Unusual Presentations of the Covid-19 Coronavirus

Unusual presentations of the Covid-19 coronavirus were unknown when it first emerged in Wuhan, China at the end of 2019. Initially the virus presented with a high fever, cough, tiredness, sore throat and aches and pains. Subsequently cases of diarrhea, conjunctivitis, headaches and loss of smell were often accompanying the illness. Patients with a weak immune system in old age or from chronic diseases are particularly vulnerable. They can come down with viral pneumonia, which often results in intubating the patient. 50% of these cases may recover, the other 50% die.

Descriptions of unusual presentations of the Covid-19 coronavirus

In the last few months doctors have seen unusual presentations of the Covid-19 coronavirus. There were cases that seemed to be fine in the first 10 days. But then sudden severe illness struck. In one case a 38-old man was diagnosed with Covid-19 coronavirus in an urgent care clinic. He was told to go home and isolate. He felt not too bad, but had a bit of a cough. The following day he woke up with his legs feeling cold and numb. His leg muscles were so weak, he could not walk. An ambulance took him to the Westchester Medical Center in New York.

Blood clot secondary to Codid-19 coronavirus

Tests showed that he had a large blood clot in his aorta right at the bifurcation of the iliac arteries. When no blood goes through the iliac arteries, no blood can reach the femoral arteries. This explained his leg symptoms. Emergency surgery removed the blood clot and saved this man’s legs and life.

Other unusual presentations of the Covid-19 coronavirus

Apart from blood clots of all sizes doctors also found kidney failure, heart inflammation and complications of the immune system. One of the doctors stated that the virus can present in one patient as difficulties to breathe. But in another patient, there can be suddenly multi-system organ failures. Doctors noted that coronavirus can infect the lining of blood vessels directly. This causes an acute inflammation and blood clots. As blood vessels supply all organs with blood, it is not difficult to imagine that a reduction in blood flow can cause multi-organ failures. Doctors have stated that this is a confusing picture, and it will take some time to understand this further. There is another coronavirus-linked syndrome that is worrisome, the pediatric multisystem inflammatory syndrome. It is commonly found in children less than 5 years of age.

Pediatric multisystem inflammatory syndrome

This syndrome can affect children less than 5 years of age, although in the beginning it was assumed that children would be less likely to have Covid-19 coronavirus infections. Pediatric multisystem inflammatory syndrome is the second phase of a coronavirus infection. Symptoms include abdominal pain, gastrointestinal symptoms and inflammation of the heart. Symptoms are persistent fever, inflammation and poor function in one or more organs. Some children present with shock. These children need admission and treatment in  a pediatric ICU ward right away. Some doctors think that the cytokine storm initiated by the Covid-19 coronavirus is responsible for this syndrome. It may be an overreaction of the immune system that can be the cause.

Delirium in patient testing positive for Covid-19 coronavirus

A patient in Saudi Arabia who has been traveling abroad presented with confusion from a delirium. He had a spiking fever and mild respiratory symptoms. A swab test for SARS-CoV-2 was positive. He recovered very quickly and  spontaneously and had no residual problems.

Unusual presentations of the Covid-19 coronavirus in elderly patients

In a study from French Switzerland coronavirus patients who were older than 70 years of age were analyzed. Half of the patients who died were over 83 years old. Symptoms can be as vague as “altered general condition”, unusual fatigue or delirium. Even a fracture can be an indication that a hidden coronavirus infection caused dizziness, loss of balance and a fall.

Gastrointestinal symptoms common in adults

In adults symptoms of fatigue, diarrhea, nausea and vomiting are common for Covid-19 coronavirus. This is in contrast to the usual presentation of upper respiratory symptoms followed by a fever and coughing.

Unusual presentations of the Covid-19 coronavirus in pregnant women

A publication from Wuhan, China reported about pregnant women shortly before and after their deliveries.

