COVID-19: Mind your Ps and Qs

There is a debate about the origin of the phrase "mind your Ps and Qs." Some believe it started with a 17th-century play by Thomas Dekker titled "The Untrussing of the Humorous Poet." Others believe it was used in British pubs to tally consumption of drinks (the P is for pints and Q is for quarts). Or it could have been advice to typesetters to make sure that lower case Ps and Qs did not get mixed up. In modern times, the expression means to be on your best behavior or to mind your manners. Some may have seen the video of Christopher Key during his courtroom appearance for not wearing his mask. He has dubbed himself the "Vaccine Police." During the outcry, he proclaimed that the prevention and cure for COVID-19 is drinking one's own urine. Hence, the P (or pee). Key assures his followers that he has been drinking his own urine for years and it is supported by research. Reuters Fact Check has verified this is absolutely false. There is no evidence or research indicating any value in drinking one's urine for COVID-19 purposes. The kidneys remove waste from the body that ends up in urine, so you would be drinking the trash your body has taken out. Dr. Jon Klein is a physician and kidney specialist at the University of Louisville School of Medicine. He recently tweeted: "I've studied how the kidneys make urine for 39 years. Do not, I repeat do not, drink urine to treat COVID. That is all." Drinking urine is one more on the list of social media-suggested COVID-19 treatments that can be dangerous with no benefit. Other risky treatments include injecting bleach; inhaling or swallowing colloidal silver; or taking hydroxychloroquine or ivermectin. There is no evidence of benefit for these treatments, and the risk of side effects can be high. High-quality science provides the Q. I applaud the science teachers in our schools who are training our next generation to understand the importance of science and the scientific method. One social media claim has been taken out of context, but actually has some clinical trial evidence that is worthy of discussion. A United Kingdom nurse claims to have been cured of COVID-19 pneumonia with sildenafil (Viagra) after being in a coma. This has been misrepresented on social media, and Fox News personality Tucker Carlson used the statement "Little Blue Miracle" on his show to propagate inaccurate information. The nurse did receive sildenafil as part of an investigational study. In the lungs, SARS-CoV-2 reduces nitric oxide and is believed to be a mechanism by which COVID pneumonia and severe acute respiratory syndrome can cause illness and death. Sildenafil has been evaluated because it increases nitric oxide in the lungs with the theory of reversing the damage caused by the virus. This is based on the FDA-approved indication of sildenafil (Revatio) to manage patients with pulmonary arterial hypertension with decreased lung function. Studies have proven that sildenafil can improve the quality of life of patients with PAH. Another Q for quality. Based on the theory, a study involving 40 patients with severe lung disease from COVID-19 and abnormal blood flow to the lungs was performed in Chile. Twenty patients received sildenafil compared to 20 patients who were given a placebo. The researchers reported that there was no change in oxygen patterns or lung blood flow, but the risk of mechanical ventilation was lower and the sildenafil group had shorter hospital stays. The authors concluded that larger studies need to confirm the results. The nurse was part of a larger study. Sildenafil does not prevent or treat mild or moderate COVID-19, but is being investigated in severe lung disease caused by COVID-19. Do not take Viagra for COVID-19, as it is not the blue pill miracle for outpatient therapy. Sildenafil has serious side effects and significant drug-drug interactions. Feel free to call the Ohio Northern University HealthWise Pharmacy to learn more about the science on COVID-19. ONU HealthWise is offering COVID-19 and flu vaccines from 4-6 p.m. Mondays through Fridays. Call the pharmacy at 419-772-3784 for an appointment outside of these time slots, or to schedule a pediatric vaccine. Kier is a pharmacist on behalf of the ONU HealthWise team.