Ofufuza odziwika akugwira ntchito usana ndi usiku kupereka malangizo amomwe mungadzisamalire bwino ngati mukuganiza kuti mukudwala. COVID-19 coronavirus.
Maphunziro azachipatala pa COVID-19 akutulutsidwa mwachangu, zomwe nthawi zambiri zimabweretsa chisokonezo pazinthu zosavuta monga zomwe zimachepetsa ululu, kapena momwe mungasamalire achibale omwe akudwala kunyumba.
Pofuna chitsogozo, National Geographic idatembenukira kwa asing'anga otsogola ndi ofufuza ku US ndi Canada kuti apereke malingaliro awo okhudzana ndi chisamaliro chapakhomo, komanso nthawi yoti akalandire chithandizo chamankhwala.
Madokotala otsogola asanu ndi limodzi amafotokoza zomwe tikudziwa mpaka pano kuchiza COVID-19 m'chipinda chodzidzimutsa komanso kunyumba.
MMENE MUNGAMANE NDI CHIWIRI
Nkhani yabwino ndiyakuti pafupifupi 80 peresenti ya milandu yonse ya COVID-19 imangowonetsa zofatsa mpaka zolimbitsa thupi zomwe sizifunikira kugonekedwa kuchipatala. Madokotala amalimbikitsa kuti odwalawa adzipatule, azikhala opanda madzi, azidya bwino, komanso azisamalira bwino zomwe angathe.
Posamalira kutentha thupi komwe kumakhudzana ndi matenda ambiri, kuphatikiza COVID-19, madotolo amati amwe acetaminophen - omwe amadziwika padziko lonse lapansi kuti paracetamol - pamaso pa ibuprofen. Matendawa akapitilira, odwala ayenera kuganizira zosinthira ku ibuprofen, akutero Julie Autmizguine, katswiri wa matenda opatsirana a ana ku CHU Sainte-Justine ku Montreal, Canada.
Iye ndi madotolo ena amafotokoza zomwe amakonda chifukwa ibuprofen ndi mankhwala okhudzana nawo - otchedwa NSAID mwachidule - amatha kukhala ndi zotsatira zoyipa kwa odwala omwe ali ndi COVID-19 coronavirus, kuphatikiza kuvulala kwa impso, zilonda zam'mimba, komanso kutuluka magazi m'mimba.
Komabe, chenjezoli silikutanthauza kuti ibuprofen ndi NSAIDs zikuwonjezera zotsatirapo za coronavirus, monga nkhani za ma virus zidanenedwera sabata yatha Unduna wa Zaumoyo ku France unanena kuti mankhwalawa amayenera kupewedwa panthawi ya chithandizo cha COVID-19.
"Sindikudziwa kuti ma NSAID awonetsedwa kuti ndi vuto lalikulu la matendawa kapena coronavirus," akutero katswiri wa coronavirus Stanley Perlman, dokotala wa ana komanso woteteza chitetezo ku University of Iowa's Carver College of Medicine.
Acetaminophen imabweranso ndi zoopsa, ndipo anthu ayenera kuitenga pokhapokha ngati alibe matupi awo kapena alibe kuwonongeka kwa chiwindi. Mankhwalawa ndi otetezeka pa mlingo wa tsiku ndi tsiku wosakwana 3,000 milligrams, koma kupitirira izi tsiku ndi tsiku kungayambitse kuvulala kwa chiwindi kapena kuipiraipira.
“Kuchuluka kwa acetaminophen ndiko kumayambitsa chiŵindi chofala kwambiri ku United States,” akutero José Manautou, katswiri wodziŵa za poizoni wa pa yunivesite ya Connecticut School of Pharmacy.
Anthu akuyenera kuwonetsetsa kuti akuwerengera mankhwala onse omwe akumwa, chifukwa mankhwala osagulitsika omwe amayang'ana zizindikiro za chimfine ndi zina zothandizira kugona nthawi zambiri amakhala ndi acetaminophen. Anthu ayeneranso kupewa kumwa mowa akamamwa acetaminophen. Chiwindi chimadalira chinthu chomwecho-glutathione-kuchepetsa mphamvu yapoizoni ya mowa ndi acetaminophen. Mukadya kwambiri zonse ziwiri, zimatha kuyambitsa poizoni m'thupi. (Thupi lanu likatenga kachilombo, izi ndi zomwe coronavirus imachita.)