Their gestational age was between 38th weeks to 41st weeks. Prior to their delivery they had no fever or symptoms of coronavirus. Following the delivery many had a mild fever of 37.5℃-38.5℃. Kidney and liver functions were normal. Two women had mild elevation of heart enzymes. The newborn babies were all healthy. Women before the delivery tend to not have any fever. After the delivery low-grade postpartum fever or mild respiratory symptoms were the only symptoms present in those with positive tests for Covdi-19 coronavirus.

Unusual Presentations of the Covid-19 Coronavirus

Unusual Presentations of the Covid-19 Coronavirus


There are unusual presentations of the Covid-19 coronavirus. Older people may present with an “altered general condition”, unusual fatigue or delirium. In very young children the pediatric multisystem inflammatory syndrome may present as abdominal pain, gastrointestinal symptoms and inflammation of the heart. On the other hand, in more severe cases acute shock may be present. In late pregnancy shortly before delivery the pregnant women had hardly any symptom and no fever. But post-delivery women with positive Covid-19 test presented with a mild fever and cold also show mild respiratory symptoms. In middle aged adults sudden blood clots stemming from inflammation of the lining of blood vessels can shut off the blood supply to multiple organs. This causes a dangerous condition of multiple organ failure. The liver, heart and kidneys are often affected.

This is still a new virus, and researchers do not know enough. Much more research is necessary to clarify the differences of presentation in patients with Covid-19 coronavirus.


What Limits Our Life Expectancy?

Most anti-aging experts say that there are a number of factors that in combination lead to what limits our life expectancy. Right now the average life expectancy is about 80 years. With a bit of effort it can be expanded until 115 to 120 years. I like to discuss what these limits are.

1.Diseases that limit our life expectancy


  • Congenital hypertriglyceridemia and familial hypercholesterolemia

We all know that certain diseases can shorten a person’s life. Some families have a history of congenital hypertriglyceridemia. There is a history of all the male family members having heart attacks at a young age and dying prematurely. In other families it is the LDL cholesterol that is congenitally elevated, causing premature heart attacks.

  • Obesity

Obese people come down with diseases that shorten their lives. There is diabetes that is more common with its own problems of nephropathy, cardiovascular disease and blindness. But obese people also can get severe osteoarthritis in hips and knees that often lead to total hip and knee replacements. With complications people will die prematurely.

  • Liver cirrhosis

A number of conditions lead to cirrhosis of the liver: chronic alcohol abuse, viral hepatitis (particularly hepatitis B and C) and non-alcoholic fatty liver disease. There are also a few less common causes.

  • Kidney failure

There are several clinical conditions that can lead to kidney failure, like diabetes, high blood pressure, polycystic kidney disease, but also abuse of non-steroidal anti-inflammatory drugs (NSAID’s) for joint disease.

Unfortunately kidney disease like this often shortens a person’s life.

  • Alzheimer’s disease and Parkinson’s disease

When a person is diagnosed with Alzheimer’s disease the life expectancy will only be about 10 years on average.

Parkinson’s disease treats the patient somewhat better with a life expectancy of between 10 to 20 years after diagnosis.

But any neurological disease seems to significantly shorten the life of a of a person. This list is not complete, but these diseases are common. All of them will shorten a person’s life expectancy. The key is prevention to avoid the onset of these diseases.

2. Mitochondria and the biology of aging

The small organelles in each cell, the mitochondria are the power packs of our cells. Mitochondria can be preserved through exercise, CoQ10 supplementation and caloric restriction. This overcomes a lack of energy and strengthens the muscles of the body, which includes the heart. As Dr. Whitaker has shown in this link, it is simple. Eat less, exercise more and take nutritional supplements.

3. DNA mutations

The big question is how do we preserve DNA against damage from the everyday metabolism by-products and ionizing radiation from space? There are many open questions. Our DNA does not sit still, it constantly moves, genes are activated and suppressed, and in this process we lose cancer suppressor genes causing cancer that eventually can kill us. Our scientists today are smart, but they are not that smart that they would know all the future research results they have not yet detected. The answer would be stabilization of DNA, as this could prevent many cancers and would definitely prolong our lives. 

