Ji Juesu/ People's Daily Central Kitchen - Dajiangdong Studio
Omi Kerong The emergency rooms of various hospitals are under great pressure. Many people are concerned, will this wave of Omicron still attack the upper respiratory tract? Will it cause pneumonia and , or even lead to the "white lung" phenomenon? In addition to basic diseases, what are the factors that aggravate the condition? Dajiangdong Studio interviewed Ai Jingwen, the attending physician of the Department of Infectious Diseases at Huashan Hospital.
On the morning of December 23, there were more than 30 COVID-19 patients under observation in the emergency room of Huashan Hospital. When the doctor in the emergency room said that they were all in critical condition, Dr. Ai Jingwen and her colleague Dr. Wang Jinyu rushed over and looked at the lung CT scans of more than 30 patients one by one. They found that about 10 of them had typical symptoms of viral pneumonia, including 1 patient with typical severe viral pneumonia (i.e., diffuse interstitial lesions). "From a front-line clinical perspective, the probability of severe pneumonia caused by Omicron and the need for intubation treatment is greatly reduced compared with the data of the original strain at the beginning of 2020 and the internationally popular strains such as Alpha, and delta in 2021," she said.
Ai Jingwen discovered a "special" phenomenon: in addition to the typical severe viral pneumonia patient, there were also elderly people in their 80s and 90s with COVID-19 infection lying around him. Although lung CT showed that the imaging manifestations of viral pneumonia were not very severe, most of them had underlying diseases, and their overall condition was very bad, and they were all severe patients. She patiently asked the family members one by one about the details of the patient's illness - "I can't eat anything after having a fever" and "I have only drank porridge for two days in a row." The family members said in unison.
This caused her concern.
After communicating with doctors Yang Shibo and Wang Yiduo in the emergency department , they discovered a common phenomenon. "We found that critically ill elderly people in the emergency room generally suffer from malnutrition." Ai Jingwen said, "When people have a fever, they really don't want to eat. The nutritional intake is insufficient within a few days. Young people can get through it, but the old man's body is like a thatched hut. Photo by Xia Yuechao
However, the emergency room is now overwhelmed. Chen Mingquan, director of the emergency department of Huashan Hospital, said that before, 30 ambulances came every day, but now that number has tripled to four times, with more than 90-120 ambulances. A large number of emergency doctors have also fallen down due to infection, and many emergency doctors have to work despite being sick. Emergency treatment The waiting time for treatment and rehydration will be longer than before. Many elderly people are hungry and weak. At this time, their lungs may not be infected with virus , but as the disease progresses and bacterial infections or other underlying diseases are superimposed, it will be more dangerous. After communicating with doctors in the ICU wards of other tertiary hospitals in Shanghai, Ai Jingwen learned that many of the elderly patients they received also had underlying diseases and bacterial infections, and often had insufficient nutritional support.
Therefore, Dr. Ai Jingwen reminded that we should be wary of the phenomenon that the elderly have reduced resistance due to lack of nutrition in the early stages of infection. In home care, special attention should be paid to supplementing nutrition and fluids in the early stages of infection for the elderly. Energy intake during the infection should be increased. This is one of the important means to help our body resist the virus. Soft foods such as porridge and soup will be easier to digest during the illness, but at the same time, attention should be paid to the intake of other nutrients. The best way is to eat two eggs a day, or it can be an easy-to-digest custard stew. If you really can't eat, you can drink milk, protein powder or other nutritional preparations to help absorb energy. If you have underlying diseases, it is best to consult your doctor on how to increase nutritional supplements. Just like what Ai Jingwen often heard from her tutor Professor Zhang Wenhong , when you are sick, you should take food as medicine. We must avoid infection caused by malnutrition, leading to critical and severe cases.
Families must pay close attention to the nutrition of the elderly and raise them as babies. It is most important to ensure adequate staple foods and complementary foods. At the same time, elderly patients must be closely monitored. It would be better if a home finger pulse oximeter could be used to monitor blood oxygen saturation. If there is no oxygen saturation instrument, you should pay attention to whether the elderly become sluggish and whether they can complete some usual activities, such as walking and chatting. This can largely detect the aggravation of the disease at an early stage. Once abnormalities are discovered, it will be more efficient to seek medical treatment in time. On the contrary, it will not be beneficial to the health of the elderly if they go to the emergency room when their condition is stable.
Editor of this issue Zou Shan
