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Semi-protected edit request on 16 January 2021 - Ivermectin

Add the following text to this Wikipedia article in the Treatment#Medications section:

On January 14, 2021, the NIH COVID-19 Treatment Guidelines were updated to remove the recommendation against the use of Ivermectin.[1] (See [2], p.17 for an explanation of NIH recommendation language). The recommendation for Ivermectin is now the same as for the widely-used monoclonal antibodies & convalescent plasma. Ivermectin is an FDA-approved pharmaceutical.--Vrtlsclpl (talk) 21:20, 16 January 2021 (UTC) Vrtlsclpl (talk) 21:20, 16 January 2021 (UTC)

 Not done As has been discussed elsewhere, the proposed edit is WP:SYNTHESIS, failing WP:V. This drug is not approved for use with COVID-19, and evidence for it is weak, hence mention here is undue. Alexbrn (talk) 21:24, 16 January 2021 (UTC)

Back and forth with blocked editor

Vrtlsclpl. The content you keep trying to add is not in the source. On Wikipedia accuracy in adding content is necessary to clearly represent a source. Close is not good enough (except in grenades) nor is extrapolation. The source says,"that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19." This does not equal recommendations were removed. Extrapolation is synthesis as noted by Alexbrn above and not compliant on Wikipedia. Multiple editors are telling you your suggested addition is not WP compliant. Littleolive oil (talk) 21:53, 16 January 2021 (UTC) I actually attached two references. The second reference is for the earlier NIH COVID-19 guidelines. The earlier guidelines contain the phrase: "recommends against the use of Ivermectin...". In the updated guidelines this phrase is removed. More importantly, the recommendation is now equivalent to the recommendations for monoclonal antibodies and convalescent plasma. Re: Alexbrn. His statement "This drug is not approved for use with COVID-19..." is true but misleading. FDA approval was granted for Ivermectin for use in onchocerciasis and strongyloidiasis. Subsequent off-label use does not require de novo FDA approval. --Vrtlsclpl (talk) 22:19, 16 January 2021 (UTC) Do not commit synthesis, and please top trying to push this hype into Wikipedia. The cited NIH source is explicit: "Ivermectin is not FDA-approved for the treatment of any viral infection." Alexbrn (talk) The NIH guidelines do in fact contain that language and it is obviously a true statement. The flaw is in your interpretation. The facts are straightforward: (a) FDA approval was granted for the use of Ivermectin for onchocerciasis and strongyloidiasis. (b) Subsequent off-label use of Ivermectin does not require FDA review. In other words: interesting but irrelevant.--Vrtlsclpl (talk) 23:53, 16 January 2021 (UTC) In a disease that is rapidly changing including the research on that disease, logically, we'd want to use the most recent updates and so most accurate information to date; earlier guidelines are of no use to us here unless we were writing a history, as context, of the disease. Why would we be interested in Ivermectin in the treatment of onchocerciasis and strongyloidiasis since this article is on Coronavirus? And off-label use does not equal an NIH recommendation for use. Vrtlsclpl. Your arguments have nothing to do with how Wikipedia works and are off-base enough to make me think you are either pushing an agenda that has nothing to do with fact or lack experience in dealing with Wikipedia. If you lack experience perhaps familiarize yourself with the policies and guidelines. If you're pushing an agenda you are doomed to failure and possibly sanctions, so be careful. Littleolive oil (talk) 00:07, 17 January 2021 (UTC) I hope I don't come across as pushing an agenda. I'm not. I am just trying to make an improvement to this article. The list of medications for treatment of COVID-19 seems arbitrary. I will be more specific. Ivermectin like Baricitinib is an FDA approved drug with the neutral NIH endorsement. As it stands however, Wikipedia included Baricitinib in the treatment options while excluding Ivermectin. I strongly suggest keeping as close as possible to governmental guidance on this issue. There is controversy within the medical community on this issue and Wikipedia should steer clear of that. Let me also address your specific concerns. As far as the mention of onchocerciasis and strongyloidiasis; those are mentioned only to make the point that Ivermectin is FDA approved. The misconception is that if Ivermectin was approved for onchocerciasis and strongyloidiasis that it is limited to treatment of those diseases. As every physician in the US knows, all drugs can be used off-label. As such, when Ivermectin was approved for use against onchocerciasis and strongyloidiasis, it was effectively approved for COVID-19. It is a semantic trick to say that Ivermectin was not FDA-approved for treatment of any viruses. Technically, yes, it was not approved for COVID-19. But it's also true that COVID-19 is an approved use for Ivermectin by virtue of the fact that it doesn't matter which disease a given drug was approved for originally. Let me reiterate. Neutrality in editing is important in all articles at Wikipedia. It is extraordinarily important in an article on treatment options for COVID-19.--Vrtlsclpl (talk) 02:38, 17 January 2021 (UTC) Seeing that request for neutrality, I shall wade in. I suspect you are looking at this purely from the perspective of 5% of the world's population. I think I know what FDA might be. Never heard of NIH. I'm guessing they are American institutions, so not relevant to 95% of the world. We need to do better in this global encyclopaedia. HiLo48 (talk) 02:44, 17 January 2021 (UTC) No offence intended. The NIH endorsement is just a useful metric in this particular case. However, I don't want to take a position on which standards Wikipedia should be using for inclusion of medications in this article. --Vrtlsclpl (talk) 03:18, 17 January 2021 (UTC) ...and neutrality is based on using the sources not on extrapolations from what any single editor thinks the sources mean. Stick to the sources. This is an encyclopedia not a research paper, not an opinion piece on the state of the covid research. What you think doesn't matter, what you think are the treatment options doesn't matter, we aren't providing life saving information on Wikipedia. As an encyclopedia we are simply reiterating what is in the reliable verifiable sources. Nothing more. You are not neutral per Wikipedia. I suggest again that you review the Wikipedia policies and guidelines so that you understand what Wikipedia means by neutrality not what any editor's idea or definition of neutrality is. And apparently there was discussion on this and editors reached a consensus. If that is true you are bucking consensus. Wikipedia operates on a collaborative platform. In the case of contention agreement among editors is the deciding factor.Littleolive oil (talk) 04:45, 17 January 2021 (UTC) "And apparently there was discussion on this and editors reached a consensus." Do you know if it is available to read through? I would definitely be interested. --Vrtlsclpl (talk) 04:57, 17 January 2021 (UTC) There have been multiple discussions about the sources on Ivermectin which you have been part of. In reviewing many of these discussions it's pretty clear you are pushing for inclusion in a way that is not supported by Reliable Sources and there is a general agreement with in those discussions on this. I am not aware of a formal consensus if that's what you're looking for. But meeting the same kind of resistance from multiple experienced editors is troublesome. Littleolive oil (talk) 01:10, 18 January 2021 (UTC)