4. Reducing telomere length

In one study the telomere length at the age of 100 was only 40% compared to the age of 20. Now we are learning that it is possible to lengthen telomeres by healthy lifestyles. Research in humans has shown that increased physical activity elongated telomeres. So did vitamin C, E, vitamin D3 supplementation and resveratrol. A Mediterranean diet and marine omega-3 fatty acid supplementation elongate telomeres as well. In addition, higher fiber intake, bioidentical estrogen in women and testosterone in men can be effective in elongating telomeres. Finally, relaxation techniques like yoga and meditation are also elongating telomeres.

Longer telomeres are responsible for longevity

Below I am listing evidence that longer telomeres are not only responsible for longevity, but protect you also against major diseases like heart attacks, strokes and cancer.

I like to start by providing a link where research explains more about this question.

Below I am going to summarize the facts that show that telomere lengthening is something to strive for.

General comments about telomere length

When telomeres shorten progressively, senescence sets in. Cells undergo a process called apoptosis, which is the normal process of cells dying. But some cells stay in that in-between state and transform into cancer cells. Shortening of telomeres affects health and the lifespan of a person. Shorter telomeres are responsible for the development of disease and reduced survival.

Telomeres as an internal clock, age-related

Telomere length can serve as an internal clock as to how long our cells and organs will live. In this context it is important to mention that lifestyles have an important role in preserving the length of telomeres (see below).

Telomere length decreases with age. In humans the loss of telomere length is about 26 (24.8–27.7) base pairs per year. This is the “clock that is ticking”. A number of factors affect the telomere length: age; genetic factors (some people come from families with longevity); certain factors that influence the gene expression, called “epigenetic factors”; social status and economic well-being; exercise; and smoking. The good news for everybody: gender does not affect the rate of telomere length loss, but lifestyle does!

Measurements of telomere length

  1. People who had their white blood cell telomere length tested and got the result of having shorter telomeres than the average in their age group, had a 3-fold higher risk of developing a heart attack. People in nursing homes with shorter telomeres had a much higher risk of death than controls with longer telomeres. Excessively short telomeres can lead to genomic instability, inter-chromosomal fusion and cancer.
  2. In cancer cells the telomeres are short, but telomerase, an enzyme that can elongate telomeres is elevated compared to the normal surrounding cells. Several studies have shown that shorter telomeres are a risk factor for cancer. An example was a genetic syndrome, called dyskeratosis congenita. Dyskeratosis congenita – Wikipedia In this syndrome the body cells have short telomeres. This leads to premature graying, vulnerability to infections, progressive bone marrow failure, predisposition to cancer at a young age and premature death in adults.

Effects of smoking and stress on telomeres

  1. Effects of cigarette smoking: If you smoke one package of cigarettes per day, you lose an additional 5 base pairs in the telomere (on top of the average of 26 cited above). If you smoke one pack of cigarettes a day over 40 years, this is the equivalent to the loss of 7.4 years of life.
  2. Stress ages you faster. A study showed that telomeres were shorter in a group of stressed women and telomerase was missing as well, when research measured white blood cells (monocytes). Accelerated telomere shortening in response to life stress. The difference between the telomere length of a control group and the stressed women was the equivalent of 10 years of life on average!

Lifestyle factors that influence telomere length 

Dietary factors

High fiber intake showed an association with elongated telomeres in a group of women, but excessive weight shortened telomeres. Polyunsaturated fatty acids, especially linoleic acid was shortening telomeres as well. Reduction of protein intake tended to cause longer telomeres, which is responsible for longevity. In rat experiments protein restriction early in life led to longevity and long telomeres. In these animals’ kidney cell telomeres were particularly long.

