What you should know about COVID-19 Pneumonia
What type of pneumonia is viral or bacterial?
Pneumonia, which affects approximately one in five patients with COVID-19, has characteristic features. Normal, non-coronavirus pneumonia, develops due to the accumulation of fluid in the lungs against the background of acute respiratory infections or influenza. In this sputum, bacteria multiply, provoking the appearance of individual foci of inflammation. A complication of COVID-19 is a viral, not a bacterial infection, so coronavirus pneumonia has a completely different course. The virus disrupts the normal functioning of the alveoli - vesicles located on the lung walls. This leads to the development of not focal, as in the previous case, but a global lesion of both lungs. Lung tissue quickly collapses, becomes fibrous.
Is asymptomatic inflammation of the lung tissue possible with covid, when, despite changes in the lungs, patients have neither cough, nor shortness of breath, nor fever?
An asymptomatic or oligosymptomatic course is more typical for forms of the disease without lung damage. Indeed, computed tomography (CT) scans of the chest in patients with mild COVID-19 may show CT evidence of mild viral pneumonia. At the same time, the gas exchange function of the lungs does not suffer, the amount of oxygen delivered to the blood remains normal, and no change in therapeutic tactics is required.
When do coronavirus symptoms usually appear, such as respiratory discomfort, shortness of breath?
The incubation period of an infection caused by the SARS-CoV-2 virus averages 5-7 days (from 2 to 14), which means that symptoms may appear during these periods. The course of the disease can be different - from mild manifestations of a common ARVI (fever, cough, weakness, headache) to severe pneumonia with respiratory failure. It is always worth paying attention to such manifestations of the disease as shortness of breath (increase in the frequency of breathing), a feeling of lack of air, pain or a feeling of tightness in the chest at any time during the illness.
Do lung changes occur in most patients with COVID-19?
In most cases - up to 80% - coronavirus infection is mild, without involvement of the lungs. COVID-19 pneumonia develops in approximately 20% of cases, of which 2 to 10% can be severe. The duration of the course and the consequences of the disease depend on many factors: the volume of lung damage, concomitant diseases, the timeliness of seeking medical help, adherence to treatment recommendations, the possibility of developing complications, etc.
Should I do a CT scan of the lungs with a coronavirus infection?
Due to the frequent false-negative results of the primary PCR study and the absence of classic signs in SARS, computed tomography (CT) is becoming the most informative way to diagnose COVID-19.
COVID-19 antigens, recognized as an absolute marker of infection, are detected by PCR. As for computed tomography, it does not detect the pathogen itself, but allows you to confirm or refute the presence of specific viral pneumonia.
CT is a highly sensitive method of radiation imaging of various anatomical structures. Non-invasive, absolutely painless examination takes a few seconds, has high sensitivity and specificity. Scanning on modern tomographs with a radiation control program is carried out at a reduced radiation exposure.
For whom is a lung CT recommended in the first place?
Computed tomography is not performed for prophylactic purposes. The study is considered necessary when symptoms of the disease appear in the following situations:
- there was contact with a patient who has a confirmed coronavirus infection (the virus was detected in a laboratory);
- there are severe symptoms and clinical signs of a respiratory disease (temperature 38 degrees and above, respiratory rate> 22 per minute, shortness of breath / cough / chest pain, blood saturation < 95% - to make a decision on inpatient treatment);
- there is a need for planned hospitalization for treatment of an illness not related to COVID-1.
CT scan for coronavirus infection is done even if the test for COVID-19 shows a negative result, and no significant changes in the lung tissue are detected on the x-ray of the lungs (the foci may still be small) - while the patient is concerned about the above symptoms, and contact with sick in the past.
What are the treatments for coronavirus pneumonia?
Approaches to the treatment of COVID-19 were formed and changed as information about the course of the infection became available, understanding of the mechanisms of its development and possible consequences based on the analysis of a large number of international publications and research results, and accumulating clinical experience. A year after the start of the pandemic, there are still no etiotropic therapy drugs with proven efficacy in the arsenal of used drugs.