KODI CHLOROQUINE NDI AZITHROMYCIN?
Magulu azachipatala akugwira ntchito mosalekeza kuti aphunzire momwe angachitire bwino COVID-19, ndipo sabata yatha, Purezidenti wa US a Donald Trump adalowa nawo mkanganowu pofotokoza kuti amathandizira mankhwala awiri omwe akhalapo kwazaka zambiri - maantibayotiki azithromycin, ndi mtundu wa mankhwala oletsa malungo chloroquine.
Zowonadi, US Food and Drug Administration sinavomereze hydroxychloroquine - yomwe nthawi zambiri imagwiritsidwa ntchito pochiza nyamakazi ya nyamakazi ndi lupus - kuti igwiritsidwe ntchito ndi COVID-19, ngakhale idavomereza mayeso ophatikizana ndi azithromycin omwe tsopano akukonzekera ku New York. Pakadali pano, akuluakulu azaumoyo padziko lonse lapansi, kuphatikiza a Anthony Fauci, wamkulu wa US National Institute of Allergy and Infectious Diseases, alimbikitsa kusamala za mankhwalawa.
"Zinthu zambiri zomwe mumamva kumeneko ndi zomwe ndidatcha malipoti osasinthika," adatero Fauci m'mawu atolankhani Loweruka kwa gulu lankhondo la White House. "Ntchito yanga ndikutsimikizira mosakayikira kuti mankhwala si otetezeka okha, komanso kuti amagwira ntchito."
Nkhani ya chloroquine idayamba ndi maphunziro ang'onoang'ono angapo ochokera ku China ndi France - onse ali ndi zofooka ndipo amapereka maphunziro ochepa kwa odwala ambiri. Zotsatira zaku France zimatengera anthu 36 okha ndipo amayang'ana kwambiri kuchuluka kwa ma virus a odwala, kapena kuchuluka kwa kachilomboka mthupi. Zowonadi, odwala okhawo omwe adamwalira kapena kutumizidwa ku chisamaliro chambiri mu kafukufuku waku France adatenga hydroxychloroquine.
"Tilibe chidziwitso chochokera ku mayesero osasinthika, olamulidwa omwe amatiuza momwe chloroquine imagwirira ntchito mwa anthu enieni," akutero Annie Luetkemeyer, katswiri wa HIV ndi matenda opatsirana ku yunivesite ya California, San Francisco, Dipatimenti ya Zamankhwala.
Kudzichiritsa nokha ndi hydroxychloroquine ndi azithromycin kwa odwala omwe ali ndi COVID-19 coronavirus kumatha kubweranso ndi zoopsa, chifukwa mankhwalawa amatha kupsinjika mtima ndikuwonjezera chiwopsezo cha arrhythmia. Lolemba, Purezidenti adalumbira kuti atumiza milingo masauzande ambiri a combo ku New York kuti akayezedwe ndi FDA, patangopita nthawi yayitali chipatala cha Arizona chinanena kuti m'modzi mwa odwala ake adamwalira atadzichiritsa yekha pa chloroquine phosphate, mtundu wa mankhwala omwe amagwiritsidwa ntchito kuyeretsa aquarium. akasinja. Akuluakulu azaumoyo ku Nigeria adanenanso za milandu iwiri ya chloroquine overdose kumapeto kwa sabata.
"Chomaliza chomwe tikufuna pakali pano ndikudzaza madipatimenti athu azadzidzidzi ndi odwala omwe amakhulupirira kuti adapeza yankho losavuta komanso lowopsa lomwe lingawononge thanzi lawo," a Daniel Brooks, mkulu wa zachipatala ku Banner Poison and Drug Information Center ku Phoenix. , akutero m’mawu ake.
KODI MANKHWALA A KUTSWA KWA MAGAZI NDI Otetezeka?
ACE inhibitors, mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza matenda a kuthamanga kwa magazi, nawonso adayaka moto panthawi yamavuto a COVID-19, pomwe malipoti ena akuwonetsa kuti odwala ayenera kusiya kumwa mankhwalawa ngati awonetsa zizindikiro.
