According to the NINTH edition of the COVID-19 Guidelines, the age of the elderly is defined as over 60 years old, which expands the range from “over 65 years old” in the eighth edition.

In addition to asymptomatic cases, most of the confirmed cases are mild, a few are ordinary, and there are also severe cases. Currently, there are 9 severe cases, all of which are receiving treatment in designated medical institutions. In which population does novel Coronavirus infection become severe? In view of the public doubts, Jiefang Daily · Shangguan news reporters interviewed Dr. Pan Jue, director of infectious diseases department of Zhongshan Hospital affiliated to Fudan University, to solve.

Among the nine patients, seven are male, two are female, one is 33 years old, and the other eight are aged from 70 to 93. They all had serious underlying diseases (such as severe immune diseases, advanced tumors, severe cardiovascular and cerebrovascular diseases, failure of vital organs, etc.) and high risk factors such as advanced age. None of them had been vaccinated against COVID-19.

Pan jue said that children under 5 and the elderly are the most important groups to judge the severity of the disease. According to the NINTH edition of the COVID-19 Guidelines, the age of the elderly is defined as over 60 years old, which expands the range from “over 65 years old” in the eighth edition.

The second predictor of severe illness is underlying illness. Older people who are already dysfunctional need particular attention. For example, cardiovascular and cerebrovascular diseases, such as coronary heart disease unstable angina patients; The basic immunity of patients with cerebrovascular diseases (cerebral infarction, cerebral hemorrhage, etc.) is relatively poor. The guidelines for the diagnosis and treatment of COVID-19 pay special attention to people with high blood pressure and obesity, which are also vulnerable to severe disease.

Will patients with chronic lung disease become severe? And the degree of lung function impairment. In acute asthma, there is increased airway responsiveness, and once the novel coronavirus infection occurs, the lung exudates to varying degrees, adding to the strain, leading to hypoxia and exacerbating the disease; The lung function of copd patients is impaired to varying degrees. In the case of novel coronavirus infection invading the lower respiratory tract, the lung function will further decline, resulting in clinical manifestations of hypoxia and dyspnea.

As for patients with diabetes and renal failure, once infected, such patients have poor tissue repair ability; All of these people are at high risk of severe illness. Patients with advanced tumors have surgery, radiotherapy, chemotherapy and other medical history, poor immune function, but also easy to severe. Patients with immune deficiency (such as AIDS patients, rheumatic diseases, organ transplant patients), severe disease is also prone to occur.

Previous studies have shown that obese people are more likely to get severe cases of COVID-19, pan jue said, citing scientific evidence. Regardless of age, obesity is one of the causes of severe disease. As for perinatal women, 42 days after delivery all belong to the high-risk group; In addition, those who smoke heavily (more than 400 years per cigarette) are more likely to become severely ill than the general population.

Pan jue said that the Novel Coronavirus diagnosis and treatment guidelines specify that the dynamic changes of clinical indicators such as C-reactive protein, lactic acid, interleukin-6, coagulation factors and oxygen saturation can indicate the presence or absence of severe cases. In severe cases, children may have symptoms such as rapid breathing rate and lethargy. Special attention should be paid to children with severe malnutrition, congenital heart disease and newborn babies.

As a novel coronavirus, it has its own characteristics that can cause damage to multiple organs in patients. As for whether it will cause severe disease, it should be discriminated and treated in time according to individual differences.

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