COVID-19 Q&A Session and Video Updates 90-92

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    Our most recent coverage of the COVID-19 pandemic includes lectures on discerning the reliability of medical information, Remdesivir updates, coronavirus-related blood clots, and more. Check out our ongoing Novel Coronavirus Pandemic Updates Explained Clearly lecture series for full videos on these and many other subjects. 


    Latest Q&A Session with Dr. Seheult and Kyle Allred

    In the most recent Q&A session with MedCram co-founders, Dr. Roger Seheult and Kyle Allred, we answered viewers’ questions ranging from the use of dexamethasone and other steroids in treating COVID-19 to how doctors stay up to date on cutting edge medical information. Watch the full video here. Tune in to our next live recording for the opportunity to have your questions answered.


    Assess The Quality of COVID-19 Info With A Validated Tool

    With the myriad  ways COVID-19 information is disseminated, our 90th pandemic update focuses on challenges in assessing the reliability and quality of online information. In this video, Dr. Seheult talks about DISCERN, a questionnaire tool built to assess the reliability of information on treatment choices, and a group of scientists who used DISCERN to test the validity of various informational COVID-19 videos on YouTube. Of the 137 videos studied, most of which were from news outlets, news channel videos received the lowest quality scores; physician-uploaded videos received the highest scores. The researchers also listed the five highest scoring videos, and we at MedCram were proud to have three of our videos included in this list. 


    Remdesivir Pricing & Disparities in Drug Availability

    In our 91st pandemic update video, Dr. Seheult discusses updated daily infection and death rates around the world, then introduces an interesting tool, called COVIDAge Risk Calculator.  This calculator takes various data points into consideration to predict one’s risk of hospitalization, ICU admission, and mortality from COVID-19. Dr. Seheult also talks about Remdesivir and navigating the drug’s impending scarcity. Lastly, he discusses the use of a COVID-19 vaccine in the Chinese military, prior to completion of the third and final phase of clinical trials. 


    COVID-19 & Blood Clots – New Endothelium & Free Radical Research

    In our 92nd COVID-19 pandemic update, Dr. Seheult revisits the conversation on oxidative stress, reactive oxygen species (ROS), and thrombosis. A new research article from the Lancet looking at endotheliopathy in COVID-19 examines the cause of thrombosis. This study found that elevated levels of von Willebrand Factor (VWF) antigen concentration correlated strongly with mortality. This research suggests antiplatelet therapy or endothelial cell modification treatments (in addition to traditional anticoagulation methods) may have a significant role in preventing COVID-19-related thrombosis. Given this information, Dr. Seheult revisits the supplement N-Acetylcysteine (NAC) due to both its antioxidant properties and potential ability to break up VWF. NAC’s role as a thrombolytic for COVID-19 patients is currently being studied by researchers at Memorial Sloan Kettering Cancer Center in New York.


    Stay Tuned for More COVID-19 Updates 

    Our COVID-19 videos are always available and free (and ad-free) at In addition, check out our full library of courses and lectures on subjects ranging from Liver Pathophysiology to Vasopressors Explained Clearly and many more!

    Meanwhile, here’s a list of all the COVID-19 resources we’ve shared so far:


    1. Dan Green on July 6, 2020 at 9:43 am

      Your hypothesis about Cov19 and ROS is about to go into phase3 trial (FDA recommended) using a form of NAC, Bucillamine an approved drug being used as Rheumatoid Arthritis Treatment. Touted as to be “16 times” more effective then NAC.

      Scientific Rationale for the Investigation of Bucillamine to Treat Infectious Diseases including Influenza or COVID-19

      Current antiviral interventions for influenza have exhibited modest efficacy, especially in improving mortality in at-risk populations, such as the elderly.1,2 Novel antivirals have been plagued by poor oral bioavailability and lack of efficacy when not delivered early.1 This is because these drugs mostly act to prevent the early processes of virus binding to cells or viral replication.2 Thiols, particularly N-acetylcysteine (NAC), with antioxidant and reducing activity have been investigated as effective therapies that abrogate the potential for influenza to cause severe disease.3,4,5 Restoration of glutathione, the major intracellular thiol antioxidant, is a critical functional activity of NAC.6 Reactive oxygen species (ROS) generation during influenza virus infection aggravate destructive inflammation and programmed death of epithelial cells.7 Studies in human cells and animal models have shown that NAC works to prevent acute lung injury caused by influenza virus infection through inhibition of these ROS-mediated mechanisms.4,7 NAC has been investigated clinically and found to significantly attenuate clinical symptoms associated with influenza infection, especially in elderly at-risk patients.5 While NAC is easily taken up by cells and has low toxicity, clinical efficacy has required long-term and high-dose administration because of modest relative potency, limiting its clinical applicability.

