Having been coughing and worried about "white lung", do I need to go to the hospital and get a lung scan? Is there a shortage of medical workers in the hospital now? Will the infection of COVID-19 cause myocarditis? Guangzhou's experts shared their answers at a recent press briefing on COVID-19 prevention and control.
Q: What is "white lung"? What will cause "white lung"?
A: The "white lung" is a colloquial expression in imaging, said Peng Jie, deputy director of the Department of Infectious Diseases and Liver Diseases Center, Nanfang Hospital, Southern Medical University.
According to Peng, there is a lot of air in normal people's pulmonary alveoli, which should be black under X-ray scanning. If there is inflammation and fluid exudation, it will appear white. If the inflammation covers 70%-80% of the lung, it will be almost covered with white. The symptom of "white lung" is severe acute respiratory distress syndrome (ARDS).
"White lung" is related to the infection of COVID-19, but it is not only caused by COVID-19. There are many kinds of lung infections that can lead to "white lung", including influenza virus, adenovirus, and syncytial virus. It is often older people with underlying medical conditions and other infections that are more likely to get "white lung".
Q: Always coughing and worried about "white lung", do we need to go to the hospital to get scans?
A: Peng Jie stressed that "white lung" is severe ARDS. There will be a very serious breathing disorder, such as incomplete speech, in which case there will be the possibility of having "white lung". Attention should be paid to elderly people with underlying medical conditions. However, common people do not have to worry too much, and when they feel uncomfortable, there is no need to blindly think that they have "white lung".
Q: Which high-risk groups are prone to progression to severe diseases?
A: According to Si Xiang, associate professor of the Department of Critical Care Medicine, the First Affiliated Hospital, Sun Yat-sen University, the risk population includes:
people over 70 years old, especially the elderly people over 80 years old,
having not received vaccines,
with chronic underlying diseases, such as chronic hypertension, diabetes, and liver and kidney problems,
as well as people with lower immunity, such as patients with blood diseases, patients after organs transplant, and patients taking hormones for a long time and with the affected immune system.
These people should get enough nutrition. We have seen, clinically that some of these patients are hospitalized due to malnutrition, dehydration, low potassium, low sodium and other problems.
Q: As the number of infected people increases, is there a shortage of medical workers? Has increased infections affected the hospital?
A: Peng Jie said that according to the situation in Nanfang Hospital and its Baiyun Hospital, Southern Medical University, there is some influence on the hospital, but it is still under control. First of all, doctors and nurses are almost at work now, so the hospital has enough personnel. Second, the hospital has prepared medicine in advance, and the patients are called upon not to store too much medicine, with 3-5 days' dosage prescribed.
Finally, according to the number of patients, the peak of fever patient visits has now passed. At the peak, more than 1,300 people come to see the doctor one day, and now the number is over 600. The number of people consulting online decreases at the same time. The next peak may be related to elderly people with underlying medical conditions, who need to be hospitalized after infection. Now there isn't an obvious peak, so the medical capacity can cope with it.
Q: Will there be a second infection after the first infection? Do antibodies produced after infection work against only one single strain?
A: Si Xiang said that the prevailing strains in China are BA5.2 and BF.7, which are both Omicron subvariants. Against the same strain or similar strains, the antibodies produced after infection have a protective effect. It is generally considered safe for 3-6 months after infection. However, for the variant with stronger immune escape, such as BQ.1.1 and XBB, the cross-protection ability of antibodies is relatively weak, and there may be a risk of repeated infections.
Q: Will the infection of COVID-19 cause myocarditis?
A: Not only the novel coronavirus, but other virus infections including a bad cold can also cause myocarditis, according to Xue Yumei, chief physician and deputy director of the Department of Cardiology, Guangdong Provincial People's Hospital.
There are also some ways in which virus infection can cause myocarditis. First, the virus can directly invade cardiac muscle. Second, immune damage affects cardiac muscle. Third, cytokine storms in inflammatory cells cause damage to various organs, including cardiac muscle. If patients don't get enough rest, there will be a possibility of myocarditis.
When there are a lot of people getting infected, everyone may have patients with myocarditis around them. However, don't worry too much. Some studies show that about 2 to 3 persons among every 1,000 people may have myocarditis. Most people won't get myocarditis after infection.
Q: What are the symptoms of myocarditis? Under what circumstances should patients go to the hospital?
A: Xue Yumei said that the symptoms of myocarditis can be severe or slight. One kind of symptom is irregular heartbeat, too fast or too slow, and even ventricular fibrillation and sudden death in severe cases. The other kind is heart failure such as chest tightness, shortness of breath, edema, nausea, and vomiting. In severe cases, patients may have cardiogenic shock and sudden death.
In conclusion, the symptoms of myocarditis can be discomfort or even sudden death. It is hard for the patients to decide by themselves. As for COVID-19 infection, usually, symptoms will be relieved in 7 days. If the symptoms are not eased in 7 days, patients should pay more attention to it and go to the hospital if necessary.
Author | Hannah, He Yang (intern)
Editor | Wing, Olivia, Abby, Jerry