Dietary supplements

Detailed studies exist about the effect of omega-3 fatty acids on telomeres. Studies followed women who consumed foods rich in omega-3 fatty acids for 5 years. A control group with low omega-3 fatty acids in their diet were also part of a study. The antioxidant effect of omega-3 fatty acids reduced the rate of telomere shortening. The control group lacking omega-3 fatty acid in the diet had much shorter telomeres. This group had a moderate risk for developing breast cancer. Other antioxidants like vitamin E, vitamin C, beta-carotene showed a link to longer telomeres and a lower risk to develop breast cancer. Antioxidants protect the DNA of telomeres from oxidative damage.

5. Decreasing hormone production

Another factor of aging is hormone deficiency in general and human growth hormone (HGH) deficiency in particular. In the past the school of thought was that HGH was only important for bone growth in children and young teenagers. However, more research revealed that it has also an important maintenance function. This maintenance concerns our muscles including the heart and to preserve our brain. Here is a review article about human growth hormone deficiency that may be mind-blowing to you. When people age, they lose HGH production putting them at a considerable risk to get heart attacks and strokes. But they are also at a higher risk of serious falls due to muscle weakness and balance problems.

Diagnosis of HGH deficiency

When the doctor detects low IGF-1 levels in the blood this is a sign of HGH deficiency. This graph shows that beyond the age of 60 HGH levels are extremely low. Tests that check for low HGH metabolites in a 24-hour urine sample are necessary to confirm this.

Replacement of HGH in aging people

When this test is also showing HGH deficiency, the time has come to do daily HGH injections with human HGH. The injection is easy, as it uses using a similar pen that is the common device for insulin injections. The dosage is only between 0.05 mg and 0.25 mg per day, and the administration is before bedtime. There is a significant cost to this treatment. For this reason, it is important to check whether the personal health care plan covers injections with human growth hormone, as it is a true hormone deficiency in many aging people.

Replacing missing HGH production with HGH injections

This is remarkably effective not only for heart attack and stroke prevention, but also to treat muscle weakness. In addition, it treats lack of mental clarity and increases general well-being. Patients report that their joint and muscle aches disappear. They can engage in physical activities again. But HGH is not the only hormone that needs monitoring. Tests for thyroid hormones, sex hormones like estrogen and progesterone in women and testosterone in men are also necessary. When levels are low, there is a need for hormone replacement in the form of nature-identical hormones. The estimate is that you gain about 10 to 15 years of good and active living by replacing missing hormones with bioidentical ones.

6. What can we do to maximize our life expectancy?

Here are a number of factors that help preserve telomeres and thus reduce aging and keep you from getting serious illnesses like heart attacks, strokes and cancer.

  • Consider eating less.
  • Include antioxidants, fiber, soy protein and healthy fats (derived from avocados, fish, and nuts).
  • Stay lean, active, healthy, and stress-free (regular exercise and meditation).
  • Eat foods such as salmon, herring, mackerel, halibut, anchovies, catfish, flounder, flax seeds, chia seeds, sesame seeds, kiwi, black raspberries, lingonberry, green tea, broccoli, sprouts, red grapes, tomatoes, olive fruit, and other vitamin C-rich and vitamin E-rich foods. They are a good source of antioxidants. Avoid tuna and grouper fish because they are too high in noxious mercury.
  • These habits combined with a Mediterranean type of diet containing fruits, and whole grains will help protect your telomeres.
  • Replace missing hormones
What Limits Our Life Expectancy?

What Limits Our Life Expectancy?


At the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about “How to extend the human lifespan by 40 years”. He said that bioidentical hormone replacement could add 15 years of life. Organ transplants, if necessary, telomerase activators and stem cell therapy can add another 25 years of life expectancy to a total of 40 years. He felt that there is a limit of about 120 to 125 years of life expectancy. I have blogged on this here: life extended by several decades.

Limits of extension of life

“Living forever” is simply not in the cards, as we do not have all the answers to preserve DNA and mitochondria from damages. What nature has done since its existence is by rejuvenation through eggs and sperms create new life. This circumvents the longevity conundrum.