Ivermectin was investigated for use in COVID and found not to be helpful. The NIH source above does specifically discuss the drug. The problem I see is that in the article we are including some drugs that were used but are no longer recommended (e.g. hydroxychloroquine) while not including others (e.g. azithromycin, and the one we're discussing now - ivermectin). I think we should to come to a decision whether to discuss formerly used/investigated drugs, maybe just list them as investigated but no longer recommended, or not include them at all. MartinezMD (talk) 05:22, 17 January 2021 (UTC)

I would say mention drugs that are investigated that are found to be not recommended as that would be considered encyclopedic knowledge, and it would prevent readers from asking "but what about drug?" when they don't see it mentioned. —Tenryuu 🐲 ( 💬 • 📝 ) 04:02, 18 January 2021 (UTC)

+1 to @Tenryuu's proposal to mention them briefly. @MartinezMD, do you think you could give us a reasonably complete list of "previously used" drugs? WhatamIdoing (talk) 21:10, 19 January 2021 (UTC)

(I mean, if it would be easy for you to make the list. Otherwise, we can all pitch in and pull together a list from scratch.) WhatamIdoing (talk) 21:10, 19 January 2021 (UTC)

There are numerous that were trialed or used on various levels, which makes me favor including only currently used/recommended in this article (or still being used broadly/notably) and just including a link to the other articles. See COVID-19 drug repurposing research, COVID-19 drug development, and Treatment and management of COVID-19. MartinezMD (talk) 22:11, 19 January 2021 (UTC)

If there are enough unrecommended drugs, maybe they could warrant a list with citations that state that the drugs are unsuitable for treating COVID-19, and linked to COVID-19 vaccine? Alternatively, if such a repository exists off-Wikipedia, that could be linked to as a source. —Tenryuu 🐲 ( 💬 • 📝 ) 22:21, 19 January 2021 (UTC)

Did you look at the list of drugs in the first article I linked? We're talking about 40 drugs there alone. I'm not adding all those with links as to why they shouldn't be included. That's just unnecessary work. MartinezMD (talk) 22:37, 19 January 2021 (UTC)

Be that as it may, I'm still leaning towards at least mentioning them, even if they don't exert that much due weight, for the second reason I mentioned. —Tenryuu 🐲 ( 💬 • 📝 ) 23:54, 19 January 2021 (UTC)

You really want to include 40, maybe 50, drugs that aren't used in mainstream treatment? I would alright with picking some notable ones and just linking to the article for the rest. We'd need to set criteria for which ones to include. I would oppose including all of them as wasteful of space in the article and undue weight. MartinezMD (talk) 00:58, 20 January 2021 (UTC)

