New Corona What is the mechanism of aggravation? Research going forward

New Corona What is the mechanism of aggravation? Research going forward: June 3, 17:25

Research to elucidate the mechanism of becoming infected with the new coronavirus and becoming more severe is underway around the world. So far, in addition to acute respiratory failure due to exacerbation of pneumonia, it has become apparent that there are cases where blood clots are formed and blood vessels are clogged, and cases where many organs fail due to immune runaway.

Of the severely ill patients, the most frequently reported cases are cases of acute respiratory failure, in which the virus proliferates in the lungs and exacerbates pneumonia, making it difficult to breathe on its own. Using an artificial heart-lung machine called ECMO, treatment is being performed while waiting for the virus to be discharged by the patient's own power while resting the lungs.

According to data from the Japanese Society of Intensive Care Medicine, the most severe symptoms occur in Japan, and about 70% of patients with ECMO have recovered.

In addition, it is thought that blood clots can be caused by the invasion of viruses into blood vessels or the occurrence of a "cytokine storm" in which the immune system runs away and attacks its own body.

A large number of cases of death due to myocardial infarction or cerebral infarction due to clogged blood vessels due to myocardial infarction, cerebral infarction, etc. were reported mainly in Europe and the United States. It is analyzed that the value of the index called "D-dimer" that indicates that it is high is also related to the risk of death.

The Ministry of Health, Labor and Welfare revised the last month's revised version of the medical treatment guide for doctors, which indicates the treatment of blood clots, and recommends treatments such as administering drugs to prevent blood clots when necessary.

Furthermore, cases in which a "cytokine storm" appears to have occurred in multiple organs, such as the kidney and liver, resulting in multiple organ failure and death have been reported in Japan and other countries.

When these symptoms are seen, drugs that suppress the immune system are used to treat rheumatism, a disease in which the immune system attacks the joints of patients and causes inflammation.

In addition, as a case of severe childhood, in Europe and the United States, symptoms such as Kawasaki disease in which inflammation of blood vessels in the whole body is reported have been reported, and some cases have died.

According to the Japan Society for Kawasaki Disease, etc., so far no similar cases have been reported in Japan, but the academic society will continue to pay close attention.

What kind of person is likely to get serious?

According to WHO = World Health Organization, about 80% of people infected with the new coronavirus have no symptoms or mild illness, but about 20% will be severe.

Among the people who are likely to become seriously ill, the CDC = Centers for Disease Control and Prevention in the United States is not only the elderly people aged 65 and over, but also those who have chronic lung diseases, chronic heart diseases, diabetes, liver diseases and other chronic illnesses. , People undergoing dialysis treatment for chronic kidney disease, smokers, people with weakened immunity due to cancer treatment or organ transplants, and people with severe obesity.

Asthma patients Isn't there a high risk of aggravation?

Research is being conducted in various countries around the world on what kind of people are likely to become seriously ill with the new coronavirus.For patients with asthma, which have been thought to be susceptible to severe illness until now, at the National Center for Child Health and Development in China and the US Analysis of patient data revealed that the risk of aggravation did not seem to be high.

A group at the National Center for Child Health and Development has analyzed whether patients with bronchial asthma are prone to illness, based on data on patients with new coronaviruses presented in papers in China and the United States.

According to it, when we examined the data of about 2200 people, those with bronchial asthma had 5.5% of the severely ill patients, while 4.1% of the mild patients showed a sufficient difference. I couldn't do it.

On the other hand, those who have COPD = chronic obstructive pulmonary disease or diabetes have a significantly higher proportion in critically ill patients.

According to the research group, in asthmatics, the protein that the new coronavirus is likely to bind to is not often found around the nose, so it may be difficult to be infected, and the risk of becoming serious when infected is not high. It is supposed to be.

Kenji Matsumoto, Director of Immuno-Allergy and Infection Research Department, National Center for Child Health and Development, said, "I don't worry excessively because of asthma, but don't underestimate the infection with the new coronavirus. It is important to continue to treat asthma. , We need to be more careful about the risk of aggravation."

New Corona Treatment Doctor "New Corona is a Systemic Disease"

Dr. Kenshi Kona, who has been treating patients at the National Center for Global Health and Medicine, which plays a central role in the treatment of new coronaviruses, said, ``If this infection becomes severe, not only pneumonia but also various organs will be inflamed, and blood coagulation will occur. There are things like abnormalities, and the perception is that it is a systemic disease, not just the respiratory system."

On top of that, Dr. Kona said, “As previously pointed out, the tendency to become more severe in older people and those with chronic illnesses does not change. Based on past treatment experience, cancer, diabetes, chronic respiratory disease People who are old or have multiple chronic illnesses are prone to serious illness, and at worst, may die, so be careful.”

Also, it is reported that obese people and people with smoking habits are more likely to become seriously ill, saying, ``Obese people lose weight and those who smoke are quit smoking In order to reduce the number of people, we want these people to review their lifestyles in preparation for the next fashion."

In addition, even young people may have severe cases, ``The probability of becoming severe depends on age and presence of chronic disease, but young and healthy people can get serious, so please be careful.'' I will.