We are living longer than our ancestors. Many diseases have become treatable, and it is encouraging to see this progress. But there is a limit of what can be done.

More information


Suppression Of Estrogen Affects Cognitive Function

Female patients with gynecological problems such as fibroids and endometriosis can be treated with leuprolide acetate depot (LAD) or Lupron. LAD suppresses ovarian function and decreases estrogen to the levels of postmenopause. In menopause estrogen levels show a natural drop. In this group the estrogen levels were chemically suppressed. The patients ranged in the ages 25 to 40 years of age-all of them well before the age of menopause. The researchers were able to observe the effects of estrogen on cognitive function without the brain changes associated with normal aging.
Dr. Barbara Sherwin, PhD, professor for psychology and obstetrics at Mc Gill University in Montreal stated that previous research has shown a connection between decreased estrogen and the deterioration of verbal memory. Taking estrogen during menopause can prevent this deterioration. The current study also showed a significant decrease in working memory and scores regarding mood in the women who are taking LAD.
Dr. Sherwin suggested also that some research points to a window of opportunity around the time of menopause where estrogen will protect.

Suppression Of Estrogen Affects Cognitive Function

Effects of estrogen (=E2) on the brain

But beyond that time, such as at the age of 65 or older, estrogen treatment does not provide these benefits. As shown in the Women’s Health Initiative study it may be detrimental.

Reference: The Medical Post, August, 22, 2006, page 45

Comment on Nov. 13, 2012:   There is a big difference between conventional hormone replacement therapy (HRT) and replacement of hormones with bio-identical hormones. The former (HRT) is what was proven by the Women’s Health Initiative study to be detrimental to postmenopausal women; the latter (bio-identical hormone replacement) is what a lot of European women have done for decades and what has benefitted them tremendously without side-effects whatsoever. Inform yourself and read more about treatment of menopause under this link (Nethealthbook).

Last edited December 6, 2012


Magnetic Therapy For Depression

Depression is a psychiatric condition, which is experienced by a lot of people. It is more than just a transient feeling of the “blues”. Depression can be a chronic and disabling disease, and in severe cases there is the risk of suicide. Great advances have been made from removing the social stigma from psychiatric illness, and cognitive therapy and effective medications can help most the patients to lead full and productive lives.
For a few patients however, depression can be drug-resistant and as a result, effective therapy will be much more difficult.
According to research by Dr. Gary Hasey at Mc Master University in Hamilton, Canada, magnets may have a future role in the treatment of mood disorders. TMS (standing for transcranial magnetic stimulation) has shown promising results in the treatment of some types of depression. A so far unpublished study found that 27% of 50 patients with drug -resistant depression achieved full response with TMS.

Simulated treatment in a control group did not produce this result in any of the patients. MRI scans have shown that depressed people have below-average brain activity in the frontal cortex of the brain. A magnetic field, which is created by passing an electric current through a hand-held magnetic coil, is aimed at the patient’s pre-frontal cortex, which stimulates the brain activity in this area. This treatment is vastly different from the well-known electro-shock treatment (ECT), where the patient needs sedation and close observation in a hospital setting. Contrary to this, TMS can be done without sedation.

Magnetic Therapy For Depression

Magnetic Therapy For Depression

The patient is conscious and can resume his normal activities after the treatment. The therapy was first discovered in the 1980’s, but a lot of research had been necessary before treatment could be made available. Other trials are also running in Great Britain, and promising results have been published in the medical paper “The Lancet”. Dr. Hasey cautions that there are still some details that have to be worked out. In the meantime Health Canada has approved TMS as treatment for drug-resistant depression.

More information about depression:

Reference: The Medical Post, February 1,2005, page 28

Last edited October 27, 2014

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Less Multiple Sclerosis (MS) With Vitamin D Supplement

In multiple sclerosis (MS) the body’s immune system appears to attack the insulation material of nerve cells (called “demyelination”) leading to areas of focal inflammation. These areas can be depicted with MRI scans (see white MS lesions, compared to a normal brain). A new study showed that vitamin D supplementation (as part of a multivitamin supplement) was reducing the risk of developing MS in women when compared to women who did not take supplements. This study was published by Munger et al. from the Department of Nutrition, Harvard School of Public Health, Boston/MA, in the Jan. 13, 2004 edition of Neurology.