Yes, I am. We can discuss which drugs would fit criteria for a hypothetical list elsewhere, but it would be helpful for interested readers to also know which drugs (particularly those that were mentioned in the news at one point) are not recommended by health organisations. —Tenryuu 🐲 ( 💬 • 📝 ) 01:55, 20 January 2021 (UTC)

How about a sentence that says something like "Other drugs, such as ______, have been proposed or promoted in the past, but proved to be ineffective"? You can fill in the blank with whichever small number of drugs you decide are most suitable for the sentence, perhaps considering both the popularity of the rumor and the strength of the evidence against that drug. WhatamIdoing (talk) 05:50, 20 January 2021 (UTC)

Consider getting that 40-50 number in there too (if we can find a source that says that). It would be good to convey that a great many drugs are considered, and often don't work out. Some failed drugs just get way more press attention than others. –Novem Linguae (talk) 06:30, 20 January 2021 (UTC)

Back and forth with blocked editor

The NIH source above is on a webpage entitled "Statement on Ivermectin".--Vrtlsclpl (talk) 13:41, 17 January 2021 (UTC) I am going to make a general summary of my appeal for an edit to this page. Before I do so, I realize it is important to address concerns expressed to me about style. They did not use these words but I think their concern could be summarized as "You are a acting like a bull in a china shop." I am concerned about that and I don't mean to offend the culture of Wikipedia of which I am admittedly only just getting to know. However, I see that Wikipedia finds itself at the intersection of an extraordinary controversy in medicine that it cannot simply wish away. A novel and extremely surprising treatment has come along outside of the normal Pharma pathways. The treatment does not have a promotional division that can overcome hurdles at regulatory agencies. And yet it has. On the strength of its effectiveness alone. At present however, our COVID-19#Treatment#Medications has excluded this medication while it has equal USFDA/USNIH status with medications on that list. In its current state, the Wikipedia reader might come to the conclusion that Ivermectin is inferior to a medication such as Baricitinib which is on the list. Put another way, as it is, the Wikipedia article contradicts the recommendations of the USNIH. There are two reasonable options to remove Wikipedia from this position: OPTION 1: Add Ivermectin to the list of medications for COVID-19 as well as other currently excluded medications. OR OPTION 2: Remove the list of medications for COVID-19 entirely. The status quo of this article is a very serious violation of Wikipedia norms of neutrality. More importantly, it is giving incomplete information to the Wikipedia reader. --Vrtlsclpl (talk) 03:57, 18 January 2021 (UTC) What we have is fine. Contrary to what you say, this is a routine situation for Wikipedia with editors who "believe" in something trying to have Wikipedia "believe" it too, and boost it in ways which are adrift of reliable sources. The only different here is the amplitude of the problem, given the interest COVID-19 generates. The FDA says ivermectin is not approved for antiviral use; by contrast for Baricitinib they granted a EUA. Alexbrn (talk) 06:01, 18 January 2021 (UTC) I think some of the confusion stems from the fact the NIH makes the same statement about Ivermectin as the two monoclonal antibody treatments ("At this time, there are insufficient data to recommend either for or against the use of..."), while one has EUA (monoclonals) but the other does not. Would the addition of a qualifier to the statement regarding availability of monoclonal antibodies to include "EUA" and the inclusion of the statement "At this time, there are insufficient data to recommend either for or against the use of..." reduce ambiguity? Sloorbeadle (talk) 07:59, 18 January 2021 (UTC) FYI, the section in question was edited today, and now pulls its text automatically from the first 4 paragraphs of the article Treatment and management of COVID-19. –Novem Linguae (talk) 08:06, 18 January 2021 (UTC) A couple of issues with the sentence: "Despite ongoing research, there is still not enough high-quality evidence to recommend so-called early treatment.[177][178]" Reference [178] is out of date. Please update the link to the current NIH COVID-19 Treatment guidelines. The statement is slightly ambiguous. The reader could interpret it to mean that there is not enough high quality evidence for Wikipedia to recommend so-called early treatment. I doubt that was the intended meaning. Pleae change the wording to "... there is still not enough high-quality evidence for the USNIH to recommend so-called early treatment." By itself, that statement implies that patients should not seek early treatment. That would be in direct contradiction to the recommendation of the USNIH: "Finally, it is important to stress that the rated treatment recommendations in these Guidelines should not be considered mandates. The choice of what to do or not to do for an individual patient is ultimately decided by the patient and their provider." (page 20,[3]) Please add the statement: "The USNIH also recommends that the ultimate decision for what to do or not to do for an individual patient is ultimately decided by the patient and their provider".--Vrtlsclpl (talk) 12:39, 18 January 2021 (UTC) A couple of issues with this sentence: "Nevertheless, in the United States, two monoclonal antibody-based therapies are available for early use in cases thought to be at high risk of progression to severe disease.[178]" As above, Reference [178] is out of date. Please update the link to the current NIH COVID-19 Treatment guidelines. Ivermectin has the exact same status for use in COVID-19 by US health authorities as the monoclonal anitbody therapies. By exclusion of Ivermectin, the statement directly contradicts those authorities. Please change that statement to read: "Nevertheless, in the United States, two monoclonal antibody-based therapies and Ivermectin are available for early use in cases thought to be at high risk of progression to severe disease.[178]"--Vrtlsclpl (talk) 15:41, 18 January 2021 (UTC) Regarding the earlier recommendation of Sloorbeadle: I strongly advise editors to stay away from legal interpretation. The U.S. agencies provide enumerated evaluation systems so that there is no need for interpretation. The USFDA either approves or disapproves the use of a drug/device. The USNIH gives a recommendation to a therapy for COVID-19 at one of four enumerated levels ([4], page 17). The monoclonal antibody therapies and Ivermectin have equivalent recommendatons/approvals in those two systems.--Vrtlsclpl (talk) 16:29, 18 January 2021 (UTC) Baricitinib received an emergency use authorization; ivermectin never did. Baricitinib also has much stronger evidence of benefit (however limited). So they are not equivalent. As for a bull in a china shop, I agree. MartinezMD (talk) 20:47, 18 January 2021 (UTC) Two things: (1) MartinezMD makes a regulatory judgement without a supporting source; that the EUA for Baricitinib gives it a regulatory status superior to that of Ivermectin which has standard USFDA approval. (2) MartinezMD asserts without a supporting source that Baricitinib also has much stronger evidence for benefit. I will abandon my advocacy for the inclusion of Ivermectin if a single credible source can be provided to support either assertion. --Vrtlsclpl (talk) 01:31, 19 January 2021 (UTC) Sir, this is an encyclopedia. There is no place for advocacy of any sort in an encyclopedia. That, I think, is the fundamental issue here. I have been trying very, very hard to assume good faith on your part, but you *must* familiarize yourself with our policies and understand what Wikipedia is and is not if you intend to continue editing. This has gone on far enough and long enough. Fvasconcellos (t·c) 07:53, 19 January 2021 (UTC) Although Vrtlsclp has been banned from the topic for a month, I'll answer to follow up. Baricitinib, combined with remdesivir, showed a small benefit in a randomized, double-blind, placebo-controlled clinical trial, 1033 patients in the ACTT-2 trial and was the basis for the EUA. Ivermectin has no studies of that academic vigor, primarily observational publications ("the quality of evidence is very low.") It would take an essay to discuss this in detail, but is already covered in the drugs' sections. See Ivermectin#COVID-19 and Baricitinib#COVID-19. MartinezMD (talk) 09:02, 19 January 2021 (UTC)  Not done for now: please establish a consensus for this alteration before using the {{edit semi-protected}} template. Answering EvergreenFir (talk) 07:03, 19 January 2021 (UTC) References