M'makalata angapo mu British Medical Journal, Nature Reviews Cardiology, ndi The Lancet Respiratory Medicine, ofufuza adafunsa ngati ACE inhibitors angathandize kukhazikitsa matenda a coronavirus m'mapapo a anthu. Chodetsa nkhawa chimachokera ku mfundo yoti SARS ndi coronavirus yatsopanoyo imalowa m'maselo ndikulumikizana ndi puloteni yotchedwa angiotensin-converting enzyme 2, kapena ACE2 mwachidule. Puloteniyi imakhala yochuluka pamwamba pa maselo a mu mtima ndi m'mapapo, kumene imathandizira kulamulira timadzi timene timakhudza kuthamanga kwa magazi.
Chimodzi mwazotsatira za ACE inhibitors ndikuti amatha kulimbikitsa ma cell kupanga ACE2 yochulukirapo. Kafukufuku wa 2005 adapeza umboni wakuwonjezeka kwa mbewa, ndipo kafukufuku wa 2015 mwa anthu adapeza kuchuluka kwa ACE2 mumkodzo wa odwala omwe amamwa mankhwala okhudzana ndi ACE inhibitors.
Koma palibe umboni waposachedwa woti ACE inhibitors imakulitsa zotsatira za COVID-19 mwa anthu, malinga ndi American Heart Association, European Society of Cardiology's Council on Hypertension, komanso kuwunika kwa Marichi 20 komwe kudasindikizidwa mu European Heart Journal. Upangiri waukulu wa madokotala ndi wakuti ngati mwakupatsani mankhwala, pitirizani kumwa mpaka atauzidwa zina ndi dokotala wanu.
"Sitiyenera kuyamba kapena kuyimitsa mankhwalawa mpaka titadziwa zambiri," akutero Luetkemeyer.
Anthu omwe ali ndi vuto la kuthamanga kwa magazi komanso matenda amtima amawoneka kuti ali pachiwopsezo chachikulu cha COVID-19, koma izi mwina zikugwirizana kwambiri ndi matendawo. Kuphatikiza apo, ma ACE inhibitors amatha kukhala ndi anti-yotupa, zomwe zingathandize mapapu a odwala a COVID-19 kuthana ndi matendawa. (Dziwani momwe mikhalidwe iyi ikupangitsira coronavirus kukhala yovuta kwambiri.)
"Limenelo lingakhale phunziro lofunika kwambiri, kuyerekezera anthu omwe ali ndi vuto la kuthamanga kwa magazi kuphatikiza kapena kuchotsa mankhwalawa, kuti awone ngati pali kusiyana kulikonse," Perlman akutero. "Koma zingakhale zovuta kwambiri kuchita, ndipo mwina zovuta kwambiri kulungamitsa."
NTHAWI YOFUNIKA KUCHITIKA KWA MEDICAL
"Mwanjira zonse, ngati muli ndi vuto la kupuma mwadzidzidzi kapena vuto linalake, tikufuna kuti mupeze chithandizo chadzidzidzi," atero a Purvi Parikh, katswiri wa matenda opatsirana komanso matenda opatsirana ku NYU Langone ku New York City. Ngati mwasankha kupempha thandizo kuchipatala chapafupi, nachi chitsanzo chimodzi cha zomwe mungayembekezere.
Pachipatala chodziwika bwino cha Inova Health System ku Fairfax, Virginia, ogwira ntchito akhazikitsa tenti yakunja kuti alekanitse anthu omwe amafotokoza matenda a kupuma ndi omwe akudwala matenda ena. Magulu awiriwa amakonzedwa m'malo osiyanasiyana a chipinda chodikirira, olekanitsidwa ndi malo osachepera asanu ndi limodzi.
Chifukwa chakuchepa kwa mayeso ku US, madotolo ku Inova ndi zipatala zina akuti anthu akafika ndi zizindikiro zochepa, odwalawa amauzidwa kuti ali ndi COVID-19 ndipo akulimbikitsidwa kudzipatula kuti aletse kudzaza dzikolo pafupifupi 920,000. mabedi okhala anthu ogwira ntchito.
