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Posted in its entirety with permission
Top Virus Doctor Says High Blood Pressure Is Big Death Risk (1)
2020-03-10 02:41:24.386 GMT
By Bloomberg News
(Bloomberg) -- Patients with hypertension appear to be at a
higher risk of dying from the coronavirus, said a top Chinese
intensive care doctor who’s been treating critically ill
patients since mid-January.
While there’s been no published research yet explaining
why, Chinese doctors working in Wuhan, the central Chinese city
where the virus first emerged, have noticed that infected
patients with that underlying illness are more likely to slip
into severe distress and die.
Of a group of 170 patients who died in January in Wuhan --
the first wave of casualties caused by a pathogen that’s now
raced around the world -- nearly half had hypertension.
“That’s a very high ratio,” said Du Bin, director of the
intensive care unit at Peking Union Medical College Hospital, in
an interview with Bloomberg over the phone from Wuhan. He was
among a team of top doctors sent to the devastated city two
months ago to help treat patients there.
“From what I was told by other doctors and the data I can
see myself, among all the underlying diseases, hypertension is a
key dangerous factor,” said Du, one of the most respected
critical care experts in China. “Though there is no research
published on that yet, we believe hypertension could be an
important factor in causing patients to deteriorate, leading to
a bad prognosis.”
Read more on how the virus reaches a fatal “tipping point”
when lungs become inflamed
As the outbreak picks up speed in Europe and the U.S.,
plunging countries like Italy into crisis, doctors are
struggling to treat the highly-infectious pathogen that’s
infected over 108,000 people globally in just three months.
Understanding the course of the disease and identifying
individuals at greatest risk are critical for optimizing care
for a global contagion that’s killed more than 3,700 people
since emerging in China in December.
Answers may lie in studying the large pool of patients in
China, where more than 15,000 remain hospitalized although new
infections have slowed dramatically. The disease turns critical
in 6% of patients and deterioration can happen very quickly.
“We’ll keep an eye on old people and those with high blood
pressure. They are the key focus,” said Du.
Besides the hypertension factor, Du’s other insights into
treating the disease are:
Move Aggressively to Ventilate
Du said that doctors should not hesitate to escalate
measures for patients facing respiratory distress, as organ
failure can set in quickly after. That means doctors should
intervene aggressively with invasive ventilation measures --
inserting a tube into a patient’s throat or cutting the throat
open to create an airway -- when low blood oxygen levels can’t
be improved by less invasive measures.
Almost half of the patients who require invasive mechanical
ventilation end up dying, but most of those who recover are
those who were put on invasive ventilation early, said Du.
“Patients need to use invasive ventilation as early as
possible, there’s no point of doing it late,” he said.
Respiratory therapists -- doctors that specialize in
ventilation and oxygen treatment -- are becoming all the more
important in treating patients critically ill with Covid-19 as
they are more knowledgeable and can fine-tune ventilators to
suit patient conditions.
No ‘Magic Bullets’ in Drugs
There is growing anticipation over drugs being developed to
treat the virus, with investors adding billions to the market
value of pharmaceutical companies testing treatments now. But Du
said drugs alone cannot save patients, especially those in
severe condition.
Read more on how the search for coronavirus drug faces long
odds
The experience of SARS, the epidemic 17 years ago that
sickened almost 8,000 people, showed that most patients can be
cured without a specific anti-viral drug, said Du. And the
abundance of antibiotics has not prevented deaths by bacterial
infections, he added.
“When there’s a virus infection, we hope there’s a drug
that can kill the virus and change the clinical outcome. But
there’s no magic bullet.”
Instead, teamwork among specialists and nurses in intensive
care units can be more crucial in keeping patients alive, he
said. “An ICU doctor should work like a conductor in an
orchestra to provide life-sustaining treatment while taking into
consideration different specialist views,” he said.
Threat of Re-infection
Reports that people who have recovered and been discharged
from hospital later test positive again -- and even die from the
disease -- have ignited fears that the virus can somehow re-
emerge.
Du said that patients becoming re-infected again within
days of leaving the hospital makes no sense “theoretically” as
the anti-bodies in their bloodstream generated from fighting the
disease do not disappear so quickly, although they don’t
necessarily stay forever.
“What we need to look at in terms of those who tested
positive again is concerns over the authenticity of their
negative results,” he said. For example, samples taken from
different areas of the same patient could test differently
depending on where the virus resides.
Test kits made by different manufacturers could also have
inconsistencies that impact test results, he said.
Mild Impact on Pregnant Women, Children
Despite their seeming physical vulnerability, pregnant
women and children do not seem to be affected by the coronavirus
in a serious manner, Du said. This is in contrast to other
viruses like influenza.
“From what we known, infected pregnant women do not get
into a serious situation with the coronavirus,” Du said. “With
influenza, pregnancy is a high risk factor that can cause severe
symptoms and lead to bad outcomes, but not this time.”
Children infected with the coronavirus also seem to
experience only mild symptoms, said Du. He has not seen any
child infections deteriorate to a state which requires intensive
care.
