The more patients with covid-19 we see, discuss with colleagues, read the experience of European and American doctors, the clearer the essence of the disease is revealed.
There is an explanation for the fact that in the first stages often led doctors into stupor.
Properties of SARS-CoV-2 virus
Usually, respiratory viruses target upper respiratory epithelials. Most often these are tracheal and upper bronchial cells. Therefore, acute respiratory viruses cause tarcheitis and bronchitis, and very rarely to pneumonia.
Pneumonia in this case is rather a complication caused by a decrease in immunity against the background of flu, most often of the bacterial nature. A true secondary infection.
This virus is more insidious.
Its task is to get as discreetly as possible to the most end sections of the respiratory tract – bronchioles and alveoli, and quietly breed there.
Unfortunately, this is where the gas exchange takes place and the most important surfactant is produced to ensure gas exchange and protect the alveoli balls from sticking together.
Those departments have no nerve endings, which is why many patients with covid pneumonia even do not cough. And they don’t have fever – because the immunity isn’t familiar with the virus, and it means the immunity don’t act.
Finally the destruction of the epithelium of the alevole and surfactant leads to the fact that they stick together, disrupting their work.
A person has latent hypoxia, organs and tissues do not have enough oxygen for life.
But the structure of the lungs is preserved and they can still adequately remove carbon dioxide from the blood, while it is the accumulation of excess carbon dioxide in the body that gives a reflex signal to breathlessness. And here, a person is obviously short of oxygen, but he’s not short of breath.
As a heart surgeon, I know firsthand what hypoxia is.
A healthy person can tolerate it asymptomatically for a few days, but during this time his body will receive a severe injury, burdened by related diseases will surrender much faster, and the consequences for him will be more serious, and for the patient after heart surgery sometimes enough a couple of hours of barely perceptible hypoxia in the analysis to make all our previous efforts meaningless.
We’re coming to a conclusion.
The patient does not know that he is sick or feels a small cold but does not feel dyspnea. He only starts to feel it when the body’s reserves are wasted, and these are the patients who will be placed in the ICU directly from the emergency car.
We approach that if this patient’s blood saturation is monitored in advance, give him oxygen in time, even at home, it is very likely that he will not become heavy. Or he’ll go to the hospital in time, where the treatment and the oxygen will also do its job.
Otherwise, we get more and more patients with organs exhausted from oxygen deprivation, with massive bacterial pneumonia. The bacterial pneumonia is appeared because the lung cells themselves also suffer from hypoxia and then the pathogenic bacterial flora do impact to lungs.
At this moment – when the bacterial pneumonia is appeared, the immunity finally understands what is the problem and tries to help the man.
It’s a cytokine storm that sweeps bacteria, viruses off the battlefield, and with them the lungs themselves, myocardium, kidneys, liver…
What conclusions can be drawn from new knowledge?
For me it is obvious – the more people infected with the new type of coronavirus will be detected, and as better they will be able to monitor the saturation of oxygen, as less death we will get in the end.
And a person who has a covid-19 in a lightweight form with a watch or gadget that can measure saturation at home becomes the perfect patient with big chances to save his life.