{"id":6922,"date":"2020-12-19T08:51:10","date_gmt":"2020-12-19T08:51:10","guid":{"rendered":"https:\/\/extraslovensko.sk\/spravy\/?p=6922"},"modified":"2020-12-19T08:51:10","modified_gmt":"2020-12-19T08:51:10","slug":"vyskum-the-lancet-respiratory-medicine","status":"publish","type":"post","link":"https:\/\/extraslovensko.sk\/spravy\/vyskum-the-lancet-respiratory-medicine\/","title":{"rendered":"Porovnanie \u00famrtnosti Covid-19 a sez\u00f3nna chr\u00edpka, Koronav\u00edrus, The Lancet Respiratory Medicine"},"content":{"rendered":"

Porovnanie \u00famrtnosti na Covid-19 koronav\u00edrus, sez\u00f3nna chr\u00edpka pod\u013ea webu The Lancet. V tejto celon\u00e1rodnej \u0161t\u00fadii porovn\u00e1vaj\u00facej epid\u00e9miu SARS-CoV-2 so sez\u00f3nnou chr\u00edpkou bolo do nemocnice prijat\u00fdch pre COVID-19 po\u010das 2 mesiacov takmer dvakr\u00e1t to\u013eko pacientov ako v pr\u00edpade sez\u00f3nnej chr\u00edpky za 3 mesiace. Existuje mal\u00e1 mo\u017enos\u0165, \u017ee niektor\u00ed pacienti hospitalizovan\u00ed v roku 2020 boli nespr\u00e1vne klasifikovan\u00ed ako koronav\u00edrus COVID-19, ke\u010f skuto\u010dne mali chr\u00edpku. <\/p>\n

Riziko nespr\u00e1vnej klasifik\u00e1cie je v\u0161ak n\u00edzke, preto\u017ee obdobie sk\u00faman\u00e9 v roku 2020 bolo na konci epid\u00e9mie chr\u00edpky vo Franc\u00fazsku. Okrem toho boli v\u00fdsledky anal\u00fdzy citlivosti, ktor\u00e1 sa obmedzila na \u0161t\u00e1dium 3 epid\u00e9mie, podobn\u00e9 ako v\u00fdsledky hlavnej anal\u00fdzy. Pozorovan\u00fd rozdiel v pr\u00edjmoch bude pravdepodobne podce\u0148ovan\u00edm, ak vezmeme do \u00favahy, \u017ee epid\u00e9mia COVID-19 vyvrcholila prv\u00fd apr\u00edlov\u00fd t\u00fd\u017ede\u0148 2020.<\/strong><\/p>\n

T\u00fdch hlup\u00e1kov na sra\u010dkosere Sputnik hlavn\u00fdch spr\u00e1vach, topkach, neonacistickom kulturblogu, reconquista, debilov LSNS \u010do popieraj\u00fa koronav\u00edrus, treba zavrie\u0165 na psychiatriu na \u010dele s redaktormi, krimin\u00e1lnikom Kotleb\u00e1kom za \u0161\u00edrenie dezinforma\u010dnej kampane. Debil Ro\u0161ta\u0161 ZM chodi ako \u017eobr\u00e1k do Ruska somra\u0165 prachy, pch\u00e1 sa riti No\u010dn\u00fdm vlkom, ale o 1489 ako n\u00e1cek popiera koronavirus a prevenciu proti n\u00e1kaze.<\/p>\n

\u0160ialen\u00fd slovensk\u00fd rusofil m\u00e1 v Rusku koronav\u00edrus, ale na Slovensku ho popiera!<\/p><\/blockquote>\n

Zhruba rok po pand\u00e9mii je zrejm\u00e9, \u017ee nov\u00fd koronav\u00edrus je hor\u0161\u00ed ako sez\u00f3nna chr\u00edpka. \u0160t\u00fadia zverejnen\u00e1 v piatok na\u010drtla, o ko\u013eko hor\u0161ie, a ukazuje takmer trojn\u00e1sobne vy\u0161\u0161iu \u00famrtnos\u0165 u pacientov s COVID-19<\/strong>. V\u00fdskum s vyu\u017eit\u00edm franc\u00fazskych n\u00e1rodn\u00fdch \u00fadajov publikovan\u00fd v \u010dasopise The Lancet Respiratory Medicine zd\u00f4raznil zv\u00fd\u0161en\u00fa z\u00e1va\u017enos\u0165 ochorenia u \u013eud\u00ed s koronav\u00edrusom COVID-19.<\/p>\n

