Autumn Davis

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Am I High Risk for Poor COVID Outcomes?

Who is at high risk for serious illness with COVID?

Anyone who is advanced in age (65+ years old), certain minority groups (African Americans & Hispanics), and those with existing medical complications are more likely to experience worse symptoms with COVID. Did you know the majority of patients being admitted to ICUs in America are Hispanics and African Americans? The other common denominators in hospital admissions are obesity and high blood pressure. Yes, certain patient populations are more likely to have poor outcomes with COVID, but is it their genetics or underlying medical conditions? Should a healthy Hispanic be concerned? I wish I could give you this answer, but this still remains an unknown.

Risk Factors for COVID

The scary truth here is most patients who require a ventilator for respiratory support, are not coming off the vent. The following % is not researched-based, it is from my own experiences and what the ICU nurses at a North Carolina hospital estimate. In the opinion of ICU nurses in NC, we agree that approximately 10% of patients who go on the ventilator actually come off the ventilator. YIKES! That is a 90% chance of death once you are put on a ventilator in the ICU. This is not to scare anyone or sway your decision, but to give you facts.

Yikes! ? This is serious!

Medical Conditions Linked to Poor COVID Outcomes

What current health conditions will not only increase, but almost guarantee you will have a poor outcome with COVID? Just an FYI, the same medical conditions causing an increased risk with COVID are not the same that increase your risk for the vaccine side effects. Most of the ICU admissions requiring ventilators are overweight African American and Hispanic minorities with high blood pressure. If you are a diabetic who does not keep their blood sugar under control, you are also high risk.

How do you know if you are obese? I am not talking about the 5-10 vanity pounds we all struggle with, but these patients are 50, 100, 200 pounds, or more over their ideal weight. If you are an overweight minority with high blood pressure, you must weigh the risks vs the benefits. If you get the virus, you may not survive. If you get the vaccine, you may experience uncomfortable side effects, but you statistically survive.

Of course, these are not the only co-existing conditions to consider. Another one of importance when considering the vaccine vs naturally battling COVID are autoimmune disorders, diabetes, cancer, and even rheumatoid arthritis, etc. Are you taking any medications that suppress your immune system? There is not enough research for how immunosuppressant medications interact with vaccine recipients to know its effects, but we do know that a suppressed immune system could lead to critical illness and potentially death if COVID is introduced.

What are immunosuppressants? We are all familiar with chemo agents and radiation, but there are many others. I listed rheumatoid arthritis because some people may be taking the medications prescribed by their provider without realizing the strong negative impact it takes on your immune response. For example, methotrexate, cyclophosphamide, and chlorambucil for starters. Again, if you do not know, ask your primary care provider if you are on any of these medications or do your own homework and ask google?.

In a future blog post that I will link here later, I will give you tips and tools to prevent hospital admission and keep your lungs healthy from my own day-to-day COVID treatment when I had the virus. I believe the key is to prevent and stay on top of things if you get sick. Once COVID takes hold of your lungs, it seems to spiral out of control. Prevent, don’t treat!

I Took Ivermectin for COVID Symptoms

Everyone is talking about using Ivermectin for COVID, but I was hesitant. Is it safe? After dealing with COVID symptoms for 3 weeks, I was inquisitive and beginning to feel desperate. When would I start feeling normal again? I consulted with another friend of mine who is a doctor. I found out he gave it to his mother and she had a full recovery within 24 hours. What is this miracle drug? Will it work? Should I take it? Most importantly, how does it work?

Before starting Ivermectin I did hours and hours of extensive research. The chief of the division of pulmonary and critical care medicine at Eastern Virginia Medical School, Dr. Paul Marik, said that ivermectin “is a safe drug that is exceedingly cheap.” I decided to ask one more doctor friend and see if they also agreed. With 2 doctors that I personally knew giving me the green light and in a moment of desperation, I decided to go ahead, but I would start using it topically for my COVID rash and see how it went. At this point, the benefits outweighed the risks.

