The following is from the original text posted by "Hou Dabao" certified by Weibo, which details the diagnosis and treatment situation over the past ten days:
In the half-month period from the complete liberalization of the medical system on the 13th to yesterday the 28th, the composition of patients coming to the hospital has changed significantly: from patients with acute attacks of chronic diseases at the beginning, to patients with a series of accompanying symptoms caused by fever, and now exclusively pneumonia patients. Yesterday, we received about 90 patients, and three died, all of them were elderly people over 80, and there were no young critically ill patients. Let me briefly describe the characteristics of yesterday's patients:
1. Not many young people came for treatment. The composition of yesterday's patients was mainly middle-aged and elderly people over 60 years old, and there were relatively few young people. I think the main reason is that the symptoms of young people are generally not severe, and the second is that emergency rooms often queue for hours, which makes many young people give up on seeing a doctor. But I still performed chest CT on a dozen young people. Most of them had severe coughs, but basically no pneumonia or mild pneumonia.
2. There are many cases of pneumonia in middle-aged and elderly people, some with underlying diseases and some without. Most of the CT scans show typical changes of viral pneumonia . The reasons why they come to see a doctor are very similar: they all come to the hospital after having recurring fevers at home for 7 to 10 days, and the fever does not go away. When they have no other choice, they come to the hospital. Upon examination, almost all of them are viral pneumonia. We work backwards 7 days, that is, around the 21st of this month, which is when these elderly people became ill. According to the epidemic report of Qingdao , the 21st was about the peak moment of infection in Qingdao. CT scans of many elderly people show that lung infection is no longer a matter of a day or two, and many have begun to absorb the disease. Most patients' pneumonia can be recovered through treatment and absorption, and a small number of them may have a certain impact on lung function.
3. Several severe pneumonias are basically combined with serious underlying diseases, such as diabetes , uremia and malignant tumors. Such patients are often complicated by severe bacterial infections, have high blood levels, and elevated PCT, and require intensive treatment with antibiotics and .
4. Because there is no specific medicine for new crown , azivudine and paxlovid are clearly recommended effective drugs in the guidelines. Paxlovid is currently very rare in the country, but we can prescribe azivudine. If we work backwards and let the elderly people who got sick during the peak period (the 21st) take the medicine as soon as possible, that is, when the elderly first develop fever around the 21st, they take Azivudine and Paxlovid as soon as possible for 3 to 5 days. In theory, it is possible to reduce the risk of pneumonia. Progress, but this is a thing for another time. Judging from the time of onset and CT scan, most of these elderly people have a disease duration of more than 5 days. At this time, it is of little significance to take Azivudine and P drugs. However, if the fever still occurs repeatedly and there is a trend of progression on the imaging, you can still take the medicine. This requires comprehensive judgment. Therefore, if an elderly person is infected for the first time and has just developed fever symptoms, they can take it as soon as possible. This is an antiviral drug that is clearly effective in the current guidelines. Because the infection peaks vary from place to place and the situation of the elderly is also different, it can be determined based on the time of fever.
5. Even if you don’t take antiviral drugs, I think the pneumonia caused by Omicron is still within the controllable range. Antibiotics are only used to prevent combined bacterial infections, strengthen nutrition and get a good rest, and the inflammation can be slowly absorbed. The whole process takes about 15 days, which means that the elderly who became ill on the 21st peak will recover around the 10th of next month. Severe infections will have a certain impact on lung function, while mild ones will not see much change.
6. Regarding the issue of the disease among young people, the threat of COVID-19 to young people lies in the acute conditions caused by the acute stage of infection. The most feared one is acute respiratory distress syndrome (ARDS), but I have never encountered such young patients. Indeed, in the week from the 13th to the 21st when the number of infections increased rapidly, extreme cases such as fulminant myocarditis and acute renal failure all appeared. Such cases often appear in the hyperacute stage of infection and are difficult to reappear after the infection recovers. I personally feel that Omicron is not likely to cause pneumonia in young people, or it is generally very mild pneumonia. Many people do not check it, and the inflammation is slowly absorbed by itself. I think the further back the time goes, the fewer young patients there will be, and the less likely they will have serious problems, because those who have troubles have already had troubles, and they will not be delayed until now.
What is clear is that no matter men, women, old or young, sick or not, COVID-19 infection still has a relatively large impact on people. In the past month, you need to take a good rest, strengthen nutrition, and avoid fatigue. It has been half a month since
was released. The most difficult time has actually arrived, and we will definitely win. I wish everyone a successful escape!
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