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The study was conducted on 301 patients the Sant’Orsola Polyclinic in Bologna, the Modena Polyclinic, the Ospedale Maggiore, the Niguarda and Humanitas Clinical Institute in Milan, the San Gerardo Hospital in Monza and the Gemelli Polyclinic in Rome. It was coordinated by Professor Marco Ranieri, Director of Anesthesia and Polyvalent Intensive Care of the S. Orsola Polyclinic, with the participation of Professor Franco Locatelli of the Bambino Gesù Hospital, president of the Higher Health Council and member of the Cts.
Covid-19, it is explained, can damage both components of the lung: the alveoli, that is, the units of the lung that absorb oxygen and release carbon dioxide, and capillaries, the blood vessels where the exchange between carbon dioxide and oxygen takes place. When the virus damages both the alveoli and the pulmonary capillaries, it almost dies. 60% of patients. When it damages a single component, it dies just over 20%.
The phenotype, which is the way in which the conditions manifest, of patients with double damage is easily identifiable through the measurement of a lung function parameter (the lung compliance less than 40, compared to a normal value of 100) and a hematochemical parameter (D-dimer greater than 1,800 with a normal value of 10).
These findings have important implications for both currently available treatments and future studies of new therapeutic interventions. Rapid recognition of the double damage phenotype will allow much higher diagnostic accuracy and a more effective use of therapies, reserving the most aggressive measures for these patients, such as Mechanic ventilationtreatment of patients with a single lesion with non-invasive helmet ventilation and admission to sub-intensive care.
In the future, these results will allow rapid identification of patients for testing in experimental anticoagulant treatments to prevent damage to the pulmonary capillaries.
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