Semi-protected edit request on 28 January 2021

Add the following to the treatment category

There is a study that if pyronaridin and altesunate(sold under the brand name Pyramax which is a fixed-dose combination medication are used in combination), it will have a therapeutic effect to moderate to severe SARS-COV-2. https://www.cell.com/trends/parasitology/fulltext/S1471-4922(20)30364-0

PaperNerd (talk) 05:49, 28 January 2021 (UTC)

 Not done Please read Wikipedia:Identifying reliable sources (medicine) (WP:MEDRS). As per WP:MEDRS, an individual study is considered a primary source &, as such, is unacceptable for medical articles. The reasons for this are numerous; for example, individual studies must be replicated & peer reviewed. For scientific & medical rigor, only a medical tertiary source or a medical secondary source are considered acceptable. Examples of the latter include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations. Peaceray (talk) 06:36, 28 January 2021 (UTC)

Papernerd, you may want to look at COVID-19 drug repurposing research. MartinezMD (talk) 06:51, 28 January 2021 (UTC)

Peaceray, I think PaperNerd's link might be a review. It appears to be tagged as a review in PubMed. [5] Not saying that it should be included, but figured I'd mention it. –Novem Linguae (talk) 07:24, 28 January 2021 (UTC)

It's an in vitro study - only tested on cells in a lab, not in living humans for COVID-19. MartinezMD (talk) 07:44, 28 January 2021 (UTC)

• PMID 33153922 is a review article in a respectable journal, referencing a number of rat studies. It might be worth a mention in our repurposing research article, although it's only saying further research might be worth doing, not that any is actually underway. Alexbrn (talk) 08:22, 28 January 2021 (UTC)

Double standards and $$$$ CoI on WP Ivermectin v Actemra/toculizimab, a CASE STUDY

What the french is this? https://en.wikipedia.org/w/index.php?title=Tocilizumab&action=edit&section=8 only list it’s on is an export ban.

