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L ‘infection caused by SARS-CoV-2 coronavirus, call COVID-19, can manifest itself in various forms, ranging from the absolute absence of symptoms in the appearance of complications severe enough to require hospitalization andintubation. In fact, the virus can trigger a bilateral interstitial pneumonia capable of evolving towards the dangerous Acute respiratory distress syndrome (ARDS), a consequence of the “cytokine storm”, a disproportionate reaction of immune system to viral invasion. This evolution of the disease, as shown by numerous investigations, is life threatening, especially in elderly male patients, with comorbilità (more diseases) and in the presence of other risk factors, such as obesity. According to rumors, Silvio Berlusconi He would have been hospitalized in San Raffaele in Milan for bilateral coronavirus pneumonia at an early stage, it is not yet known if with involvement of the interstitium.
What is bilateral interstitial pneumonia?
Pneumonia, as specified by the Humanitas institute, is an acute inflammation of the light, generally linked to infectious causes. The pathogens responsible for pneumonia are usually battery, like the municipality pneumococcus, but can also be caused by mushrooms me virus, like the SARS-CoV-2 coronavirus. Bilateral pneumonia is an infection that affects both lungs, and this is the condition that occurs most often in COVID-19 patients if it develops, as opposed to common pneumonia. Other common features of bilateral COVID-19 pneumonia include frosted glass opacity highlighted by TAC and abnormalities in some laboratory results, related for example to liver function, as highlighted in the study “Comparative study on the clinical characteristics of coronavirus pneumonia 2019 (COVID-19) with other pneumonias”. Finally, the term “interstitial” refers to the interest ofinterstizio, or the “thick and thin network of connective tissue that supports the bronchi, vessels and pulmonary alveoli”, as explained by Professor Gianfranco Schiraldi of the Italian Auxiliary Institute.
How the coronavirus affects the lungs
To better understand the impact of COVID-19 on this delicate anatomical part, we can refer to the elegant explanation of the Bambino Gesù Hospital, which starts from the functioning of breathing. When we breathe, thearia penetrates into bronchi and from there, passing through increasingly thin branches (the bronchioles), one reaches pulmonary alveoli, which are like “microscopic balloons with a very thin wall, which allows oxygen to pass from the air to the blood and carbon dioxide to pass from the blood to the air.” The alveoli swell when air enters the lungs and deflate when we exhale CO2. The interstitium is basically the scaffolding that separates the alveoli and allows them to easily exchange oxygen and carbon dioxide, putting them in contact with the blood vessels. The SARS-CoV-2 coronavirus is capable of hitting the interstitium, into which cells due to the inflammatory process infiltrate. “The scaffold therefore thickens, becomes bulky and prevents the alveoli from fully expanding during inspiration. He starts to lack oxygen and it is difficult for him to breathe ”, explains the Hospital Bambino Gesù.
What is ARDS?
A mild form of pneumonia can also occur in patients with very mild symptoms. respiratory symptoms, but in some cases the condition can worsen to the point of death of the patient. “If the inflammation persists – explains the Roman hospital – scar tissue (fibrosis) can form that replaces the alveoli. There is a true severe interstitial pneumonia. As this process progresses, breathing becomes increasingly difficult. ” The above can complicate the picture cytokine storm, which involves the payment of inflammatory fluids in lung tissue and a possible acute respiratory distress syndrome or ARDS (acute respiratory distress syndrome), a condition that affects the functioning of the lungs due to severe tissue injury and fluid accumulation. The oxygen concentration in the blood collapses and the most serious patients should be assisted with mechanical pulmonary ventilation (intubation). In cases where pneumonia is mild and saturation does not reach dramatic levels, patients can be treated in subintensive therapy with a CPAP helmet.
As specified, fortunately only a small percentage of patients infected with the SARS-CoV-2 coronavirus arrive in critical condition, while for many others the prognosis is certainly much more favorable. But precisely because these and other complications, such as fulminant myocarditis who killed a teacher in El Napolitano in perfect health, COVID-19 should not be underestimated, and it is necessary to follow all the measures provided by the health authorities: social distancing at least one meter; use of mask where necessary and constant hand hygiene with soap and water or a hydroalcoholic gel. To date, according to the interactive map developed by scientists at Johns Hopkins University, there are 26.3 million infected and around 870 thousand deaths from the SARS-CoV-2 coronavirus in the world. There is still no cure or a vaccine, although the investigation is making concrete progress.
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