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Covid-19 will, of course, be the main topic when Austrian lung specialists and thoracic surgeons have their annual virtual congress this week (October 14-16). ÖGP President Ernst Eber (Graz University Children’s Hospital) has already stated in advance: “Only about eight percent of all confirmed infected people in Austria belonged to the age group 0-14. Only 1.5 percent They were under the age of five. Of 4,000 children and adolescents only had to be treated as inpatients so far. ” Only a small minority of them entered the intensive care unit.
Fewer receivers
According to the expert, the reasons for this could be that children and adolescents have fewer ACE2 receptors in their tissues. SARS-CoV-2 uses these receptors on the cell surface for docking. A second possible factor according to the pulmonologist: a trained immune system. “Children suffer a relatively high number of viral infections. As a result, it may be the case that their immune systems are specially trained. Children also receive many vaccines.” They would be infected with SARS-CoV-2 less often, and then especially in the family by adults, with SARS-CoV-2, on the other hand, any disease would be milder.
Premature closure
The great excitement that infections often cause in kindergartens and schools, including the rapid closure of facilities, is apparently quite premature. Eber: “Basically the transmission from children to others is very, very low. The infection rate in schools is 0.5 percent, in kindergartens 1 percent. It is important that it arrives quickly. It is important let it do so. Contacts were quickly identified. And rapid tests to avoid complete closure of schools. ” The data on the low transmission rate of SARS-CoV-2 in schools and kindergartens comes mainly from studies in Australia.
In any case, society will have to deal with SARS-CoV-2 and Covid-19 for a long time. Tobias Welte (Hannover School of Medicine): “Expectations regarding vaccine development were clearly too optimistic.” In order to make final statements about efficacy and tolerability, hundreds of thousands of test subjects must be included in clinical studies. “We will have the first results at the end of this year and the beginning of next.” However, a widely applicable vaccine will only be available much later.
Forecast: For winter 2020/21
Welte: “We will have to live with this new virus and with the pandemic this fall, winter 2020/2021 and in the year 2021. There is nothing left but ‘driving in sight’. The population must understand that the Small restrictions, how to maintain distance, protection for the mouth and nose, etc. and disinfection are less of a problem compared to a confinement “. A possible post-Covid-19 period will probably only be able to speak of the summer of 2021 at the earliest or even 2022.
The Secretary General of the ÖGP, Bernd Lamprecht (Kepler University of Linz), emphasized the progress in medical knowledge about SARS-CoV-2 and Covid-19. Remdesivir and dexamethasone already have effective drugs in certain stages of the disease. Mortality among seriously ill Covid 19 patients has been reduced by 10 to 15 percent. We also learned something new about artificial respiration for patients. Questions about a post-Covid syndrome with potentially permanent damage are still unanswered.
“No permanent damage”
A positive observation, as the expert explained: “Fortunately, we have seen an almost complete recovery of lung function in the follow-up of the patients at three and six months.” There is no reason to associate Covid-19 with chronic and permanent damage as a rule. However, in individual cases, as well as after severe pneumonia from another cause, persistent fibrotic changes in lung tissue may occur (“scarring”; note).