Kwa iwo omwe akudwala ndi COVID-19 coronavirus ndipo akufika ndi zizindikiro zazikulu monga kupuma movutikira, ogwira ntchito yazaumoyo amayamba kuyang'ana kwambiri momwe wodwalayo alili, kuthamanga kwa magazi, komanso kuchuluka kwamadzi m'mapapo awo - zonsezi ndicholinga choti sungani mkhalidwe wawo kukhala wokhazikika. Amayesanso kuthana ndi kutentha thupi, komwe kungayambitse kusapeza bwino komanso kuwononga ma cell.
Milandu yowopsa kwambiri ya COVID-19 imafunikira kuyika wodwala pa makina olowera mpweya - chipangizo chomwe chimazungulira mpweya ndikutuluka m'mapapu a munthu - kwa nthawi yopitilira sabata imodzi. Ichi ndichifukwa chake akuluakulu azaumoyo ali ndi nkhawa kwambiri ndi kuchepa kwa makina olowera mpweya. Society of Critical Care Medicine ikuti mpaka 200,000 ma ventilators amapezeka m'zipatala zaku US, koma ena ndi achikulire ndipo sangachize bwino COVID-19. Pakadali pano, kuyerekeza kumodzi kovutirapo kukusonyeza kuti anthu aku America opitilira 900,000 atha kupeza COVID-19 ndipo amafunikira mpweya wolowera.
Milandu yoyipa kwambiri ya COVID-19 imatha kuyambitsa zomwe zimatchedwa acute kupuma kwapang'onopang'ono (ARDS), kuvulala koopsa m'mapapo komwe kumatha kuyambitsidwa ndi mitundu yambiri ya matenda oopsa. Zipatala zili ndi njira zodziwika bwino zogwirira ntchito ndi ARDS. Odwala ayenera kuikidwa m'mimba mwawo kuti mapapu azitha kupuma bwino, komanso kuti asapatsidwe madzi ambiri. Kuphatikiza apo, ma ventilators a odwala ARDS amayenera kukhazikitsidwa kuti azizungulira mpweya wocheperako, kuti achepetse kupsinjika kwa alveoli, timagulu tating'ono ta mapapu.
M'zipinda zachipatala, ogwira ntchito akusamala kuchepetsa kugwiritsa ntchito zida zomwe zimatha kutulutsa madontho opumira, monga zida zothandizira mpweya zomwe zimakankhira mpweya m'mapapo. Zipatala zina zikugwiritsa ntchito kusamala kwambiri ndi zida zotchedwa nebulizers, zomwe zimasintha mankhwala amadzimadzi kukhala mphutsi zopumira, chifukwa mphutsi zimatha kukweza SARS-CoV-2 m'mwamba. (Ichi ndichifukwa chake sopo ndi wabwino kuyeretsa polimbana ndi coronavirus.)
MANKHWALA AMALONJEZERA KWAMBIRI?
Ofufuza ndi madotolo padziko lonse lapansi tsopano akuthamanga kuti ayesere ngati mankhwala osiyanasiyana omwe analipo kale atha kuphatikizidwa polimbana ndi COVID-19. Madokotala omwe anafunsidwa ndi National Geographic adawonetsa chiyembekezo chachikulu pa remdesivir, mankhwala oletsa ma virus omwe amapangidwa ndi Gileadi Sciences.
"Chokhacho chomwe ndimapachika chipewa changa ndi remdesivir," Perlman akutero.
Remdesivir imagwira ntchito motsanzira chomangira cha ma virus a RNA, ndikulepheretsa kuti kachilomboka kachuluke. Kafukufuku wina wodziwika bwino waku China, wofalitsidwa pa February 4 mu Cell Research, adati remdesivir idasokoneza kubwereza kwa SARS-CoV-2 mu labu. Koma mankhwalawa akadali oyesera ndipo adakumana ndi zolepheretsa m'mbuyomu. Remdesivir poyambilira adapangidwa kuti amenyane ndi Ebola, koma mayeso ake azachipatala mwa anthu adalephera.
Mosasamala kanthu, kupeza chithandizo chotheka kumafuna kuyesedwa kolimba kwa anthu, komwe kudzatenga nthawi kuti achite. "Poyang'ana m'mbuyo, zikadakhala zabwino tikadachita khama kwambiri pamankhwala othana ndi coronavirus," Perlman akuwonjezera. "Zosavuta kunena tsopano, [koma] miyezi isanu yapitayo, sizinali zophweka."
