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SARS-CoV-2 感染患者管理,重点关注慢性肺部疾病患者(截至 2022 年 1 月 10 日):奥地利肺病学会(ASP)更新声明。

Management of patients with SARS-CoV-2 infections with focus on patients with chronic lung diseases (as of 10 January 2022) : Updated statement of the Austrian Society of Pneumology (ASP).

机构信息

Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria.

出版信息

Wien Klin Wochenschr. 2022 May;134(9-10):399-419. doi: 10.1007/s00508-022-02018-x. Epub 2022 Apr 21.

Abstract

The Austrian Society of Pneumology (ASP) launched a first statement on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in May 2020, at a time when in Austria 285 people had died from this disease and vaccinations were not available. Lockdown and social distancing were the only available measures to prevent more infections and the breakdown of the health system. Meanwhile, in Austria over 13,000 patients have died in association with a SARS-CoV‑2 infection and coronavirus disease 2019 (COVID-19) was among the most common causes of death; however, SARS-CoV‑2 has been mutating all the time and currently, most patients have been affected by the delta variant where the vaccination is very effective but the omicron variant is rapidly rising and becoming predominant. Particularly in children and young adults, where the vaccination rate is low, the omicron variant is expected to spread very fast. This poses a particular threat to unvaccinated people who are at elevated risk of severe COVID-19 disease but also to people with an active vaccination. There are few publications that comprehensively addressed the special issues with SARS-CoV‑2 infection in patients with chronic lung diseases. These were the reasons for this updated statement. Pulmonologists care for many patients with an elevated risk of death in case of COVID-19 but also for patients that might be at an elevated risk of vaccination reactions or vaccination failure. In addition, lung function tests, bronchoscopy, respiratory physiotherapy and training therapy may put both patients and health professionals at an increased risk of infection. The working circles of the ASP have provided statements concerning these risks and how to avoid risks for the patients.

摘要

奥地利呼吸学会(ASP)于 2020 年 5 月发布了关于严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染的第一份声明,当时奥地利已有 285 人死于该病,且尚未开展疫苗接种。封锁和社会隔离是防止更多感染和医疗系统崩溃的唯一可用措施。与此同时,奥地利有超过 13000 人死于 SARS-CoV-2 感染,冠状病毒病 2019(COVID-19)是最常见的死亡原因之一;然而,SARS-CoV-2 一直在不断变异,目前,大多数患者受到 delta 变异株的影响,该变异株疫苗非常有效,但 omicron 变异株正在迅速上升并成为主要流行株。特别是在疫苗接种率较低的儿童和青年人群中,预计 omicron 变异株的传播速度会非常快。这对未接种疫苗的人构成了特别威胁,他们患严重 COVID-19 疾病的风险较高,但对正在进行主动接种的人也构成了威胁。很少有出版物全面解决慢性肺部疾病患者 SARS-CoV-2 感染的特殊问题。这就是更新这份声明的原因。肺病专家照顾许多 COVID-19 死亡风险较高的患者,也照顾可能面临疫苗接种反应或接种失败风险较高的患者。此外,肺功能测试、支气管镜检查、呼吸物理治疗和训练治疗可能会使患者和卫生专业人员面临更高的感染风险。ASP 的工作圈就这些风险以及如何为患者避免风险提供了声明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb3a/9114098/87cf2fc45e91/508_2022_2018_Fig1_HTML.jpg

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