Porovnanie SARS-CoV-2 a sez\u00f3nna chr\u00edpka, pod\u013ea The Lancet Respiratory Medicine<\/h1>\n

Vedci porovnali \u00fadaje o 89 530 pacientoch hospitalizovan\u00fdch s COVID-19 v marci a apr\u00edli tohto roku so 45 819 pacientmi hospitalizovan\u00fdmi so sez\u00f3nnou chr\u00edpkou v obdob\u00ed od decembra 2018 do konca febru\u00e1ra 2019.<\/p><\/blockquote>\n

Zistili sme, \u017ee nemocni\u010dn\u00e1 \u00famrtnos\u0165 pre koronav\u00edrus SARS-CoV-2 bola takmer trikr\u00e1t vy\u0161\u0161ia ako pre sez\u00f3nnu chr\u00edpku, s vekovo \u0161tandardizovan\u00fdm pomerom \u00famrtnosti<\/strong> 2,82. U pacientov s SARS-CoV-2 bola navy\u0161e dvakr\u00e1t vy\u0161\u0161ia pravdepodobnos\u0165 invaz\u00edvnej mechanickej ventil\u00e1cie a pacienti s SARS-CoV-2 hospitalizovan\u00ed na JIS zostali takmer dvakr\u00e1t tak dlho ako pacienti s chr\u00edpkou. <\/p>\n

Autori poznamen\u00e1vaj\u00fa, \u017ee rozdiel v po\u010dte hospitaliz\u00e1ci\u00ed u ktor\u00fdch bolo dvakr\u00e1t viac \u013eud\u00ed prijat\u00fdch na SARS-CoV-2 ako na chr\u00edpku – mo\u017eno \u010diasto\u010dne vysvetli\u0165 existuj\u00facou imunitou proti chr\u00edpke, \u010di u\u017e z d\u00f4vodu predch\u00e1dzaj\u00facej infekcie alebo o\u010dkovania.<\/p><\/blockquote>\n

Vy\u0161\u0161ia miera smrti spojen\u00e1 s COVID-19 u pacientov vo veku 11\u201317 rokov m\u00f4\u017ee nazna\u010dova\u0165, \u017ee je potrebn\u00e9 by\u0165 obzvl\u00e1\u0161\u0165 ostra\u017eit\u00ed u mlad\u00fdch \u013eud\u00ed s nadv\u00e1hou alebo obezitou. Zv\u00fd\u0161enie \u00famrt\u00ed u det\u00ed m\u00f4\u017ee by\u0165 \u010diasto\u010dne spojen\u00e9 s pediatrick\u00fdm z\u00e1palov\u00fdm multisyst\u00e9mov\u00fdm syndr\u00f3mom (tie\u017e zn\u00e1mym ako Kawasakiho syndr\u00f3m). Skuto\u010dne sa pozoroval neo\u010dak\u00e1vane vysok\u00fd v\u00fdskyt tohto syndr\u00f3mu, a to aj u dospievaj\u00facich s COVID-19, ale zost\u00e1va zriedkav\u00fd a pravdepodobne nevysvet\u013euje zv\u00fd\u0161en\u00e9 riziko \u00famrtia. Navy\u0161e, aj ke\u010f tento syndr\u00f3m m\u00f4\u017ee niekedy vies\u0165 k smrti, doposia\u013e nebola hl\u00e1sen\u00e1 \u017eiadna s\u00favislos\u0165 s nadv\u00e1hou.<\/p>\n

COVID-19 a sez\u00f3nna chr\u00edpka<\/h2>\n

Na\u0161e objavy nazna\u010duj\u00fa, \u017ee z\u00e1va\u017enos\u0165 by mohla s\u00favisie\u0165 s komorbiditami spojen\u00fdmi s ka\u017ed\u00fdm v\u00edrusov\u00fdm ochoren\u00edm. Medi\u00e1n veku pacientov hospitalizovan\u00fdch pre COVID-19 vo Franc\u00fazsku bol v rozmedz\u00ed uvedenom v in\u00fdch ve\u013ek\u00fdch medzin\u00e1rodn\u00fdch \u0161t\u00fadi\u00e1ch. Celkov\u00e9 sk\u00f3re komorbidity malo tendenciu by\u0165 ni\u017e\u0161ie u pacientov s COVID-19 ako u pacientov so sez\u00f3nnou chr\u00edpkou a pacienti prijat\u00ed s SARS-CoV-2 boli \u010dastej\u0161ie mu\u017ei s men\u0161\u00edm po\u010dtom komorbid\u00edt, ako bolo predt\u00fdm pozorovan\u00e9<\/p>\n