Ivermectin info from RCT reviews and even best practice guidelines is censored from this article but not expensive proprietary drugs? WP CoI policy is failing and as a result more people are dying from covid every day. --2600:387:6:80D:0:0:0:A3 (talk) 19:14, 18 January 2021 (UTC)

We can only add what is reliably sourced per our Wikipedia guidelines. Content has nothing to do with anything but the reliability of the sources. Please feel free to review WP:VERIFIABILITY, WP:RS WP:MEDRS and WP:NPOV. Littleolive oil (talk) 20:15, 18 January 2021 (UTC)

"People get COVID because they read Wikipedia." You are a great comedian. Keep it up. GeraldWL 06:57, 19 January 2021 (UTC)

I got covid from reading wikipedia too 😔 Sloorbeadle (talk) 04:29, 30 January 2021 (UTC)

"COVID-019" listed at Redirects for discussion

A discussion is taking place to address the redirect COVID-019. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 January 30#COVID-019 until a consensus is reached, and readers of this page are welcome to contribute to the discussion. CrazyBoy826 20:15, 30 January 2021 (UTC)

Effect of COVID-19 on Health Care Workers

A study found that being a health care worker is not associated with poorer outcomes among patients hospitalized with COVID-19, but was associated with lower intensive care unit admission rates and a shorter overall hospital length of stay. However, the physical, psychological, and social burden of COVID-19 was found to be significant. Health care workers experienced depression, anxiety, insomnia, frustration and stigmatization.

WKeditorinchief (talk) 16:33, 30 January 2021‎ (UTC)

Thanks for this suggestion, @WKeditorinchief. It sounds like the second half is from the strain of the pandemic, which affects all healthcare workers, rather than from getting infected. If so, then that second part belongs in the COVID-19 pandemic article and/or Impact of the COVID-19 pandemic on healthcare workers, rather than this disease article. Does that sound right to you? WhatamIdoing (talk) 22:13, 30 January 2021 (UTC)

"COVID-20" listed at Redirects for discussion

A discussion is taking place to address the redirect COVID-20. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 February 3#COVID-20 until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Jalen Folf (talk) 21:01, 3 February 2021 (UTC)

Permanent severe lung damage even after asymptomatic infection

From this report I've learned that even asymptomatic cases can develop lung damage that is severe and may be permanent (even if it isn't always; there are people who report that it cleared up spontaneously for them after a while). This is absolutely scary stuff. I feel we really need to mention this, to counter all the misinformation and downplaying going on. Neither here nor in Long COVID do I find this laid out clearly. --Florian Blaschke (talk) 15:10, 19 January 2021 (UTC)

Would need WP:MEDRS. Is there any on this? (Add: to answer my own question, PMID 33462701 looks promising, but we'd need a German speaker who has access). Alexbrn (talk) 15:14, 19 January 2021 (UTC)

Also needs to be very careful, once appropriately sourced, with wording. It's difficult to say the damage is permanent when we have less than 16 months of data, so we need to make sure we don't assume beyond what the source actually says. "Appears permanent" and "is permanent" are different, and we will likely want to link to a particular diagnosis/syndrome describing the type of damage seen (similar to this article's reference to ARDS). Bakkster Man (talk) 16:02, 19 January 2021 (UTC)

Well, fortunately for us, it looks like both @Florian Blaschke and @Bakkster Man read German. Can either of you read the paper that Alex linked? WhatamIdoing (talk) 21:28, 19 January 2021 (UTC)

The paper linked above is a systemic review, but of air polution. It makes reference to COVID-19 risks being exacerbated by air polution, but references only a single primary study on the topic ([6]). I wouldn't consider either to meet MEDRS for this topic. Fortunately, the two review studies linked below by MartinezMD do meet MEDRS and I agree with his perspective on how to integrate the current consensus into this article. Bakkster Man (talk) 14:27, 20 January 2021 (UTC)

On a somewhat related note, would this article on lung damage in asymptomatic patients meet WP:MEDRS? It was published in the International Journal of Radiation Oncology • Biology • Physics a few months ago, and it takes a look at the findings done in prior studies. —Tenryuu 🐲 ( 💬 • 📝 ) 22:09, 19 January 2021 (UTC)

Maybe? It's an editorial (which is technically bad) in an excellent journal (which is good). I think that adds up to being better than a newspaper article, but It's not the ideal. It might be better to cite two sources, and this could be the second one. WhatamIdoing (talk) 05:54, 20 January 2021 (UTC)