The rash did not respond to hydrocortisone cream or Benadryl, it was actually spreading. Once I started applying Ivermectin to my abdomen, the rash started to decrease. Surprisingly, 2 days after applying Ivermectin topically, my energy levels were improving. Prior to using Ivermectin, I was asking, “When will my energy levels improve? Will I ever feel normal again?” Was the minimal absorption into my bloodstream (systemic absorption) from applying Ivermectin paste on my skin contributing to my recovery?

Covid skin rash is an indicator of the severity of illness. Skin rash is also a sign of a hyperimmune response as a result of COVID. I applied Ivermectin paste to my skin rash and it helped my symptoms.

My primary care is still hesitant to prescribe experimental research treatments, so I purchased Duramectin 1.87% for horses. Many use this paste for rosacea without side effects.

At this point, I was over 3 weeks into the virus. I was exhausted and tired of dealing with COVID. As I said, I felt desperate. The virus’s effects were lingering on and on. What would be the long term effects of the virus on my body? I know other healthcare workers who are just now back to normal energy levels after 2-3 months. My friend’s husband is still fatigued and works part-time hours 6 months after COVID.

I decided to dig in a little bit deeper before making a final decision to take Ivermectin orally. Ivermectin paste is given for rosacea. Ivermectin oral tablets are given to treat scabies, river blindness, and some types of diarrhea. This medication has been around since the 1970s, making me feel much safer taking it. I did not discover any major side effects reported within the 50 years Ivermectin was used. I felt reassured.

I still want to know how it will work in my body before taking it orally. After hours of research, I discovered that research presents theories of how Ivermectin works, but they are not 100% sure. How does Ivermectin work as an antiviral? In theory, they believe it attaches to the beta 1 heterodimer, preventing the COVID virus from entering the cells. I know, I know, what does that even mean?

Here is a silly explanation of how researchers believe Ivermectin works against COVID. Imagine COVID as an intruder in your body. The COVID intruder wants to go inside the cells of your body. Well, Ivermectin is the security gate for your cells. When you put a security gate at the entrance points of the cells, COVID can not get inside. When COVID is blocked, our body can attack it and eliminate the virus.

COVID enters our cells and destroys them.
Ivermectin closes the gate, keeping COVID out. Preventing cell damage and replication.

When Ivermectin is not there, COVID is not blocked from going inside our cells. Once the virus is inside our cells, it can destroy the cell and make copies of itself. Now there are even more COVID invaders around to destroy cells and continue replicating themselves. With so many COVID invaders inside your body, the body’s immune system goes into overdrive, creating a hyperimmune response.

I was still hesitant. I determined what an accurate dose was for an adult would be based on body weight and diluted the paste into a less concentrated liquid form, easier to dose accurately. During anesthesia school they always said, “Start low, go slow!” and “You can always add more, but you can’t take it away.” Applying this thought process, I only took 1/4 of the recommended amount. Even though I only took a microdose, my energy level drastically improved overnight.

My energy improved when applying Ivermectin on my skin, but dramatically increased when I took it orally. Over the next week my strength and stamina continue to increase.

I did not have any side effects, so I repeated the same microdose the next day and a final dose on the third day. Incredible! In the end, I had all my energy back. I felt like my old self again. The rash did not spread anymore, but it was still visible. Day by day, my energy and stamina improved. Within a week of taking Ivermectin, my strength started to return. I did not want to rush my recovery and backslide again. Even though I felt stronger, I continued doing yoga for exercise and will progress slowly while the rash remains on my abdomen.

As long as a rash is present, I see this as a visual indication the inflammatory proteins are still circulating. How long do inflammatory proteins remain in our body after the virus is no longer present? Research shows these proteins linger around for at least a month after the virus is gone, but it could be longer. Yes, Ivermectin may potentially destroy the COVID virus, but the risk for side effects related to the inflammatory proteins is still a very real concern. You will still need to take a blood thinner (Aspirin 325mg or 81mg) daily for a minimum of 30 days. Blood clots are a serious risk after this virus, even if you take Ivermectin, and even if you do not have a visible rash.