Ke\u010f\u017ee sa zd\u00e1, \u017ee cukrovka a nadv\u00e1ha s\u00fa osobitn\u00fdmi rizikov\u00fdmi faktormi pre hospitaliz\u00e1ciu<\/strong> v COVID-19, hlavn\u00e9 komorbidity ako srdcov\u00e9 zlyhanie, chronick\u00e9 respira\u010dn\u00e9 ochorenie a cirh\u00f3za, aj ke\u010f \u010dasto spojen\u00e9 s COVID-19, boli \u010dastej\u0161ie pozorovan\u00e9 v skupine so sez\u00f3nnou chr\u00edpkou. Vy\u0161\u0161\u00ed kr\u00e1tkodob\u00fd vplyv t\u00fdchto troch stavov v porovnan\u00ed s cukrovkou a obezitou je \u010fal\u0161\u00edm argumentom v prospech skuto\u010dne zv\u00fd\u0161enej z\u00e1va\u017enosti COVID-19. <\/p>\n

Aj ke\u010f teda rozdiely v komorbidit\u00e1ch m\u00f4\u017eu vysvet\u013eova\u0165 rozdiel v z\u00e1va\u017enosti ochorenia, rozdiel m\u00f4\u017ee by\u0165 sp\u00f4soben\u00fd aj prehnanou imunitnou odpove\u010fou v SARS-CoV-2 alebo exacerb\u00e1ciou komorbid\u00edt pri chr\u00edpkovej infekcii. \u010eal\u0161\u00edm zauj\u00edmav\u00fdm bodom je, \u017ee sa nezdalo, \u017ee by \u013eudia \u017eij\u00faci s HIV v na\u0161ej \u0161t\u00fadii boli viac ovplyvnen\u00ed v\u00edrusom COVID-19 ako sez\u00f3nnou chr\u00edpkou. <\/p>\n

To podporuje hypot\u00e9zu, \u017ee virologicky kontrolovan\u00e9 (tj. Antiretrov\u00edrusovo lie\u010den\u00e9) popul\u00e1cie HIV nemaj\u00fa podstatne vy\u0161\u0161ie riziko vzniku z\u00e1va\u017en\u00e9ho SARS-CoV-2 (ako sa pozorovalo v krajin\u00e1ch s n\u00edzkou mierou antiretrov\u00edrusovej lie\u010dby).25). Za zmienku stoj\u00ed, \u017ee \u013eudia s HIV by tie\u017e nemali by\u0165 pova\u017eovan\u00ed za osoby s ni\u017e\u0161\u00edm rizikom kv\u00f4li mo\u017en\u00e9mu prevent\u00edvnemu \u00fa\u010dinku antiretrov\u00edrusovej lie\u010dby.<\/p>\n

Na rozdiel od koncentr\u00e1ci\u00ed cytok\u00ednov sa u pacientov s SARS-CoV-2 zistilo podobn\u00e9 alebo v\u00e4\u010d\u0161ie zv\u00fd\u0161enie nieko\u013ek\u00fdch reaktantov v ak\u00fatnej f\u00e1ze a in\u00fdch biomarkerov. Koncentr\u00e1cie D-dim\u00e9ru boli 5-kr\u00e1t vy\u0161\u0161ie u pacientov s kritick\u00fdm SARS-CoV-2 ako u pacientov so sepsou, \u010do nazna\u010duje, \u017ee uv\u00e1dzan\u00e9 s\u00favislosti medzi D-dim\u00e9rom a z\u00e1va\u017enos\u0165ou v SARS-CoV-2 s\u00fa konzistentn\u00fdm a rozli\u0161ovac\u00edm sign\u00e1lom. Aj ke\u010f predikcia vyvodenia je mimo r\u00e1mca tejto \u0161t\u00fadie, schopnos\u0165 D-dim\u00e9ru a prokalciton\u00ednu rozli\u0161ova\u0165 SARS-CoV-2 od in\u00fdch infek\u010dn\u00fdch pr\u00ed\u010din d\u00fdchac\u00edch \u0165a\u017ekost\u00ed<\/strong> si m\u00f4\u017ee vy\u017eadova\u0165 \u010fal\u0161ie sk\u00famanie.<\/p>\n

\"s\u00favislosti<\/a>
\nMechanick\u00e9 porovnanie z\u00e1palov\u00fdch procesov u pacientov s koronavirusom SARS-CoV-2 v porovnan\u00ed s ARS, sepsou a CRS indukovanou CAR T bunkami<\/p>\n

