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The Sars Cov 2 does not choose the guest based on age. And even if the proportion of asymptomatic patients remains prevalent, both the young and the old end up in intensive care. It is still too early to understand whether new patients have great differences with those who have managed to heal, but for rescuers the age of the most serious has certainly dropped today.
“Those who come to us – explains Massimo Antonelli, director of the department of Anesthesia and resuscitation of the Gemelli Polyclinic in Rome and a member of the CTS – are all patients whose severity is substantially identical to what we saw in the months of March and April. The virus is the same and the way it affects you is the same. Perhaps there is a difference in the fact that the average age is slightly lower. Previously, we mainly saw older patients, those that we define as more fragile, that is, between 65 and 85 years. The average age was then 62 years. Now we meet in addition to elderly patients, also a large group of young people, between 40 and 70 years old.
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If it is true that previous pathologies affect the aggravation of symptoms as before, but sometimes it can happen that even those who have a state of health without particular criticalities end up intubated. “In some cases there are no previous pathologies to determine the aggravation – Antonelli specifies – they are people who apparently are well, in other cases there are those concomitances that we have also observed in the past, for example hypertensive patients, or often diabetic”.
Early care can make a difference. “In the most severe cases we have noticed that, starting with the therapy promptly, we have a response that allows us to have a slightly shorter duration of the course, that is, patients are able to resolve the clinical picture first. However, in many other cases, improvement occurs after a fairly long period of time, sometimes 20 days.
HEAVY SITUATION
The situation in intensive care begins to get complicated everywhere. In Lombardy, from February 20 to the end of June, 4,600 patients undergoing COVID resuscitation were hospitalized. Giacomo Grasselli, head of adult intensive care at the Milan Polyclinic and a member of the intensive care coordination in Lombardy, sees several new cases arriving. And now he fears that the situation will become really unbearable. “Sick youth have been with us even before. We also had thirty. Now surely there are some more young people, many between 40 and 50 years old, but also 60 and 70 ”.
The characteristics of those who end up in intensive care Grasselli had already observed and classified them in some studies published in the Jama and Lancet journals. “Seventy percent of the patients – he explains – had at least one comorbidity, the majority were hypertensive or had concomitant chronic diseases that certainly increase the risk of serious forms of the disease, as in all pathologies. In young people, however, what is also observed with severe cases of influenza and Covid is that many are overweight. And precisely because of this, they often acquire a severe form of the infection.
Alessandro Vergallo, president of Aaroi-Emac, the Association of Anesthetists and Resuscitators of the Italian Emergency Hospital of the Critical Area (Aaroi-Emac) confirms that the age of intensive care patients has dropped. “We have witnessed a decrease of just under 10 years,” he emphasized, “but the data are not very significant in terms of the trend of infection, because the age gap is extremely wide, ranging from 30 to 90 years” .
DECISIVE DAYS
However, now the whole game is based on the system’s ability to care for patients. “At first, in the northern regions, the sick came to the emergency room in desperate conditions and were urgently intubated. Today, early diagnosis allows at least to treat cases in a more timely manner. But to continue doing it, new beds are needed immediately, but especially specialist doctors ”.
Last updated: 06:42
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