COVID-19… What is new in 2021?
Maxime Coles MD

A recent Canadian study among thousands of children tested positive for the COVID-19 with typical signs of headache and fever and loss of taste and smell. A third of the children and teens with the virus showed no symptoms.

Identifying SARS-CoV-2 infection is challenging because the rate of infection is certainly higher than reported. Influenza like symptoms like cough, sore throat and running nose are also frequent signs in the children tested positive or negative in Edmonton Canada, study published in the CMAJ (Canadian Medical Association Journal).

2400 children were considered for the study in the province of Alberta, Canada from April to September 2020.

Loss of smell/taste was found 7 times higher in the kids tested positive and fever was found in almost 70%. A combination of loss of smell, headache and upset stomach was also demonstrated.

I urge parents with kids in kindergarten and primary schools to consider those parameters as landmarks.

On December 29, 2020, A 3-year-old boy in Missouri was discovered to have a stroke after he tested positive for the virus. He is expected to fully recover from the stroke. He was found to have a blood clot and underwent surgical treatment. At first, he stopped eating and taking fluids and he was seen at the local clinic. A COVID-19 test was performed and found to be positive but in front of the localized signs with speech slurred and the inability to move his right side, he was diagnosed with a stroke. Emergent trepanation and evacuation of the hematoma allowed him to survive and recuperate well. The speech came back and he was able to re-gain function of his right side upper and lower extremities.

No other case in the literature or around the world has been reported on a child with a non-traumatic bleed. I am sure that an older individual may have not have the chance to recuperate the way this toddler did. This COVID-19 pandemic has not stopped surprising us. Be vigilant and wear your mask even if you decided to take the vaccine in a near future like I have done this last week.

What are the side effects of the COVID-19 vaccine?

Maxime Coles MD

For some, receiving the COVID-19 vaccine may become an unpleasant experience. No matter what vaccine you will chose to receive, both the Pfizer/Biotech or the Moderna can be quite “reactogenic”. Getting the shot itself may be unpleasant but the shot may make you feel sick for one day or two even through there is no virus to infect you in the injected material. It will certainly stimulate a strong immune response that can cause an uncomfortable sore arm, fever, chills, and headaches. You must be prepared at least for these little side effects. It is surely not as bad as getting the disease itself.

All vaccine you do receive will cause some kind of reaction because this is the role of the vaccine to trigger the body to react against a certain pathogen. In fact, this is a positive reaction allowing us to judge if your immune system has responded well. Mainly, fever, fatigue, chills or even the flu or cold symptoms and even the COVID symptoms can be present once your immune system is stimulated. The virus will not be present. This is a reactogenic reaction of the vaccine which is expected.

These COVID-19 vaccines may be a little more reactive than the flu vaccine but should remind the shingles vaccine. These vaccines can be so reactive that it is never a good idea to vaccinate all your hospital staff at once because of the kind of reaction it can give to the group taking it. It is good then for the hospital to stagger the vaccinations and never offer an entire unit the vaccine together on the same given day.

Even nursing home will not vaccinate all of their staff at once, because of the side effects.

The USA embarks on its largest vaccination campaign in history. It is also complex. Someone who get vaccinated may become unpleasantly surprised with a side effect and not come back for the second dose and they certainly will discuss it with their friends and family. People has to know in front what will happen. We have already pointed out that sore arms, fever and headaches are injection expected. This is a reaction of our immune system to a foreign substance injected. Once injected, the innate immune system recognizes the vaccine material and react to the spike protein. This is what sets off the reactions. Immune cells are recruited to your arm which can become inflamed and sore. The whole body can react with fever and fatigue

Your body will develop an adaptive immunity to fight the material injected. The B cells will make antibodies to bind the spike protein and the T cells will then recognize the infected cells. This adaptive immunity will protect you against COVID-19. This is what is called the reactogenicity which need not to be confused with an anaphylactic reaction. We do not know much what in the injection creates this anaphylactic reaction but the vaccine contains sugar as a cryoprotectant, and salts.  An observation of 30 minutes is recommended by the CDC and the FDA to minimize the effect of an anaphylaxis which can be easily treated with an “EpiPen” of epinephrine or an anti-histamine injection. People who have experienced such reactions have all recovered. You can always report any adverse reactions to these organizations via a hotline which is set up to monitor the reactions. These side effects are expected to last less than 48 hours.

For both vaccines, the reactogenicity of the mRNA vaccine is largely due the bubble of fat used for packaging. These bubbles are called lipid nanoparticles and are more reactive on animals. They can be used also in the flu vaccine but COVID-19 is worse than the flu and we have already discussed about the victims of this pandemic in the USA compared to only 60,000 deaths from the flu. The coronavirus pandemic has done enough and even the one recuperating from the disease, may never feel the same anymore. I prefer having a sore arm or a mild elevation of temperature or muscle soreness for a day or two then in and Intensive Care Unit as a victim of the COVID-19.

I wish all to understand the advantages in taking either of those vaccines and hopefully together we will eradicate this coronavirus SARS-CoV-2 forever. I took my first dose of the Moderna vaccine and use the moment to invite all who may have “cold feet” to take a step toward eradicating the virus. This is the only way we, as a society, will reach this “Hurd Immunity” level to eliminate forever this SARS-CoV-2 from the surface of the earth.

Ivermectin, the anti-parasitic medication
in the treatment of COVID-19

Maxime Coles MD

A new medication in use and showing efficacy in the prophylaxis and the treatment of the COVID-19:  Ivermectin. Large improvements in clinical outcomes are reported when Ivermectin is used both in prophylaxis and as a treating agent in all phases of the disease. Data derived from multiple large experiments that appear to have occurred in South American countries when authorities decided to use the medication. It is apparent that there is a strong feeling that Ivermectin may prove to be a global solution to the pandemic.

In march 2020, Professor Paul E Marik created a Front Line COVID-19 Critical Care Alliance of experts to review the emerging basic science and clinical data on the disease and created a treatment protocol for hospitalized patients (MATH+) in which Methylprednisolone, Ascorbic Acid, Thiamine, Heparin, Ivermectin, Vitamin D, Atorvastatin, Melatonin, Zinc, Famotidine and therapeutic plasma exchange were used. The MATH+ has been adopted while the number of dead in the USA has reached 315,000 over a little less than 7 million of cases.

Ivermectin is a widely used anti-parasitic medication with known antiviral and anti-inflammatory properties found to be very potent and effective in the treatment of COVID-19. Ivermectin inhibits SARS-CoV-2 replication binding to the host tissue via several mechanisms. It diminishes the viral load and protect against organ damage in multiple animal models infected with coronaviruses. Ivermectin was found to hasten the recovery and prevents deterioration in symptomatic patients. In brief, it has reduced the mortality in critically ill patients with COVID-19.

Ivermectin has been used for it anti-viral properties in Influenza, Zika, HIV, Dengue fever, and now in SARS-CoV-2. It has inhibited the replication of the virus in cell culture model and the near absence of viral material 48 hours after the exposure. Ivermectin was found to have the highest biding affinities to spike the protein S1 domains to SARS-CoV-2.

I encourage everybody to review this article and get familiar with this new protocol regimen for hospitalized patients with COVID-19. The article is:

Review of the emerging Evidence Demonstrating the Efficacy of Ivermectin in the prophylaxis and Treatment of COVID-19…. Pierre Kory MD, G, Umberto Meduri MD, Jose Iglesias DO, Joseph Varon MD, Keith Berkowitz MD, Howard Kornfeld MD, … Paul Marik MD et al.