November 27, 2020

A virus without a pattern



If there is something that doctors who are trying to stop the impact of covid-19 since the pandemic began, it is that, so far, there are many more doubts than certainties about the behavior of this virus and that every day that passes, they find new cases that provide unknown data about the disease.

Eight months after the irruption of the coronavirus In Córdoba, the head of Internal Medicine at the Reina Sofía hospital, José López Miranda, cannot draw a pattern that all patients who are admitted for covid meet, since through the emergency room door Patients of very different ages, men and women, enter every day. “There are many young people arriving, among whom obesity and diabetes are risk factors,” he points out, “we have cases of young and middle-aged people with and without risk factors who have a very bad time when they face the virus.”

However, the main marker that can turn the lethal virus is “age and multiple pathologies”, therefore, the majority of admitted patients are older, although “we still know very little about asymptomatic patients, who are not exempt from a series of long-term complications that affect all organs.”

According to Dr. López Miranda, “the virus does not kill by itself, but by the affectation that it produces in the respiratory tract and by the inflammatory response syndromes that it generates and that damage the blood vessels, and can affect the liver, kidneys or the heart, due to the microthromboses that it produces and that can damage the brain and cause strokes “

These side effects in asymptomatic patients do not arrive in a standard period of time for everyone. “Sometimes they occur after a month, other times within three weeks or up to two and three months after infection, but we do not know if they can take even longer, since there is not enough perspective yet “, comments López Miranda. For the head of Internal Medicine, the question is that” we are only seeing the tip of the iceberg, we do not yet know what is underneath. the large number of asymptomatic people that exist, since only those who are very sick come to hospitals, “although it ensures that”these cases are not very frequent so far“. The hospitalization time of a covid patient also varies greatly depending on the case.” There are people with very serious conditions who can spend months in hospital, “he says, although” we could say that the average is usually between eight and ten days”.

Another issue that arouses concern in the population is the possibility of being reinfected by covid after the disease has passed and if these cases are occurring, since there are studies that suggest that antibodies weaken very soon. According to Dr. López Miranda, “the antibodies don’t go away.” The immune system, he explains, is adjusting little by little without disappearing completely, although “we do not know how important reinfections may have if people continue to be in contact with the virus.” In his opinion, “if the immune system of a person is strong, there would be no problem, but if it is in low hours, it is possible that there is a worse prognosis”. For now “We only have exceptional cases and most of them mild.”

The Reina Sofía hospital does not provide statistical data on its patients to determine the impact of cases according to the age or sex of the patients, and refers to the Andalusian Institute of Statistics. According to the data published so far, although mortality is concentrated among people over 65, young or middle-aged people are not without risk, since at least one death from covid-19 has been registered in Córdoba in a patient between 30 and 44 years old and another 16 deaths in patients between 45 and 64 years old. In young people, mortality is higher in men while it increases in women as they get older, perhaps because the number of elderly women is much higher than that of men.

Older people die more, but there are many more infections among young people so it largely depends on them to stop the virus, insists the expert. Of the total cases confirmed so far in the province, 9.2% are under 15 years of age, 21% people between 15 and 29 and 18% between 30 and 44 years while the number of positives in the elderly represents 14.3% (from 65 to 84 years of age) and 5.5% (with more than 84).

Does this mean that young people can relax in the face of the virus? The resounding answer is no. “Covid-19 is an extremely contagious virus that takes advantage of asymptomatic phases to infect at very high levels, so either we make a paradigm shift in how we understand social relationships and accept that we cannot meet 15 or 20 people or remove our masks or reduce the safety distance, or who are going to suffer the consequences are the parents and grandparents of these young people. “According to López Miranda,” young people can not only get caught by the train but also have to prevent the train from catching the rest of the family membersWe have cases of marriages affected at the same time and both admitted by the virus. “

To those who are still skeptical about the effects of the coronavirus, López Miranda tells them “to volunteer in the covid units and see the sick and in 0.2 seconds you will understand the seriousness of the situation. “ The worst moment is yet to come. “The perfect storm can occur in the short term if flu and covid are spread simultaneously in the same person,” he says, “something that remains to be seen and that is why it is so important to get vaccinated.”

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