Why is it difficult to treat viral pneumonia? How do we ordinary people protect ourselves? Bo Shining, a doctor in the ICU of Peking University Third Hospital, explained this and made recommendations.
Whether it is atypical pneumonia, influenza pneumonia, or today’s new coronary pneumonia, although the pathogens are different, they are all pneumonia caused by viruses. The pathophysiological mechanisms and clinical manifestations of these three are similar, and the treatment methods are similar. It can be said without a doubt that most of the infections caused by these three viruses are relatively mild, and they will get better after rest and symptomatic treatment and can be cured. Only those who have had serious complications, such as respiratory failure or even multiple organ failure, leading to a critical condition, need ICU admission for rescue treatment.
So why are some viral pneumonias causing such serious consequences? Two key reasons: First, there is no specific medicine; second, the body’s self-defense ability is reduced.
Viruses are different from bacteria. We have medicine for common bacterial infections. But it is too difficult to develop antiviral drugs. The first reason is that viruses are not the same as bacteria. After they enter the human body, they will penetrate into the cells and insert their genetic material into the chromosomes in the cells. Therefore, drugs that can interfere with virus replication will inevitably cause humans. The cell function is abnormal; the second reason is that the virus will multiply rapidly and constantly mutate. You have just developed a drug and the virus has changed. The third reason is that many bacteria have some similarities in structure or metabolism. Antibiotics that act on a certain part or metabolic link of one kind of bacteria can be effective against other bacteria. However, there are too many types of viruses and few in common, and it is difficult to find broad-spectrum antiviral drugs.
This determines that we have no specific medicine for most viral infections. Even if there are drugs with a certain effect, the effect on the virus is only “inhibition”, and the earlier the application, the better the effect, and the later application effect is not ideal. How good are many virus infections? It depends on our body’s self-defense ability.
In response to bacterial pneumonia, the human body naturally has two basic defenses: cough and expectoration; white blood cells, especially neutrophils among them, increase.
Coughing and expectoration are for expelling sputum, necrotic substances, and even pathogenic microorganisms. In the ICU, a key indicator for evaluating the patient’s prognosis is whether the patient’s expectoration is “strong”. Sometimes, expectoration is even more important than antibiotics.
The increase of white blood cells, especially the increase of neutrophils, is also an important defense mechanism of the body during bacterial infection, in order to increase the power of sterilization. However, the main symptoms of patients with new coronavirus pneumonia are fever, fatigue, and dry cough. Laboratory examination: the total number of white blood cells is normal or decreased, and the lymphocyte count is decreased.
Dry cough means that although the human body activates the cough reflex, it wants to excrete viruses or necrotic substances from the body. However, the cunning virus is hidden in the cell. There are few secretions in the airways and less phlegm. Although part of the virus can be excreted with droplets through coughing, this also satisfies the nature of the virus to accelerate its spread in order to reproduce itself, and it cannot effectively remove pathogens. Therefore, the alveolar cells are constantly under attack, but it is difficult for the human body to expel them effectively through expectoration. Can’t cough up, coupled with the reduction of lymphocytes, the forces fighting the virus, these two key defensive capabilities have declined. The virus continuously replicates and invades cells. In severe cases, most of the alveolar cells of the patient are compromised within two or three days. Under X-ray or CT, it appears as “white lung”.
When faced with the threat of virus, as ordinary people, what we can do is to protect our immune system through strengthening self-protection, good sleep and peace of mind. The rest will be handed over to public health managers and doctors. Bar.
