Garg Ravindra Kumar, Singh Gyan Prakash, Garg Rajiv, Kumar Neeraj, Parihar Anit
Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Department of Anaesthesia, King George Medical University, Lucknow, Uttar Pradesh, India.
J Family Med Prim Care. 2021 Jan;10(1):84-92. doi: 10.4103/jfmpc.jfmpc_1600_20. Epub 2021 Jan 30.
Severe coronavirus disease-2019 (COVID-19) is a distinct entity that rapidly evolves and may abruptly culminate in to a critical illness. As per Chinese experience, approximately, 15% of patients of COVID-19 progress to severe disease and 5% become critically ill. The incidence of severe and critical illness is higher among men, patients older than 65 years of age and in persons with other medical comorbidities. Cytokine storm cause pronounced lung damage and multiorgan failure. Coagulopathy is a key component of severe COVID-19. Critically ill patients are generally predisposed to a high risk of thromboembolism as well. Lymphopenia predisposes to severe disease. None of the antiviral or immunomodulators has proven efficacy in severe COVID-19. Supplemental oxygen need be administered in patients with hypoxemia. Excessive breathing effort, acute respiratory distress syndrome (ARDS), encephalopathy, and multiorgan failure are indications for mechanical ventilation. In a large number of patients, the overall outcome is poor. Health care workers in intensive care units are exposed to the enormous risk of acquiring hospital acquired SARS-COV-2 infection.
重症冠状病毒病2019（COVID-19）是一种独特的疾病实体，其病情迅速发展，可能突然演变为危重症。根据中国的经验，大约15%的COVID-19患者会发展为重症，5%会发展为危重症。重症和危重症的发病率在男性、65岁以上的患者以及有其他合并症的人群中更高。细胞因子风暴会导致严重的肺损伤和多器官功能衰竭。凝血功能障碍是重症COVID-19的一个关键组成部分。危重症患者通常也有发生血栓栓塞的高风险。淋巴细胞减少易导致重症。在重症COVID-19中，尚无任何抗病毒药物或免疫调节剂被证明有效。低氧血症患者需要给予补充氧气。呼吸费力、急性呼吸窘迫综合征（ARDS）、脑病和多器官功能衰竭是机械通气的指征。在大量患者中，总体预后较差。重症监护病房的医护人员面临着感染医院获得性SARS-CoV-2的巨大风险。
