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New crown after rehabilitation still have sequelae, take the stairs are panting(1)

Source: newsin.us
[Life Information]     28 Jun 2020
As of 26, at least 497.71 people were infected death, more than 9.68 million 4490 confirmed cases. Coronavirus can not only damage the patient's respiratory system, it can also cause many complications, and other organ systems can be damaged in some cases, scientists said recently. Most horrendous of all, it is not just the difficulty of recovering a patient who has been recovered by a doctor, but...
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New crown after rehabilitation still have sequelae, take the stairs are panting

As of 26, at least 497.71 people were infected death, more than 9.68 million 4490 confirmed cases. Coronavirus can not only damage the patient`s respiratory system, it can also cause many complications, and other organ systems can be damaged in some cases, scientists said recently. Most horrendous of all, it is not just the difficulty of recovering a patient who has been recovered by a doctor, but the sequelae "may affect the patient in the coming years ".

"We initially thought it was a respiratory tract virus, but it turned out to attack other organs, such as the pancreas, the heart, the liver, the brain, the kidney ," said Topol (Eric Topol), director of the Scripps Research Center in California and a cardiologist, according to Reuters. These were unexpected things at first. "

In addition to breathing difficulties, patients can also be associated with thrombosis caused by stroke, associated with severe inflammation, resulting in multiple organs attacked. virus also causes complications to the nervous system, headache, dizziness, taste, olfactory loss, epilepsy and delirium.

These complications have a long recovery period and may not return 100 per cent to pre-morbid conditions, which may have a significant impact on the lives of patients. The diversity of Coronavirus performance is somewhat unique, says Sadiya Khan of cardiology at the northwestern medical center. Survivors may have to pay for the complications later.

Dr salisbury (Helen Salisbury) of oxford university points to another depressing news: although the epidemic usually disappears in two to three weeks, it is estimated that one in ten people will have longer symptoms. For many patients ," chest X radiographs are normal and there is no sign of inflammation ", but when they do exercises they were good at, they tend to feel breathless and breathless even taking the stairs.

Earlier, the Ministry of Foreign Affairs and the Health and Health Commission jointly invited Academician Zhong Nanshan to answer the "epidemic" for foreign students, saying :" As long as there is no basic disease, recovery will be rapid. Patients with new coronary pneumonia than SARS patients with pulmonary fibrosis is not too heavy, the former lung injury looks not too big, slowly will recover, so the sequelae are not large. "Although most patients recover slowly, some of the underlying sequelae can not be ignored.

At the beginning of March, Lauren Nichols, a 32-year-old woman, began to show signs of intense burning as she breathed like acid reflux. But she didn`t go to the doctor until it got worse, and finally her Covid-19 test was positive. But tell her it`s just the beginning. Over the next eight weeks, she developed a variety of symptoms, including chronic fatigue, diarrhea, nausea, tremors, headaches, attention difficulties, and short-term memory loss.

"Guidelines provided by the American Centers for Disease Control and Prevention (CDC) are completely inconsistent with my symptoms, which means that the medical community can not`prove` my symptoms ," she said. It also plunged me into a vicious circle of doubt, confusion and loneliness. "

新型冠状病毒
 


Coronavirus potential long-term health impacts

About 5 to 80 per cent of people in Covid-19 tested positive may be asymptomatic or appear only days or even weeks after testing, many of them with transient and mild symptoms. The World Health Organization says patients with mild conditions are expected to recover for more than two weeks, and those with severe or critical conditions are expected to recover in three to six weeks.

Because Covid-19 is a new type of disease, even the earliest patients recovering in China have only been a few months, so the long-term health trajectory of severe patients has not been studied. But doctors say new coronal virus can attach to cells in many parts of the body and penetrate many major organs, such as the heart, kidney, brain and even blood vessels.

"The difficulty we face is finding out the long-term impact ," said Dr. Joseph Brennan, a cardiologist at Yale University School of Medicine. "While some patients may recover completely, he and other experts are concerned that patients with neo-crown pneumonia may suffer long-term damage, including lung scars, heart injuries, neurological and mental health effects.

Some of the new patients need years to recove

According to the National Department of Health ,45 per cent of Covid-19 patients in need of continuous medical care ,4 per cent require hospitalization and 1 per cent require permanent emergency care. studies SARS( other coronal virus, such as severe acute respiratory syndrome) and MERS( middle eastern respiratory syndrome), and preliminary evidence obtained by the researchers suggest that some patients still need years to fully recover. Unfortunately, for other patients, this injury may never recover.