The study is based on data from two large nurses health studies (NHS with 92,253 women followed from 1980 to 2000 and NHSII with 95,310 women followed from 1991 to 2001). The study material was pooled into one database. Among these 187,563 women 173 developed MS during the course of the original studies. When the group of women who took 400 IU or more of Vit.D supplements (as multivitamins) were compared to the group who took less than 400 IU or none, the investigators found that they were 40% less likely to develop MS. Other factors that can lead to higher frequencies of MS such as smoking or latitude at birth had been adjusted for. There has not been a change in the results of the protective effect of Vit.D. With food being the only source for vitamin D (skim milk, fish) the protective effect against MS was not demonstrable. However, when food vitamin D was combined with additional multiple vitamin tablets (with vitamin D) the protective effect against MS was observed.

Less Multiple Sclerosis (MS) With Vitamin D Supplement

Less Multiple Sclerosis (MS) With Vitamin D Supplement

In the introduction the authors pointed out that Vit. D has been shown in other studies to be an immune response modulator weakening autoimmune reactions. This effect has been shown clearly in a mouse model of MS, called experimental autoimmune encephalopathy. There are also data available from human research, which showed that certain cytokines are released in the presence of vitamin D so that the immune cells are less likely to attack the brain tissue. There were also seasonal variations that could be demonstrated in this study, which indicated that MS lesions were progressing at times when vitamin D levels were low and that they were regressing when vitamin D levels were high.

The authors of this study stressed that this is the first study to suggest a protective effect of vitamin D against MS, which would have to be confirmed in other studies that preferably would also include males. It shows a very strong statistical connection, but cannot conclusively prove causation. The investigators said that further studies will also be needed to confirm the notion that vitamin D may be beneficial as part of the treatment in MS patients.

Link regarding vitamins and minerals:

Last edited December 8, 2012


Blood Clots In Legs Can Be Caused From Long Flights

A new study from Australia has shown that the risk for developing blood clots in the legs (deep vein thrombosis) is increased 4-fold in the first two weeks after a long-haul airplane flight. This was published on Nov. 8, 2003 in the British Medical Journal (BMJ. 2003;327:1072) with the lead author being Dr. C.W. Kelman of the Commonwealth Department of Health and Ageing, Canberra.

Data was collected of 5,408 patients who had been hospitalized to Western Australian hospitals for deep vein thrombosis between 1981 and 1999. A total of 153 Australians were admitted with blood clots in the leg veins within 100 days of international flights. 46 of these patients developed their blood clots within 14 days of arrival, which was much more than would have been expected in the general population. The researchers found that between 15 days and 100 days following a long-haul flight the risk of developing clots in the deep veins of the legs was not increased from the background rate of the general population. The patients who had developed their blood clots within 14 days of a long flight had a risk that was 4.17-fold higher than the average population’s risk. Of these patients 76% were thought to have developed the clots as a result of a flight. In terms of a yearly risk, if a person does one long-haul flight per year, the probability of developing a clot in the leg veins would be about 12% higher than in a non-traveling comparison group. As this condition is treated effectively with blood thinners, the death rate is quite low, approximately 1 per 2 million long-haul flights.

Blood Clots In Legs Can Be Caused From Long Flights

Blood Clots In Legs Can Be Caused From Long Flights

This would be much lower than the risk of death from car accidents. The authors suggested that more study is needed to determine the risk factors for developing flight induced deep vein thrombosis. When this is known, investigations will be able to concentrate on blood clot prevention from air travel.

Link to a chapter on pulmonary emboli, which can develop from a deep vein thrombus that breaks loose.

Last edited December 9, 2012