I can not recommend anyone to use my methods to take Ivermectin orally, but you can ask your primary care provider for a prescription. I calculated a weight-based dose, but I have 3 years of doctorate anesthesia training and calculate weight-based doses for patients all the time.

Something to consider before taking Ivermectin, do you have asthma? If you have asthma, consult with your physician because it could make it worse. Ivermectin could affect the same receptors known to contribute to asthma symptoms. I have asthma, so I took my inhaler to counteract potential effects and I was fine.

Be Careful Taking Ivermectin if You are an Asthmatic.

We do not know exactly how it works, but it seems to be effective. I was impressed with my results. My energy was not improving at all until I took this drug. Would I take it again? Absolutely yes! It has been over a week since I took Ivermectin and I did not experience any negative side effects. I still have the COVID rash, but it did not spread. If anything changes, I will update you.

Are People with Allergies More Likely to Experience COVID Symptoms?

I am young, healthy and fit. I took all of the recommended vitamins (C, D, Zinc) before I had COVID and during COVID. I am 100% sugar-free, the epitome of health. I do have severe allergies which require weekly allergy shots. I thought I would be someone who would experience mild symptoms if any at all with COVID. Boy was I wrong!

I started out with facial swelling, developed a dry cough and mild shortness of breath, chest burning that lingered for over 3 weeks, and then a late-onset COVID rash appeared. Strange! I am curious if later on, we discover that most of the people with weird COVID symptoms also have bad allergies. Do people who experience a hyper-immune response share a common genetic mutation that is not present in those without symptoms? We do not know this answer yet, but I am curious.

Could Allergies Contribute to Hyperimmune Response with COVID

We know a chromosome mutation is responsible for eczema. Someone with eczema is 60% more likely to develop asthma and allergies. They are also more likely to get other conditions such as rheumatoid arthritis, ADHD, etc. Why am I sharing this? I have eczema, I developed allergies in childhood, began suffering from asthma in my teens, and of course, I am the poster child of ADHD?!

According to the  Journal of Allergy and Clinical Immunology, someone with allergies has altered human leukocyte antigen (HLA) genes that produce active IgE. When they are exposed to an allergen, their body produces active IgE, causing their body’s allergy symptoms (swelling, rash, runny nose, sneezing, etc). Sure someone without allergies may still produce IgE, but the response may not be strong enough to produce symptoms in the body. Could this be the reason some people are not experiencing any symptoms at all? Are altered HLA genes causing some people to experience symptoms or even contribute to worse symptoms?

HLA genes are responsible for initiating an immune response. Could these altered HLA genes contribute to the hyperimmune response? I am curious to know the answer to this question. There must be something that links the 2/3 of the population with symptoms together. Maybe one day we will know the answer to this question.

For now, I know that my symptoms with COVID were related to a hyperimmune response. The virus started with facial swelling (mostly of the eyes and lips) and has ended with a COVID rash. During the peak of the virus symptoms, I did not experience respiratory symptoms manageable by normal treatment methods. My chest burning was caused by inflammation. My shortness of breath, a result of the inflammation in my airways. How did I treat these? I did take an inhaler and my nebulizer out of an abundance of caution, but this did not make them go away. When I treated my symptoms as an allergic response with antihistamines and steroids, my symptoms went away.

My very first COVID symptom was facial swelling. YIKES!

COVID rash that started in week 3 and still continues after a month. The rash lasts longer than the virus stays in your body.

It is possible for you to experience more symptoms and potentially more long-COVID symptoms if you have severe allergies. This is not proven, but possible. The common denominator between my friends and me who had more symptoms and long-lasting symptoms is allergies. Time will tell. This is an unknown, but definitely a strong possibility.