Pokia\u013e ide o v\u00fdsledky hospitalizovan\u00fdch pacientov, respira\u010dn\u00e9 komplik\u00e1cie
boli \u010dastej\u0161ie v pr\u00edpadoch koronav\u00edrusu SARS-CoV-2 ako v pr\u00edpade sez\u00f3nnej chr\u00edpky. <\/h2>\n

Podobne ako v in\u00fdch \u0161t\u00fadi\u00e1ch sme zistili, \u017ee p\u013e\u00facne bakteri\u00e1lne koinfekcie boli v SARS-CoV-2 zriedkav\u00e9, na rozdiel od toho, \u010do sa hl\u00e1silo v pr\u00edpade chr\u00edpkov\u00fdch epid\u00e9mi\u00ed. Av\u0161ak v na\u0161ej \u0161t\u00fadii bola frekvencia p\u013e\u00facnych bakteri\u00e1lnych s\u00fabe\u017en\u00fdch infekci\u00ed ve\u013emi podobn\u00e1 pre SARS-CoV-2 a chr\u00edpku. <\/strong><\/p>\n

Preto sa zd\u00e1, \u017ee SARS-CoV-2 m\u00e1 vy\u0161\u0161\u00ed potenci\u00e1l pre respira\u010dn\u00fa patogenitu, pravdepodobne vyvolan\u00edm zv\u00fd\u0161enej regul\u00e1cie mal\u00e9ho po\u010dtu z\u00e1palov\u00fdch medi\u00e1torov (vr\u00e1tane IL-6), a \u017ee respira\u010dn\u00e9 komplik\u00e1cie s\u00fa zodpovedn\u00e9 hlavne za nadmern\u00fa \u00famrtnos\u0165 pozorovan\u00fa u SARS-CoV-2 . Ako u\u017e bolo sk\u00f4r uveden\u00e9, pacienti s SARS-CoV-2 maj\u00fa vy\u0161\u0161ie riziko p\u013e\u00facnej emb\u00f3lie.<\/p>\n

Rozli\u0161enie \u00famrt\u00ed pacientov medzi Covid-19 a sez\u00f3nn\u00fdmi chr\u00edpkami<\/h2>\n

Porovnanie medzi SARS-CoV-2 a sez\u00f3nnou chr\u00edpkou tie\u017e nemus\u00ed by\u0165 priame, preto\u017ee sledovan\u00e9 obdobia s\u00fa od seba vzdialen\u00e9 zhruba 1 rok. Nem\u00f4\u017eeme zisti\u0165, \u010di je sez\u00f3nna chr\u00edpka 2018\u201319 reprezentat\u00edvna pre v\u0161etky sez\u00f3nne chr\u00edpky, hoci vo Franc\u00fazsku i\u0161lo o naj\u0165a\u017e\u0161iu sez\u00f3nu za posledn\u00fdch 5 rokov. Niektor\u00ed pacienti s SARS-CoV-2 mohli tie\u017e ma\u0165 s\u00fa\u010dasne chr\u00edpku, ale tento scen\u00e1r je nepravdepodobn\u00fd, preto\u017ee chr\u00edpkov\u00e9 diagnostick\u00e9 postupy boli pr\u00edstupn\u00e9 po\u010das cel\u00e9ho obdobia \u0161t\u00fadie. <\/p>\n

Nem\u00f4\u017eeme v\u017edy rozli\u0161ova\u0165 medzi ak\u00fatnymi a chronick\u00fdmi stavmi; napr\u00edklad pri srdcovom zlyhan\u00ed sa rovnak\u00fd k\u00f3d pou\u017e\u00edva pre chronick\u00e9 srdcov\u00e9 zlyhanie a pre srdcov\u00fa dekompenz\u00e1ciu. Navy\u0161e, PMSI stacion\u00e1rna datab\u00e1za pre SARS-CoV-2 so zr\u00fdchlen\u00fdm prenosom \u00fadajov o pacientoch s\u00favisiacich s SARS-CoV-2, bol len ned\u00e1vno vyvinut\u00fd na \u017eiados\u0165 vl\u00e1dy (na z\u00e1klade nariadenia z 21. apr\u00edla 2020) a tieto \u00fadaje e\u0161te len \u010dakaj\u00fa na konsolid\u00e1ciu. Je to najm\u00e4 d\u00f4sledok za\u0165a\u017eenia n\u00e1\u0161ho syst\u00e9mu zdravotnej starostlivosti, jeho mobiliz\u00e1cie k starostlivosti o chor\u00fdch jedincov a ochoty r\u00fdchlo kona\u0165. <\/p>\n