      Bucillamine (N-(mercapto-2-methylpropionyl)-l-cysteine), which has a well-known safety profile and is prescribed in the treatment of rheumatoid arthritis in Japan and South Korea for over 30 years, is a cysteine derivative with 2 thiol groups that is 16-fold more potent than NAC as a thiol donor in vivo, giving it vastly superior function in restoring glutathione and therefore greater potential to prevent acute lung injury during influenza infection.8 Bucillamine has also been shown to prevent oxidative and reperfusion injury in heart and liver tissues8 and is highly cell permeable for efficient delivery into cells.8,9 Bucillamine has unrealized potential for the treatment of influenza with both proven safety and proven mechanism of action similar to that of NAC, but with much higher potency, mitigating the previous obstacles to using thiols therapeutically. It is also reasonable to hypothesize that similar processes related to ROS are involved in acute lung injury during nCov-19 infection, possibly justifying the investigation of bucillamine as an intervention for COVID-19.

      Revive is developing a product and clinical development plan intending to unlock the full potential of Bucillamine. The Company will announce its initiatives as they unfold.

      About Revive Therapeutics k


      1. Muthuri SG, Venkatesan S, Myles PR et al. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data Lancet Respir Med. 2014 May;2(5):395-404. doi: 10.1016/S2213-2600(14)70041-4.

      2. Duwe S. Influenza viruses – antiviral therapy and resistance. GMS Infect Dis. 2017; 5: Doc04.

      3. Zhang RH, Li CH, Wang CL et al. N-acetyl-l-cystine (NAC) protects against H9N2 swine influenza virus-induced acute lung injury. Int Immunopharmacol. 2014 Sep;22(1):1-8. doi: 10.1016/j.intimp.2014.06.013.

      4. Ungheri D, Pisani C, Sanson G et al. Protective effect of n-acetylcysteine in a model of influenza infection in mice. Int J Immunopathol Pharmacol. 2000 Sep-Dec;13(3):123-128.

      5. De Flora S, Grassi C, and Carati L. Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. Eur Respir J 1997; 10: 1535–1541 DOI: 10.1183/09031936.97.10071535

      6. Poole LB. The Basics of Thiols and Cysteines in Redox Biology and Chemistry. Free Radic Biol Med. 2015 Mar; 0: 148–157. doi: 10.1016/j.freeradbiomed.2014.11.013.

      7. Mata M, Morcillo E, Gimeno C, Cortijo J. N-acetyl-L-cysteine (NAC) inhibit mucin synthesis and pro-inflammatory mediators in alveolar type II epithelial cells infected with influenza virus A and B and with respiratory syncytial virus (RSV). Biochem Pharmacol. 2011 Sep 1;82(5):548-55. doi: 10.1016/j.bcp.2011.05.014.

      8. Horowitz LD. Bucillamine: a potent thiol donor with multiple clinical applications. Cardiovasc Drug Rev. 2003 Summer;21(2):77-90.

      9. Sagawa A, Fujisaku A, Ohnishi K et al. A multicentre trial of bucillamine in the treatment of early rheumatoid arthritis (SNOW study). Mod Rheumatol. 2011 Jun;21(3):251-7. doi: 10.1007/s10165-010-0385-4Q

    2. Steve Koch on July 6, 2020 at 6:01 pm

      I enjoy watching your COVID videos. They have greatly helped my wife and I understand and prepare for and possibly prevent contracting the virus. Thanks for the public service that you are providing to the medical community and others like my wife and me.

      One possible treatment for COVID (and other illnesses such as many forms of cancer, NASH, AIDS, etc.) that I recently come across is what seems like a promising drug called Leronlimab (developed by Cytodyn originally for the treatment of AIDS). I have not heard you mention it on your COVID episodes, perhaps because it is under the radar and no papers have yet been published in the journals you cite in your videos.

      I understand that Cytodyn expects to have Phase 2 trial results later this month. Apparently, the safety of the drug has been proven with AIDS patients in the past, so if the results are positive, there is some chance it could receive some sort of approval for some subsets of COVID patients.

      In case you haven’t investigated it and want to learn more…

      Given your biochemical expertise, it would be interesting to hear any comments you might have about this in a future COVID video or Q&A session. As of yet, there are no peer-reviewed papers published, so I will not be surprised if you withhold your judgment until a later time.

      Thanks again, and keep up your excellent work.

    3. Lynn Nunes on July 9, 2020 at 11:51 pm

      What does Dr S think about this doctors early inhaler treatment? [Inhaled budesimide(sp?)]

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