Pfizer vs Moderna: What are the Differences

Is One COVID Vaccine Better than the Other?

Pfizer and Moderna vaccines are very similar. They are both mRNA vaccines administered in 2 doses within a month. The end result will be the same for both, with 95% protection after your second dose. So one is not better than the other. If you decide to get the vaccine, chose whichever one you feel comfortable with. The FDA recommends Moderna 20-0 for the vaccine of choice based on the amount of available research. This may change as we learn more information about Pfizer.

What are the differences between the vaccines? Pfizer is slightly less effective after the initial dose, with ~52% protection. Moderna reported 80% protection with their initial dose. Moderna does administer a larger dose of 100mcg for both doses, and the second dose is administered after 28 days. On the other hand, Pfizer administers 30mcg for both doses and recommends administering the second dose 21 days after the first.

Pfizer Moderna
52% protection after 1st dose80% protection after 1st dose
2 x 30 mcg IM injections2 x 100 mcg IM injections
2nd dose given after 21 days2nd dose given after 28 days
95% protection after 2nd dose95% protection after 2nd dose
mRNA vaccines for COVID

The only 2 vaccine options available as of January 2021 are Pfizer (BNT-162b2) and Moderna (mRNA-1273). Currently (as of February 2021), only high-risk populations are allowed to get the vaccine, which are healthcare providers and the elderly population.

What is an mRNA Vaccine?

Vaccines traditionally contain either weakened viruses or purified signature proteins of the virus, which is what some of the upcoming vaccine options are using. Johnson & Johnson’s COVID vaccine uses a viral vector while Novavax uses a protein subunit. Pfizer and Moderna are mRNA vaccines. Instead of injecting a viral protein, they are injecting mRNA genetic material into the body.

If most vaccines are made from viruses or proteins, why are they using mRNA? Let’s talk about how an mRNA vaccine works? COVID is an RNA virus, so the vaccine mimics what the virus does to our body in real life. After the vaccine is injected, your body produces a part of the viral proteins that are in the COVID virus.

Will the vaccine give you COVID? The mRNA only tells the body to produce a specific fragment of the COVID viral protein. Have you heard them talk about the spikes on the surface of the virus? That is what your body produces, the harmless spikes.

mRNA Vaccines Selectively Produce Covid Spikes

How does the vaccine produce antibodies? Our body recognizes the vaccine as an unwanted invader and starts producing antibodies to protect itself. Well, now your body had a sneak preview of how the virus works. It will already have antibodies to fight against COVID and you are more likely to experience mild symptoms. The virus does not prevent you from getting COVID, it prevents severe illness.

Common COVID Vaccine Side Effects

If you get the vaccine, report any side effects you experience to Vsafe. They are tracking all of the effects there. Both vaccines are known to cause similar side effects. The most common side effects are fatigue (feeling tired), headaches, fever, chills, joint pain, and muscle pain. Both of the vaccines are causing redness at injection sites, mild asthma flareups, swelling, etc. A rare but serious potential side effect from either vaccine is a severe allergic reaction. These usually occur in someone with severe food or drug allergies.

Each vaccine has a few unique side effects. For example, Pfizer is linked to rare occurrences of Bell’s Palsy. This is rare but possible. If you are a woman with facial filler you may experience mild facial swelling, but these were easily managed with Benadryl and over the counter medications. Many are experiencing swollen lymph nodes after the second Moderna dose.

I know a few healthcare workers who tested positive for COVID after the first dose, and some after their second dose. We do not feel as if the vaccine caused COVID, but that they were already exposed before getting the first vaccine. You are not 100% protected, even after the 2nd dose, so it is possible to get COVID after getting the vaccine. The hope is the vaccine will decrease the severity of your COVID symptoms. TBD!

So, YES! Unfortunately, you still need to wear a mask. I really hope we learn enough to effectively manage the symptoms or discover a vaccine that allows us to return to normal life. I know I am not alone, I do not like the new normal.