With COVID-19 pneumonia, non-drug methods occupy an important place - prone position (lying on the stomach) as an independent therapeutic measure, oxygen therapy, options for hardware respiratory support. In all cases of coronavirus infection, it is necessary to monitor the amount of fluid consumed.
Taking into account the mechanisms of the development of the disease, the pharmacotherapy algorithm for COVID-19 pneumonia includes antiviral drugs, drugs for the prevention of thrombosis, hormonal anti-inflammatory therapy, and if there are signs of a bacterial infection, antibiotics.
Despite the algorithmization of therapeutic approaches, which is undoubtedly important in epidemic conditions, the volume of pharmacotherapy and the choice of specific drugs from each group are determined by the doctor, and only based on the specific clinical situation and the individual characteristics of the patient.
Do patients with pneumonia caused by coronavirus always need to be treated in the hospital?
At home, it is possible to treat non-severe pneumonia in a person without risk factors, if there are conditions that ensure isolation and adherence to treatment recommendations, as well as medical (including remote) control.
Is it possible to do inhalation with coronavirus pneumonia?
With a coronavirus infection, inhalations (steam inhalations, nebulizer therapy), as aerosol-forming procedures, should be abandoned. Exceptions are dosing inhalation devices - aerosol and powder, used for constant basic therapy and emergency care for chronic diseases - bronchial asthma and chronic obstructive pulmonary disease.
Nebulizer therapy should be used only for health reasons, taking precautions for the spread of infection through an aerosol (isolation of the patient during inhalation, ventilation after inhalation, surface treatment with antiseptics).
How to restore the lungs after coronavirus pneumonia?
Basic rules of rehabilitation:
- Perform aerobic exercise in a sitting position or even lying down and reclining. You can do the exercise bicycle, loads on the hands are required. If additional weight is used when training hands, then the principle here is this - less weight - more repetitions. You can train on an exercise bike, but you need to start from a more horizontal position. It is important that the exercises should be regular and with a fairly high frequency - from 4 to 6 days a week. Increase the load smoothly and gradually.
- With active cardio loads, you will probably have to wait a long time. In any case, you need to start with walking. Then gradually you can use the bike. But the best thing is to walk and walk, breathe fresh air. Improving gas exchange is also rehabilitation!
- We eat right! In this case, this means: eat in small portions, pay attention to the fact that there were enough calories, no rigid diets. The body needs both proteins and fats. Carbohydrates are also important, but sweets should be replaced with a lot of fiber (vegetables, greens). This normalizes digestion and increases the emotional background.
- Sleep after an illness is necessary for at least 7 hours. We ventilate the bedroom before going to bed, slow down physical activity 2-3 hours before bedtime. If there is such an opportunity, then before going to bed it is better to take a walk and not overeat, finish dinner 1.5 - 2 hours before bedtime.
- Try not to use gadgets right before going to bed, because it causes overexcitation of the nervous system. Don't take your phone to bed with you. Because if you woke up in the middle of the night, and you have a phone at hand, the likelihood that you will start reading something is high. And as soon as you read something, the brain has already rebuilt to other activities.
- We are all now in a state of stress, both those who have been ill and those who have not been ill. A feature of this infection is hypoxia, oxygen starvation. This may be a prerequisite for the development of anxiety, post-traumatic stress disorder, depression. In such cases, psychological support is needed - seek qualified help.
- Control your vitamin D levels. If the analyzes reveal its insufficiency, it will be necessary to take it additionally.
- Alcohol is excluded. Yes, some doctors from Italy, for example, write that a glass of wine would not hurt. But in the early stages of rehabilitation, alcohol is contraindicated. Since the vessels were subject to a serious attack of the virus during the illness, it is not worth exposing them to an alcohol load during the rehabilitation period.
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