Covid-19: The mystery of why coronavirus kills some young people

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All she had was a really low temperature, one that doctors didn’t even really consider a fever, she said. She had a little congestion, but she was recovering. He was not at all worried either when he started to feel bad. After all, they were both young and healthy.

The two worked in the Cliffside Park school district in New Jersey, both as special education teachers – she in school # 4, he in school # 6. High school star baseball player , he pursued his passion by coaching the university baseball team.

For Ben, however, his symptoms quickly became more severe. He was short of breath and the last Friday in March he told Brandy it was time to go to the emergency room. “He was really worried,” says Brandy. “He came into our room where I was lying, and he said, you know, I have to go, I have to take me to the hospital. “

“Are you sure you want to go? She asked him. He said, “Yes, I have to. Brandy drove him to the hospital immediately. She could not enter with him, however, as they did not accept visitors. So she sat in the car all evening and they texted back and forth. “He updated me all the time,” she said.

At the hospital, Ben received oxygen and responded well, said Brandy. They gave him liquids and Tylenol, and then sent him home the same evening. “Keep doing what you do at home,” they said.

The following Sunday, he felt better and showed signs of improvement, said his wife. He got out of bed and had dinner for the first time.

“Sunday was a great day. He was moving around and talking to us, ”said Brandy. Ben was on the road to recovery, it seemed. That night, however, his symptoms returned.

Ben and Brandy Luderer taught in the same New Jersey school district.

“Ben always said the nights were the worst for him, he was sweating and when he went to bed in a certain way,” said Brandy. “It was particularly difficult for him to breathe. “

Ben had a hard time getting comfortable that night. Because Ben was sleeping in the bedroom and Brandy on the couch, they were texting to communicate. At one point, Ben texted his wife and said, “I’m fighting. Brandy asked him if he should return to the emergency room, and Ben replied that he was not sure.

“So I just tried to do everything I could to make him comfortable, you know, calm his breath, you know, make him cool,” said Brandy. She borrowed a humidifier from a friend to try this out.

Once Ben finally settled into his bed, Brandy listened by the door to their bedroom.

“I could hear by the door that he was still breathing and I fell asleep,” she said. She recorded it again at 2 am, and everything seemed OK. However, when she woke up at 6 a.m., she found her 30-year-old husband lifeless in their bed.

“Whether he has known you for five minutes or has known you all his life, he would give you the same respect and try to reach out and help you and make you laugh in every way possible. He was just the kind of selfless person he was, “recalls Brandy.

Listening to Brandy tell the story, my heart broke for her. They were husband and wife, but also best friends, both working in the same school district, driving to work every day. She didn’t know what she would do on her own Monday, let alone the rest of her life.

And Brandy was left with a mystery. She knew her husband was sick, but how was it that a healthy 30-year-old boy with no pre-existing conditions had declined so quickly?

Ben Luder’s story is one of many that have puzzled health officials around the world. Why do some young people get sick and die so suddenly?

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It is true that Covid-19 appears to affect the elderly most severely, especially those with pre-existing conditions such as heart disease, lung disease and diabetes. An older person’s immune system may not be able to fight the disease as well, and the virus may more easily replicate, overwhelm the body, and cause multiple organ system failure.

And yet, as we begin to take a closer look and hear more stories, it becomes clear that there are a lot of people like Ben, who are younger and who get very sick and die. I recently heard the story of 39-year-old healthy living DJ Conrad Buchanan from Florida who also died of coronavirus despite the absence of underlying disease, according to his wife. .

We have known for some time that this new disease, Covid-19, was not just the disease of an elderly person. It has become clear that young people and healthy people are by no means immune to this infection and could become sick enough to require hospitalization.

In an initial survey by the United States Centers for Disease Control and Prevention, for 2,449 patients of known age, 18% were between 45 and 54 years of age, and 29% were between 20 and 44 years of age. Of those who were hospitalized, 18% were aged 45 to 54 and 20% were aged 20 to 44.

Young people are much less likely to die, but an unusual pattern seems to be emerging. As Dr. Anthony Fauci told me, this is what makes the coronavirus an “unusual disease”.

“I am fascinated,” he said, “… by what I would call pathogenesis. “

“You know, there are so many people who are doing well and then people who, bingo, are on a ventilator, they are on ECMO (cardiopulmonary apparatus) and they are dead,” Fauci told me. when I interviewed him for my podcast, “Coronavirus: Fact vs. Fiction. “

“I mean, the dichotomy between that, there is something there, Sanjay, that we miss from the point of view of pathogenesis.” And I don’t think it’s only if you’re elderly or if you have underlying conditions. Something else is going on there, we hope we will come to understand. “

So, what could be behind this? Scientists and researchers are wondering if the answer could lie in our genes and are starting to try to understand what differentiates people with mild cases from those who die.

One possibility is a gene variation in the ACE2 gene. ACE2 is an enzyme that attaches to the outer surface of lung cells, as well as to the heart. In an article in Science magazine, Dr. Philip Murphy, immunologist, from the National Institute of Allergy and Infectious Diseases, said that “variations in the ACE2 gene that alter the receptor could make it easier or more difficult for the virus in lung cells “.

It is also possible that an essential ingredient produced by the body, known as a surfactant, which allows the lungs to expand and contract better, may be depleted in some patients with coronavirus. If you think of your lungs as a sponge, the surfactant would be the detergent that would make them soft and supple. Without a surfactant, however, your lungs become rigid and difficult to tighten. This may be the reason why some patients continue to struggle even on the respiratory system.

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Another avenue being considered is to better understand how your body’s immune system reacts to viruses and bacteria in the first place. In some young and healthy people, a very reactive immune system could cause a massive inflammatory storm that could overwhelm the lungs and other organs. In these cases, it’s not an aged or weakened immune system that’s the problem – it’s the one that works too well. Some front line clinicians have hypothesized that steroids, an immune system inhibitor, appear to provide benefits to some people.

This may be because some younger, healthier people, who thought they were not vulnerable to this disease, were less diligent in physical distance and were therefore exposed to much higher viral loads. of the environment.

To better define the underlying pathology, this can still take months and can be variable in patients, regardless of their age. While it is true that a significant percentage of young people may be at greater risk because Americans have a high referral rate for preexisting diseases such as diabetes, it is perfectly healthy young people, such as Ben and Conrad, we must better understand.

For now, regardless of your age or underlying condition, the advice remains the same. Stay at home, wash your hands and minimize your exposure to viruses. Even if you develop mild symptoms, it is probably best to stay home to recover.

But if you develop difficulty breathing, persistent pain or pressure in your chest, sudden confusion or inability to wake up, or bluish lips or face, please, it’s time to go to the hospital. ‘hospital.

Ben Luder’s wife says doctors still can’t explain exactly what happened.

“We don’t really know,” Brandy told us. ” I do not really know. “

For now, all she can do is take it minute by minute, hour by hour and day by day to measure how quickly her life has changed.

“Ben and I were the kind of couple who did everything together,” she said. “So it’s very difficult to figure out where to go with this when you don’t have your life partner with whom you did it all. So I’m still trying to wrap my head. “

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