The three primary Lung defences to maintain “iron homeostasis”, two of them are in the alveoli.
The first of the two are macrophages that roam around and scavenge up the free radicals of the oxidative iron. The second is a lining on the epithelial surface which has a thin layer of fluid packed with high levels of antioxidant molecules such as ascorbic acid (Vitamin C) among others.
When too much iron is in circulation, it begins to overwhelm the lungs’ counter measures begins, the process of pulmonary oxidative stress. This leads to damage and inflammation, which leads to the so-called Cytokine storm; this can be documented on high-resolution CT scans of
In COVID-19 patient lungs, It is a fact that it affects both lungs at the same time and Pneumonia rarely ever does that, but COVID-19 does every single time.
The liver is attempting to do its best to remove the iron and store it in its ‘iron vault’. Only its getting overwhelmed too. It is starved for oxygen and fighting a losing battle from all the haemolysis haemoglobin and the freed iron ion. The liver will start releasing alanine aminotransferase (ALT) which is the second of 3 primary COVID 19 severity score indicators.
A patient must be managed on maximum oxygen flow through a hyperbaric chamber on 100% oxygen at double or multiple atmospheres of pressure, for 90 minutes twice per day for five days.
This is in order to give what has left of their functioning haemoglobin a chance to carry enough oxygen to the organs and keep them alive.
We do not have nearly enough of those hyperbaric chambers, and we might use all parked grounded aeroplanes as a ready-made functional hyperbaric chamber with the advantage of providing double atmospheric pressure with an aerosol of prostacyclin as pulmonary hypertension modulator.
Blood transfusion with packed fresh red blood cells to patients after plasmapheresis may ameliorate the cytokine storm.
The main point that patients will require ventilators if they present late with multi-organ system failure to tie them over this life or death scenario. However, intubation is futile unless the patient’s immune system modulates the situation. We must address the root of the illness and avoid using traditional teachings to manage a failing system.
No longer armchair pseudo-physicians sit in their little ivory towers, proclaiming “Chloroquine use is stupid as malaria is bacteria, COVID-19 is a virus, anti-bacteria drug no work on the virus!”. A drug does not need to act on the pathogen to be effective directly. Chloroquine lowers the blood pH and interferes with the replication of the virus.
We advise that if COVID-19 positive patients are conscious, alert, compliant, they must be kept on maximum oxygen and initiate hyperbaric oxygen as early as possible.
If we reach the inevitably to ventilate, it must be done at low pressure but with maximum oxygen flow. We must avoid tearing up the lungs with maximum PEEP as we are doing more harm to the patient because we are managing the wrong organ.
There is a small village in northern Italy where the majority of its population suffers from thalassemia. They had no deaths and no cross-community spread. Moreover, parts of Nepal which are 1km above sea level are COVID-19 free. All points that we are chasing the wrong organ; it is not the lungs; it is a blood problem.
MacKenzie&Greeff