Who Should Not Get the COVID Vaccine?

Anyone who has severe food and drug allergies is at risk for serious side effects from both vaccines. Pregnant women should reconsider the vaccine since both the WHO and American College of Obstetrics and Gynecology (ACOG) only recommend high-risk patients to receive the vaccine when the benefits outweigh the risks. Asthma is not an eliminating factor but consider the risk. If you feel like your asthma is severe enough that you would be at risk, consult with your primary care before getting the vaccine.

What Are the Unknowns?

As we follow vaccine recipients we will know how long they are protected. Will you need a booster to remain protected? How often will you need a booster? This is a guarantee, but the timeline for when this will be necessary is unknown. These are all things that will be determined as we learn more.

What are the side effects? we know what people are experiencing, but we are learning more every day. This is truly a live research study with the entire world. Make sure you report your side effects to Vsafe. At least this will allow us to know more about the unknowns.

Will the Vaccine Be Effective Against Mutated Strains

Both Moderna and Pfizer are working on a booster that will be effective against the mutated strains of COVID. No one is saying if the current 2 dose vaccines will or will not be effective. If they are developing a booster to target the mutations, this suggests they are questioning if it will be effective? We are our own research study. What happens in the patient population receiving the vaccine will determine what side effects occur and if it works against the mutated strains. I guess time will tell.

Final Thoughts About the Vaccines

We are all in this together. With so many unknowns it is difficult for us all. If you want to know if you are a good candidate for the vaccine visit my post “How to Determine If You Should Get the Vaccine”.

Who Is at Risk for Critical Illness with COVID?

We know certain population groups make up the majority of ICU admissions. Someone with male pattern baldness, African Americans/Hispanics, and certain co-existing diseases (high blood pressure, diabetes, autoimmune disorders, and diabetes) are more likely to experience critical illness with COVID. African Americans and Hispanics are approximately 5 times more likely to suffer from severe illness.

Who is a High Risk for Severe Illness from COVID

  • African Americans and Hispanics
  • High blood pressure/Hypertension
  • Obesity

Approximately 1/3 of people with COVID will not have any symptoms, 80% experience mild symptoms, and 20% suffer from severe illness. What is the common link between people whose hyper-immune response leads to critical illness with COVID? Age, healthy lifestyle choices, and taking vitamins factor in, but are not the determining factors.

I am a young, healthy female with a strong immune system. I do not smoke. I work out 5-6 days/week. My lungs are strong and healthy. I took vitamin c, d, zinc, lysine, multivitamins before and while I had COVID. Vitamin supplements will not prevent COVID, but they can make you more likely to experience mild symptoms. I thought I would be one of the lucky ones without symptoms or at most, very mild symptoms. So, why did I have weird symptoms and linger on for weeks? Something in my body makeup created a hyperimmune response causing my own body to attack itself.

We do not yet understand why some people are more likely to experience severe illness, but I can share the common trends observed in ICU patients. African Americans or Hispanics, especially those who are overweight (obese) with high blood pressure (hypertension/HTN) are the majority requiring hospitalization. Why is this?

Why Does COVID Make Some People Sick?

Racial Disparity with COVID Symptoms

Do African Americans and Hispanics share a gene that creates a severe hyperimmune response? Do these same ethnicities have as high of a risk if they are healthy? Are these patients also obese or do they have high blood pressure? TBD! Hopefully, future studies will identify the common link and we can determine why the racial disparity is occurring with COVID symptoms.

High Blood Pressure Linked to Critical Illness from COVID

Why does high blood pressure make you more likely to experience critical illness? The proteins, etc responsible for causing high blood pressure, also cause your immune system to release inflammatory cells and cytokines. At baseline, the inflammatory cells and inflammatory cytokines responsible for heart, lung, kidney damage, and blood clots with COVIDs hyperimmune response are circulating in their body. Yikes!

