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    • Interesting video, describing a research protocol able to delineate 6 or 7 major criteria seperating those patients with a 4 times greater risk of dying from Covid 19 Acute Respiratory distress.. I have not reviewed the actual paper, and cannot comment on its conclusions other than to offer a bit of interpretation of the comments of the physician in the video.

      The criteria are a bit complicated, because several of the individual criteria actually contain from 2-> 6 "either/or" components, and some are three levels deep. This protocol is actually an algorythm, best evaluated by a computer program.

      Most of the blood tests mentioned seem to center around factors associated with systemic inflammation, but they are precisely quantified in this video.

      I was struck by the fact that the paper could seperate those with 28% risk of dying from those with less than 6.6% risk of dying with a specificity of 79% and a sensitivity of 85%. This kind of predictive power will help identify, earlier, those patients who will almost certainly end up in the Intensive Care Unit.

      The C Reactive Protein levels greater than 4.6 mg/dl are significantly high levels, and would alarm a physician I think.

      Elevated liver enzymes ( ALT, AST alkaline phosphatase) would suggest active inflammation in the liver which would be another worrisome sign.

      The BUN/Creatinine ratio greater than 29 would also concern a physician about the possibility of bleeding in the upper gastrointestinal tract, especially in children, but can be unremarkable in very old patients, say > 80 years of age, or indicate dehydration or heart failure, or renal hypo-perfusion.

      To have 6 or 7 such tests abnormal, all in the same patient, would indeed be alarming, and suggest widespread systemic disease, not just a pulmonary disease. And we also know that Covid 19 disease is a systemic illness with wide ranging organ damage, including widespread vasculitis, which can contribute to the cytokine storms that are so deadly.