Uzn\u00e1vame, \u017ee napriek zhroma\u017e\u010fovaniu celon\u00e1rodn\u00fdch \u00fadajov s\u00fa z\u00e1very o podpore a \u00famrt\u00ed na JIS u det\u00ed zalo\u017een\u00e9 na malom po\u010dte (napr. u det\u00ed mlad\u0161\u00edch ako 5 rokov, tri \u00famrtia boli spojen\u00e9 s COVID-19 a s chr\u00edpkou). V t\u00fdchto pr\u00edpadoch nebolo mo\u017en\u00e9 pos\u00fadi\u0165, \u010di je mo\u017en\u00e9 genetick\u00e9 vlastnosti sp\u00e1ja\u0165 so z\u00e1va\u017enos\u0165ou. Napokon pre niektor\u00e9 premenn\u00e9 nie s\u00fa inform\u00e1cie doplnen\u00e9 do absolut\u00f3ria, ak neexistuje priamy vplyv na starostlivos\u0165 o pacienta po\u010das hospitaliz\u00e1cie (napr. faj\u010denie). Toto je \u010dasto pr\u00edpad hospitaliz\u00e1ci\u00ed dennej starostlivosti, ale neplatilo to pre hospitaliz\u00e1cie uva\u017eovan\u00e9 v tejto \u0161t\u00fadii.<\/p>\n

Anal\u00fdza COVID-19, SARS-CoV-2, sez\u00f3nna chr\u00edpka, HIV vo Franc\u00fazsku<\/h2>\n

Z\u00e1verom mo\u017eno kon\u0161tatova\u0165, \u017ee medzi pacientmi s SARS-CoV-2 a sez\u00f3nnou chr\u00edpkou, ktor\u00e9 si vy\u017eaduj\u00fa hospitaliz\u00e1ciu, existuj\u00fa v\u00fdznamn\u00e9 rozdiely.<\/strong> Zd\u00e1 sa, \u017ee koronav\u00edrus SARS-CoV-2 m\u00e1 vy\u0161\u0161\u00ed potenci\u00e1l respira\u010dnej patogenity, \u010do vedie k v\u00e4\u010d\u0161iemu mno\u017estvu respira\u010dn\u00fdch komplik\u00e1ci\u00ed u pacientov s men\u0161\u00edm po\u010dtom komorbid\u00edt a je spojen\u00e9 s vy\u0161\u0161\u00edm rizikom \u00famrtnosti, najm\u00e4 u dospievaj\u00facich, hoci je potrebn\u00e9 urobi\u0165 ak\u00e9ko\u013evek z\u00e1very pre t\u00fato vekov\u00fa skupinu.
\n\"Porovnanie
\nTieto zistenia sa potvrdili aj po zv\u00e1\u017een\u00ed obmedzen\u00ed spojen\u00fdch s n\u00e1hlym pr\u00edlevom pacientov po\u010das epid\u00e9mie. V bud\u00facnosti ur\u010dite zv\u00fd\u0161i zlo\u017eitos\u0165 riadenia pacientov aj mo\u017enos\u0165 prekr\u00fdvania sa chr\u00edpky a epid\u00e9mi\u00ed SARS-CoV-2.<\/p>\n","protected":false},"excerpt":{"rendered":"

Porovnanie \u00famrtnosti na Covid-19 koronav\u00edrus, sez\u00f3nna chr\u00edpka pod\u013ea webu The Lancet. V tejto celon\u00e1rodnej \u0161t\u00fadii porovn\u00e1vaj\u00facej epid\u00e9miu SARS-CoV-2 so sez\u00f3nnou chr\u00edpkou bolo do nemocnice prijat\u00fdch pre COVID-19 po\u010das 2 mesiacov takmer dvakr\u00e1t to\u013eko pacientov ako v pr\u00edpade sez\u00f3nnej chr\u00edpky za 3 mesiace. Existuje mal\u00e1 mo\u017enos\u0165, \u017ee niektor\u00ed pacienti hospitalizovan\u00ed v roku 2020 boli nespr\u00e1vne klasifikovan\u00ed […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-6922","post","type-post","status-publish","format-standard","hentry","category-biohazard"],"_links":{"self":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/posts\/6922","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/comments?post=6922"}],"version-history":[{"count":0,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/posts\/6922\/revisions"}],"wp:attachment":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/media?parent=6922"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/categories?post=6922"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/tags?post=6922"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}