All 3 sources are extremely weak. The Texas surgeon is likely well-intentioned with her statements but alarmist. She offers nothing but observation of a significant minority of cases without any long-term understanding (since no one knows). The second looks at epidemiologic data with disease severity. These require very robust data and analysis to make a valid cause-effect link. The third study (on x-ray findings) just says there are a lot of asymptomatic people and that they don't know what the future holds for them. Lung injury is clearly a part of many people's disease course, with some reports of lung transplants needed, but these particular reports are not helpful to a good understanding of the scope of the problem. MartinezMD (talk) 06:21, 20 January 2021 (UTC)

I offer for your review these studies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529085/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643287/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736754/ Two are reviews, and another is a prospective, multicentre, observational primary, but well-designed, study. They all say essentially the same thing - a lot of people have lung involvement, the findings persist in many people (either by symptoms and/or by imaging), we don't know what the long-term holds for them, and it could be bad. I think it would be appropriate to include something like this in the article. To meet MEDRS, only the reviews should be used, but I included the third here for any interested editors to have a better understanding of the current state. MartinezMD (talk) 07:36, 20 January 2021 (UTC)

@MartinezMD, I agree with @Bakkster Man about these papers. Do you want to have a go at getting them in the article, and maybe also in Long COVID? WhatamIdoing (talk) 00:15, 31 January 2021 (UTC)

How's this?

Injury to the lungs, by a variety of mechanisms, is the most common problem in COVID-19 "By a variety of mechanisms, the lungs are the organs most affected in COVID-19". The majority of CT scans performed show lung abnormalities in people tested after 28 days of illness. People with advanced age, severe disease, prolonged ICU stays, or who smoke are more likely to have long lasting effects, including pulmonary fibrosis. Overall, approximately one third of those investigated after 4 weeks will have findings of pulmonary fibrosis or reduced lung function as measured by DLCO, even in people who are asymptomatic, but with the suggestion of continuing improvement with the passing of more time."

Echoing my math teacher, check my work please. I can add it, with well-proposed revisions, if the editors agree. The sources have a lot of information, but teasing out the appropriate summarized detail is not easy. MartinezMD (talk) 07:33, 31 January 2021 (UTC)

Does your source say "the most common", or is it merely "a common" injury? Bakkster Man (talk) 16:26, 3 February 2021 (UTC)

Good catch. I misread the source a little. It says "Recent evidence suggests that the lungs are the organ most affected by COVID-19". So most effect, not necessarily most in number. I'll have to change phrasing. See above correction. MartinezMD (talk) 16:46, 3 February 2021 (UTC)

Hearing no further comment, I've added it to the article. MartinezMD (talk) 23:42, 6 February 2021 (UTC)

References

Please mention about fungal infection

Recently doctors find fungal infection on rise among those who recovered from Covid-19 Source Rizosome (talk) 02:50, 8 February 2021 (UTC)

Needs a secondary source. No where near enough reliability in the article you linked. MartinezMD (talk) 03:15, 8 February 2021 (UTC)

Potentially non WP:MEDRS sources

(i) "A retrospective study found that restrictions on gatherings and education facilities along with business closures were effective in limiting the pandemic. The best manner of adopting and relaxing policies are uncertain, however, as conditions vary across locations and times.[152]"

[152] = Brauner, Jan M.; Mindermann, Sören; Sharma, Mrinank; Johnston, David; Salvatier, John; Gavenčiak, Tomáš; Stephenson, Anna B.; Leech, Gavin; Altman, George; Mikulik, Vladimir; Norman, Alexander John; Monrad, Joshua Teperowski; Besiroglu, Tamay; Ge, Hong; Hartwick, Meghan A.; Teh, Yee Whye; Chindelevitch, Leonid; Gal, Yarin; Kulveit, Jan (15 December 2020). "Inferring the effectiveness of government interventions against COVID-19". Science: eabd9338. doi:10.1126/science.abd9338. ISSN 0036-8075. PMID 33323424. S2CID 229282008.

This is an original research article and hence, a primary source. To my understanding it is therefore not WP:MEDRS.

We don't have blanket ban on primary sources. I quote WP:MEDRS "Text that relies on primary sources should usually have minimal weight, only describe conclusions made by the source, and describe these findings clearly so that all editors even those without specialist knowledge can check sources". WP:WEIGHT applies here. Graham Beards (talk) 22:25, 8 February 2021 (UTC)

Statements about the effectiveness of different non-pharmaceutical interventions (NPIs) don't have minimal weight as NPIs can affect the lives of many people in these times. Establishing a causal effect of NPIs on viral spread and determining their effectiveness is a challenge and it won't be settled by this one recent retrospective study.Lucleon (talk) 22:58, 8 February 2021 (UTC)

(ii) "Non-cooperation with distancing measures in some areas has contributed to the further spread of the pandemic.[150]" [150]= Ward A (28 April 2020). "Has Sweden found the best response to the coronavirus? Its death rate suggests it hasn't". Vox. Retrieved 30 April 2020.