Obesity Is Causing Critical Illness from COVID

Why is obesity linked to poor outcomes? All that excess fat does more than just add a few pounds. Obesity suppresses your immune system and causes an inflammatory response from the immune system, just like high blood pressure does. People who are overweight have more fat cells, which increases leptin hormone production. Leptin is what makes us feel full, but it also causes inflammation. Combine this with less of the factors that decrease inflammation, double trouble! With chronic inflammation at baseline, being overweight carries more than a few extra pounds, you also carry a high risk for critical illness with COVID.

#COVIDSurvivor

I Survived COVID and This Is What I Learned

COVID is not like the flu virus or any other illness I experienced in the past. Watching others recover from COVID was completely different than going through it. Day by day, I managed and dealt with the weird symptoms. 4 weeks after being infected with COVID and I am still experiencing some long-term effects. Why is this? Why did I start to feel better and backslide within 24 hours of stopping my Pepcid? Literally, my body did a full 180 and I felt like I was at the peak of my symptoms again. Once I restarted my Pepcid, my symptoms improved.

Why are there so many weird COVID symptoms? Why are some people asymptomatic (the lucky ones who do not have any symptoms) while someone else ends up in the ICU on a ventilator? Age is not the answer. Older adults who are 80, 90 years old are becoming a #COVIDsurvivor, while young healthy adults and teens are losing their lives to the virus. This is all related to your immune system response. A hyper-immune response creates the symptoms and creates the long-term effects in COVID long haulers.

Why Does COVID Cause Weird Symptoms?

Before having COVID I wondered, why are people having a COVID rash? It seems so weird for a virus to cause a rash, COVID toes, facial swelling, etc. The rash may be the very first symptom someone experiences while others are experiencing it late into the disease process, or even long after they are fully recovered. I know healthcare workers who are still dealing with a COVID rash 2-3 months after recovery.

Now, after going through the strange symptoms myself it makes sense. This virus triggers our immune system to go into overdrive, creating a hyper-immune response. We want our immune system to kick in when we get sick, but not like this.

Our Immune System is Hyper Active with Covid

COVID activates our complement system, which is usually a good thing. Our body activates the complement system to protect itself from viruses (flu, RSV, etc.), but when it is too active, it releases toxins that cause inflammation. Now, this explains why my face swoll up like a balloon. These toxins (C3a, C4a, and C5a) can cause swelling in your heart vessels, lungs, kidneys, and cause blood clots. The virus is not attacking your organs, it triggers your own body to attack itself.

How Can You Treat COVID at Home

To treat my COVID symptoms, I had to treat it as if I was experiencing an allergic reaction. The medications you would take for an allergic reaction (Benadryl, Pepcid, Claritin, and steroids) were the most effective. Benadryl, Pepcid, and Claritin are histamine blockers, helping to calm your hyperimmune response. This virus is different than anything I experienced before. Usually, when you start feeling better you can stop taking the medications. When I did this with COVID, I relapsed and experienced a huge setback.

During my third week with COVID, I developed a COVID rash within 24 hours of discontinuing Pepcid. My energy level dropped, I felt short of breath, my chest burning felt worse, and a rash appeared on my stomach. It took me another week to recover, but the rash is still there.

The risk for clots and problems from inflammation does not go away immediately after your symptoms go away. Blood clots are a major problem with COVID. Why are most 18-20 something people dying? Pulmonary embolus, which is a blood clot that moves into your lungs. To prevent clots, I took 325mg Aspirin daily and I will continue taking it for 30 days (for a total of 2 months). MDs are prescribing blood thinners for 30 days after a patient leaves the hospital. Even when you start to feel better, continue taking aspirin. I am continuing Pepcid and Claritin for another month as well.

Of course, my treatment was much more extensive than this. If you want to learn more about how I treated COVID at home, you can follow my daily journey on my blog posts or see the full list of medications and why I took them in the post, “My COVID Home Treatment Plan”.

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