Certainly, we do not know that there are many sequelae, but there are some potential long-term effects that have emerged in some Covid-19 patients.


Pulmonary scar symptoms

During March, Melanie Montano ,32, tested positive for Covid-19. More than seven weeks after her first illness, she continued to develop intermittent symptoms, including burning and dry coughing.

Brennan says these symptoms occur because "virus produce an incredibly aggressive immune response, so the lungs are filled with debris and pus, making the lungs less flexible. "Normal lungs appear black on CT scans, while Covid-19 patients usually have lighter gray patches, or" frosted glass-like shadows ," which may not heal.

Our researchers have long discovered this. One domestic study found that 77% of Covid-19 patients had CT scans showing the lesion. Another study, published in the journal Radiology, suggested that 66 of 70 inpatients found some degree of lung damage in CT scans and that more than half of the patients developed lesions that could develop scarring. A third study showed that the lesion was not just present in critically ill patients. Of 58 asymptomatic patients ,95% had frosted glass-like shadows in their lungs. More than a quarter of people develop the symptoms in a few days.

Covid-19患者的肺通常有较浅的灰色斑块
 

"A change in tissue can cause permanent damage ," says Ali Gholamrezanezhad radiologist at the University of Southern California`s Keke School of Medicine. "While it is not yet known whether permanent lung damage occurs in patients with persistent lung symptoms, doctors can learn more from those who SARS and MERS recovered.

A small longitudinal study published in the journal Nature followed 71 SARS patients from 2003 to 2018 and found that more than a third of the patients had residual lung scars, which could mean their lung capacity was impaired. the sequelae of MERS are somewhat difficult to infer because fewer than 2500 people are infected ,30% to 40% of them death. but one study found that about one third of the 36 MERS survivors also had long-term lung injury.

Gholamrezanezhad recently conducted a literature review on SARS and MERS, saying :" For this group, lung function will never recover, that is, their ability to perform normal activities will never return to normal levels. Moreover, Covid-19 scarring rates may ultimately be higher than those of SARS and MERS patients, as these diseases usually attack only one lung and Covid-19 appear to often affect both lungs, which also increases the risk of lung scarring.

he has seen residual scarring in Covid-19 patients and is therefore designing a study to determine which factors may expose some to a higher risk of permanent injury. He suspects that any type of lung disease or other health condition may increase the risk of long-term lung injury. In addition, he claims :" The older you get, the more likely you are to have scars on your lungs. "

Normal activity may become more challenging for people with these lung scars. "Climbing the stairs and other routine activities can make these people breathless ," Brennan said. "


Stroke, embolism and blood clots

An unexpected high incidence of thrombosis in many patients hospitalized for Covid-19 may be due to inflammation in the body. But these clots can lead to pulmonary obstruction, stroke, heart attack and other serious and lasting complications.

forming blood clots in the brain can cause a stroke. although stroke is more common in the elderly, stroke is now reported even in young Covid-19 patients. approximately 5% of Covid-19 patients hospitalized in Wuhan, have a stroke, and SARS patients have similar conditions.

许多Covid-19患者都出现了血液凝块
 

among young stroke patients, the death rate is relatively low and many can recover. But research shows that only 42 to 53 percent of people return to work.

Blood clots also cut off blood circulation in parts of the lung tissue, a condition known as pulmonary embolism, which can be fatal. two studies in france show that 23% to 30% of Covid-19 severe patients have concurrent pulmonary embolism problems. A study found that patients with pulmonary embolism developed symptoms including fatigue, palpitations, shortness of breath, and significant physical activity limitations.

Blood clots from other major organs can also cause serious problems. renal failure is a common problem in many Covid-19 severe patients, and dialysis machines are blocked by the patient`s blood clots. some of these acute kidney injuries may be permanent and require continuous dialysis.

Non-organ blood clots are also severe. For example, deep venous thrombosis occurs when blood clots form in the veins, and usually in the legs. Nick Cordello, a Tony-nominated Broadway actor, recently had to remove his right leg because of a clot with new coronary pneumonia.

Even after the patient recovers, blood clots are likely to cause abnormalities. Chicago, for example, a 32-year-old woman suddenly suffered from severe leg swelling a week after discharge death, which was caused by deep venous thrombosis. Another example is Troy Randall, a 49-year-old cardiologist in New Jersey, who was declared able to return to work after recovering from a stroke.

although data are still lacking, a study found that as many as 31% of Covid-19 severe patients have this problem. At the same time, the International Society for Thrombosis and Blood Stasis has issued guidelines requiring Covid-19 recovering patients to continue taking anticoagulant drugs after discharge.

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