To contact Bloomberg News staff for this story:
Dong Lyu in Beijing at dlyu3@bloomberg.net;
Claire Che in Beijing at yche16@bloomberg.net
To contact the editors responsible for this story:
Rachel Chang at wchang98@bloomberg.net
Sharon Chen
via email
Posted in its entirety with permission
Top Virus Doctor Says High Blood Pressure Is Big Death Risk (1)
2020-03-10 02:41:24.386 GMT
By Bloomberg News
(Bloomberg) -- Patients with hypertension appear to be at a
higher risk of dying from the coronavirus, said a top Chinese
intensive care doctor who’s been treating critically ill
patients since mid-January.
While there’s been no published research yet explaining
why, Chinese doctors working in Wuhan, the central Chinese city
where the virus first emerged, have noticed that infected
patients with that underlying illness are more likely to slip
into severe distress and die.
Of a group of 170 patients who died in January in Wuhan --
the first wave of casualties caused by a pathogen that’s now
raced around the world -- nearly half had hypertension.
“That’s a very high ratio,” said Du Bin, director of the
intensive care unit at Peking Union Medical College Hospital, in
an interview with Bloomberg over the phone from Wuhan. He was
among a team of top doctors sent to the devastated city two
months ago to help treat patients there.
“From what I was told by other doctors and the data I can
see myself, among all the underlying diseases, hypertension is a
key dangerous factor,” said Du, one of the most respected
critical care experts in China. “Though there is no research
published on that yet, we believe hypertension could be an
important factor in causing patients to deteriorate, leading to
a bad prognosis.”
Read more on how the virus reaches a fatal “tipping point”
when lungs become inflamed
As the outbreak picks up speed in Europe and the U.S.,
plunging countries like Italy into crisis, doctors are
struggling to treat the highly-infectious pathogen that’s
infected over 108,000 people globally in just three months.
Understanding the course of the disease and identifying
individuals at greatest risk are critical for optimizing care
for a global contagion that’s killed more than 3,700 people
since emerging in China in December.
Answers may lie in studying the large pool of patients in
China, where more than 15,000 remain hospitalized although new
infections have slowed dramatically. The disease turns critical
in 6% of patients and deterioration can happen very quickly.
“We’ll keep an eye on old people and those with high blood
pressure. They are the key focus,” said Du.
Besides the hypertension factor, Du’s other insights into
treating the disease are:
Move Aggressively to Ventilate
Du said that doctors should not hesitate to escalate
measures for patients facing respiratory distress, as organ
failure can set in quickly after. That means doctors should
intervene aggressively with invasive ventilation measures --
inserting a tube into a patient’s throat or cutting the throat
open to create an airway -- when low blood oxygen levels can’t
be improved by less invasive measures.
Almost half of the patients who require invasive mechanical
ventilation end up dying, but most of those who recover are
those who were put on invasive ventilation early, said Du.
“Patients need to use invasive ventilation as early as
possible, there’s no point of doing it late,” he said.
Respiratory therapists -- doctors that specialize in
ventilation and oxygen treatment -- are becoming all the more
important in treating patients critically ill with Covid-19 as
they are more knowledgeable and can fine-tune ventilators to
suit patient conditions.
No ‘Magic Bullets’ in Drugs
There is growing anticipation over drugs being developed to
treat the virus, with investors adding billions to the market
value of pharmaceutical companies testing treatments now. But Du
said drugs alone cannot save patients, especially those in
severe condition.
Read more on how the search for coronavirus drug faces long
odds
The experience of SARS, the epidemic 17 years ago that
sickened almost 8,000 people, showed that most patients can be
cured without a specific anti-viral drug, said Du. And the
abundance of antibiotics has not prevented deaths by bacterial
infections, he added.
“When there’s a virus infection, we hope there’s a drug
that can kill the virus and change the clinical outcome. But
there’s no magic bullet.”
Instead, teamwork among specialists and nurses in intensive
care units can be more crucial in keeping patients alive, he
said. “An ICU doctor should work like a conductor in an
orchestra to provide life-sustaining treatment while taking into
consideration different specialist views,” he said.
Threat of Re-infection
Reports that people who have recovered and been discharged
from hospital later test positive again -- and even die from the
disease -- have ignited fears that the virus can somehow re-
emerge.
Du said that patients becoming re-infected again within
days of leaving the hospital makes no sense “theoretically” as
the anti-bodies in their bloodstream generated from fighting the
disease do not disappear so quickly, although they don’t
necessarily stay forever.
“What we need to look at in terms of those who tested
positive again is concerns over the authenticity of their
negative results,” he said. For example, samples taken from
different areas of the same patient could test differently
depending on where the virus resides.
Test kits made by different manufacturers could also have
inconsistencies that impact test results, he said.
Mild Impact on Pregnant Women, Children
Despite their seeming physical vulnerability, pregnant
women and children do not seem to be affected by the coronavirus
in a serious manner, Du said. This is in contrast to other
viruses like influenza.
“From what we known, infected pregnant women do not get
into a serious situation with the coronavirus,” Du said. “With
influenza, pregnancy is a high risk factor that can cause severe
symptoms and lead to bad outcomes, but not this time.”
Children infected with the coronavirus also seem to
experience only mild symptoms, said Du. He has not seen any
child infections deteriorate to a state which requires intensive
care.
To contact Bloomberg News staff for this story:
Dong Lyu in Beijing at dlyu3@bloomberg.net;
Claire Che in Beijing at yche16@bloomberg.net
To contact the editors responsible for this story:
Rachel Chang at wchang98@bloomberg.net
Sharon Chen