A news website is to my understanding also not WP:MEDRS. Lucleon (talk) 22:09, 8 February 2021 (UTC)

"Dark-skinned people are at particular risk of a vitamin D deficiency which can impair the immune system.[180][181]" [180] Villasanta, Arthur (15 September 2020). "Dr. Fauci Reveals Immune System Boosters For COVID-19: Vitamins That Help Prevent Coronavirus". International Business Times. Retrieved 13 November 2020. Vitamin D is important to the function of the immune system and vitamin D supplements have previously been shown to lower the risk of viral respiratory tract infections. [181] Busby, Mattha (10 January 2021). "Does vitamin D combat Covid?". The Guardian. Retrieved 10 January 2021.

Two news websites also don't make WP:MEDRS to my understanding. Lucleon (talk) 22:18, 8 February 2021 (UTC)

Then find a better source. The statements are not controversial. Graham Beards (talk) 22:25, 8 February 2021 (UTC)

The sentence about vitamin D makes no assertion related to COVID-19 and the source itself is unsupported, using their own version of WP:SYN. I removed it. And as far as needing to find a supporting statement, the burden is not on the editor making the correct removal. This is a highly scrutinized article and the WP:MEDRS standards apply. MartinezMD (talk) 22:33, 8 February 2021 (UTC)

Which is a valid reason. Although the statement alone is not inaccurate. See Ames BN, Grant WB, Willett WC (February 2021). "Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities?". Nutrients. 13 (2). doi:10.3390/nu13020499. PMID 33546262.{{cite journal}}: CS1 maint: unflagged free DOI (link) Graham Beards (talk) 22:41, 8 February 2021 (UTC)

You are correct, the statement alone is not inaccurate, but applying it to COVID is WP:SYN. I removed the other addition. Lucleon was correct in removing it. MartinezMD (talk) 22:49, 8 February 2021 (UTC)

I don't agree with you about the first addition for the reasons I have given above. Lucleon was not correct in deleting it and shows a poor understanding of WP:MEDRS. When new editor makes good faith additions, more considered reasons for reverting should be given. We were all new here once. Graham Beards (talk) 22:59, 8 February 2021 (UTC)

PS. The article is riddled with non WP:MEDRS compliant sources. Graham Beards (talk) 23:07, 8 February 2021 (UTC)

Yes. For medical assertions they need MEDRS, which is why we're trying to avoid adding more. We've gone through this before, a full medrs tagging session and I think I made all the updated edits that were marked. Feel free to point them out. MartinezMD (talk) 23:12, 8 February 2021 (UTC)

Just FYI, for other articles I'm okay with tagging as needing correct sources, but for this one we are requiring stricter criteria. There are sanctions against using preprints, for example, and the expectation to stick to MEDRS. See Wikipedia:General sanctions/Coronavirus disease 2019 "Sources for any content related to medical aspects of the disease are expected to adhere to the standards laid down at WP:MEDRS." MartinezMD (talk) 23:30, 8 February 2021 (UTC)

It would be quicker to list the ones that are compliant. A quick audit reveals numerous primary studies (e.g. 47, 56,57,63,66,68, 70), bare URLs (230), letters (58) commentaries (59) and news websites (e.g. 310). Against this backdrop, a new editor makes a good faith addition that would be perfectly acceptable on millions of other pages only to be reverted with only a coded reason by another editor who could not be bothered to provide either a proper link in the edit summary ("Not WP:MEDRS") or an explanation here or on the new editor's Talk Page. If you are going to bite the newbies, at least tell them why. Graham Beards (talk) 09:37, 9 February 2021 (UTC)

^ Graham Beards I've looked at the numbered items. Most of them are basic science articles describing enzymes or receptors. They aren't making medical assertions such as treatment recommendations, mortality figures, etc. Source # 70 (currently) looks like a review and not a primary study. #230 is in an imported table from another article, and I can't figure out where the original citation lies. And 310 (if the numbers didn't change from when I last checked) is a WHO letter which satisfies WP:MEDORG. As editing continues in the article, there's a likelihood the numbers might not match up. It might be better if we start a new thread, pick one citation at a time, include the name so the numbering won't create a mixup, and we can address it individually. MartinezMD (talk) 04:49, 10 February 2021 (UTC)

I have spent my morning away from the frontline and worked on the citations and other issues.Graham Beards (talk) 14:12, 10 February 2021 (UTC)

I saw that, thank you. MartinezMD (talk) 18:09, 10 February 2021 (UTC)

Please refrain from speculations about my motives. When reading the article I simply noticed three passages which were not supported by WP:MEDRS compliant sources. They are listed above. Lucleon (talk) 13:58, 9 February 2021 (UTC)

