-the-skin microcirculatory and nerve stimulant solution that has been validated to significantly improve microcirculation. It’s platform solution uses vaporized ultra-purified carbon dioxide that acts as a catalyst for the body to help improve its functions and heal itself.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

Reduce unwanted doctor visits, recommended and ranked top by experts!

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Hydroxychloroquine Fails to Help Coronavirus Patients in Largest Study of the Drug to Date

In a study published in the New England Journal of Medicine, scientists led by a team at Columbia University found that people infected with COVID-19 taking hydroxychloroquine do not fare better than those not receiving the drug.

The study published Thursday is the largest to date to investigate the drug, which is approved by the U.S. Food and Drug Administration to treat malaria and certain autoimmune disorders, as a treatment for COVID-19. Dr. Neil Schulger, chief of the division of pulmonary, allergy and critical care medicine at Columbia, and his team studied more than 1,300 patients admitted to New York-Presbyterian Hospital-Columbia University Irving Medical Center for COVID-19.

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Some received hydroxychloroquine on an off-label basis, a practice that allows doctors to prescribe a drug that has been approved for one disease to treat another — in this case, COVID-19. About 60% of the patients received hydroxychloroquine for about five days. They did not show any lower rate of needing ventilators or a lower risk of dying during the study period compared to people not getting the drug.

 

“We don’t think at this point, given the totality of evidence, that it is reasonable to routinely give this drug to patients,” says Schluger. “We don’t see the rationale for doing that.” While the study did not randomly assign people to receive the drug or placebo and compare their outcomes, the large number of patients involved suggests the findings are solid.

Based on the results, Schluger says doctors at his hospital have already changed their advice about using hydroxychloroquine to treat COVID-19. “Our guidance early on had suggested giving hydroxychloroquine to hospitalized patients, and we updated that guidance to remove that suggestion,” he says.

The original support of hydroxychloroquine came largely from a small study conducted in France that suggested people receiving the drug did better than those not getting it. In the U.S., President Trump also expressed interest in the drug as a possible way to control the growing pandemic. However, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and member of Trump’s White House Coronavirus Task Force, urged caution and recommended more rigorous studies and data on the drug’s effect on COVID-19.

Still, Schluger says the urgent need to help patients in the middle of a pandemic led many doctors and hospitals to latch on to hydroxychloroquine as a potentially effective therapy. “Physicians see patients who are dying at an unbelievable rate, and want to do something to try to help them,” he says. “But I think the history of medicine shows us that some hunches are right and many, many, many of them are wrong.” In a survey conducted by health care polling company Sermo, 55% of physicians around the world who were surveyed reported using hydroxychloroquine. Only 29%, however, rated it as highly safe — the drug is linked to higher risk of abnormal heart rhythms.

The results of the current study are likely to change how doctors treat hospitalized patients who are severely ill. But Schluger says it’s still possible that hydroxychloroquine can play a role in controlling COVID-19, perhaps as a way to prevent infection among people who are at high risk of getting exposed to the virus, such as health care workers. Other studies are investigating that possibility.

“It’s really important for us to know which treatments work, and which do not, so patients should be offered the chance to be in a clinical trial,” says Schluger. “It’s probably the best thing they can do for themselves and for society as a whole, so we can get answers really quickly to identify the treatments that work and discard the treatments that don’t work.”

HOW D’OXYVA CAN HELP?

Our organization has been on the forefront in the fight against the novel coronavirus that originated in Wuhan, China (Covid-19) since January of this year due to our organization’s operations in major countries across Asia. We all should understand the need to act now and arrest this crisis head on by spurring economic activity wherever we can and providing effective, affordable and rapid testing and treatments for the masses.

D’OXYVA is the only fully noninvasive, completely painless over-the-skin microcirculatory and nerve stimulant solution that has been validated to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

Reduce unwanted doctor visits, recommended and ranked top by experts!