I have not said anything about your motives and I don't believe you in any case since you missed loads more.Graham Beards (talk) 14:48, 9 February 2021 (UTC)

How objective and nice of you to accuse me of not telling the truth without any evidence to support it. Probably better to end this conversation. I didn't read the entire article btw. Lucleon (talk) 15:00, 9 February 2021 (UTC)

Running these sources by everyone quick for reinclusion on Vitamin D. Review of multiple studies on Vitamin D, with no evidence that Vitamin D can treat acute COVID, but "very low quality" evidence that vitamin deficiency is a risk factor for severe COVID symptoms. I'd suggest that - with the right phrasing the the evidence is limited - this is a proper MEDRS secondary source for inclusion that A) Vitamin D is unlikely to be an effective treatment, and B) Vitamin D deficiency may increase risk of severe COVID symptoms. There's also this recommendation from the UK NHS which mirrors the previous study's findings: that supplements in the case of Vitamin D deficiency are of additional importance due to potential COVID risk, but Vitamin D is not recommended as a treatment once diagnosed with COVID. This mirrors previous UK/NHS recommendations around COVID (may be obsolete, replaced with this one, I'll keep digging) stating that treating deficiency is recommended for multiple reasons, COVID risk being a possibility as well. For comparison, the US NIH does not recommend for or against Vitamin D due to insufficient data specific to COVID. They do point to prior studies indicating vitamin D deficiency is common among dark skinned ethnicities, and may result in more respiratory infections and pneumonia. How we combine some or all of these sources into an updated paragraph, I'm looking for suggestions. Bakkster Man (talk) 15:59, 9 February 2021 (UTC)

I'll also mention, the UK is providing free Vitamin D supplements and citing the COVID risk, though I'm not sure if it makes sense to include here or not (the prior NHS study is probably better here, this is more a UK response type article). Pointing it out mostly to indicate their level of confidence in the data. Bakkster Man (talk) 16:01, 9 February 2021 (UTC)

I'll start working on the non-MEDRS sources. For vitamin D, I think Bakkster's proposal about Vitamin D would be appropriate. We could say that in spite of no good evidence it helps, the UK is dispensing it (although I'd want to know if that is still the case prior to inclusion). For Graham, bare urls are just a formatting issue that we can easily correct. Primary studies do need to go out, but I won't throw out the baby with the bath water. Letters depend on what they say; I've seen a few that are functionally reviews but simply submitted as letters. As for other sources, news releases, etc, we'd have to see them on a case-by-case basis. the MEDRS standard is for the medical assertions only. For other types of statements regular RS standards would apply.

Also, The last time primary/non-medrs sources were pointed out I believe I was the only one to update the sources. it would be nice if perhaps some of the other editors would help here. MartinezMD (talk) 17:37, 9 February 2021 (UTC)

I'd suggest the UK dispensing is 'due to limited evidence', rather than 'in spite of no good evidence' is better wording. That said, if you concur on the quality of the sources I can take the first stab at the wording to split the work. Bakkster Man (talk) 17:52, 9 February 2021 (UTC)

Yes, be neutral. I wasn't meaning to suggest that specific wording. Your source is the UK's NHS itself. That's as appropriate a source as any. MartinezMD (talk) 18:06, 9 February 2021 (UTC)

First draft of this in Coronavirus disease 2019#Healthy diet and lifestyle. Could probably use some refinement of the language. Bakkster Man (talk) 20:16, 9 February 2021 (UTC)

Typo

Towards the end of the third paragraph in the beginning of the article, there is a typo. "Serveral testing methods have been developed to diagnose the disease." "Serveral" being the typo. Joolsrules (talk) 20:25, 11 February 2021 (UTC)

Thanks for spotting that. It has been corrected.A. Randomdude0000 (talk) 20:43, 11 February 2021 (UTC)

Epidemiological data

The data and one of graphs are getting dated. Do we need to cover the epidemiology in full here when we have COVID-19 pandemic? (And please don't suggest anymore transclusions, which make the page difficult to edit). Graham Beards (talk) 14:07, 10 February 2021 (UTC)

How about the four graphs are made into a smaller gallery of four images in a row? I'm also fine with getting rid of two and leaving two on the side. The graphs are dated, but are in a way more straight forward and better than any graph in the pandemic article. The prognosis table could also be in the collapsed state which would make it take up minimal space. --Guest2625 (talk) 09:55, 11 February 2021 (UTC)

Yes, something needs to be done and these are great suggestions. When tables are collapsed do the refs still appear in the list? Graham Beards (talk) 10:02, 11 February 2021 (UTC)

Yes. The references will still appear below. The layout is now uniform. --Guest2625 (talk) 11:56, 12 February 2021 (UTC)

Well done, thanks. Graham Beards (talk) 12:02, 12 February 2021 (UTC)