新型冠狀病毒是如何致死的

新型冠狀病毒是如何致死的

More than 1.300 people, almost all in China, have now died from COVID-19 — the newly minted name for the coronavirus disease first identified in Wuhan, China, that has infected more than 55.000 people.

目前已有1300多人死于COVID-19.幾乎所有人都在中國。COVID-19是在中國武漢首次發(fā)現(xiàn)的冠狀病毒病的新名稱，已感染超過5.5萬人。

Yet according to the World Health Organization, the disease is relatively mild in about 80% of cases, based on preliminary data from China.

然而，根據(jù)世界衛(wèi)生組織的數(shù)據(jù)，根據(jù)中國的初步數(shù)據(jù)，大約80%的病例病情相對較輕。

What does mild mean?

(病情)較輕是什么意思?

And how does this disease turn fatal?

這種疾病是如何致命的?

The first symptoms of COVID-19 are pretty common with respiratory illnesses — fever, a dry cough and shortness of breath, says Dr. Carlos del Rio, a professor of medicine and global health at Emory University who has consulted with colleagues treating coronavirus patients in China and Germany.

埃默里大學(xué)醫(yī)學(xué)和全球衛(wèi)生教授卡洛斯·德爾里奧博士表示，COVID-19的首批癥狀在呼吸道疾病中相當(dāng)常見-發(fā)燒、干咳和呼吸急促。他曾與中國和德國治療冠狀病毒患者的同事進(jìn)行過咨詢。

"Some people also get a headache, sore throat," he says. Fatigue has also been reported — and less commonly, diarrhea. It may feel as if you have a cold.

“有些人還會頭疼，喉嚨痛，”他說。疲勞也有報道-但不太常見的是腹瀉。可能會覺得你好像感冒了。

Doctors say these patients with milder symptoms should check in with their physician to make sure their symptoms don't progress to something more serious, but they don't require major medical intervention.

醫(yī)生說，這些癥狀較輕的患者應(yīng)該咨詢他們的醫(yī)生，以確保他們的癥狀不會發(fā)展到更嚴(yán)重的程度，但他們不需要重大的醫(yī)療干預(yù)。

But the new coronavirus attacks the lungs, and in about 20% of patients, infections can get more serious. As the virus enters lung cells, it starts to replicate, destroying the cells, explains Dr. Yoko Furuya, an infectious disease specialist at Columbia University Irving Medical Center.

但這種新的冠狀病毒會攻擊肺部，在大約20%的患者中，感染可能會變得更嚴(yán)重。哥倫比亞大學(xué)歐文醫(yī)學(xué)中心的傳染病專家古屋洋子博士解釋說，當(dāng)病毒進(jìn)入肺細(xì)胞時，它開始復(fù)制，破壞細(xì)胞。

"Because our body senses all of those viruses as basically foreign invaders, that triggers our immune system to sweep in and try to contain and control the virus and stop it from making more and more copies of itself," she says.

她說：“因為我們的身體感覺到所有這些病毒基本上都是外來入侵者，這就觸發(fā)了我們的免疫系統(tǒng)，試圖控制病毒，阻止它復(fù)制越來越多的病毒。”

But Furuya says that this immune system response to this invader can also destroy lung tissue and cause inflammation. The end result can be pneumonia. That means the air sacs in the lungs become inflamed and filled with fluid, making it harder to breathe.

但古屋說，這種免疫系統(tǒng)對這種入侵者的反應(yīng)也會破壞肺組織，引起炎癥。最終結(jié)果可能是肺炎。這意味著肺部的氣囊會發(fā)炎并充滿液體，使呼吸變得困難。

Del Rio says that these symptoms can also make it harder for the lungs to get oxygen to your blood, potentially triggering a cascade of problems. "The lack of oxygen leads to more inflammation, more problems in the body. Organs need oxygen to function, right? So when you don't have oxygen there, then your liver dies and your kidney dies," he says.

德爾里奧說，這些癥狀還會使肺部更難將氧氣輸送到血液中，可能會引發(fā)一系列問題。他說：“缺氧會導(dǎo)致更多的炎癥，更多的身體問題。器官需要氧氣才能發(fā)揮作用，對吧?所以當(dāng)你沒有氧氣的時候，你的肝臟和腎臟就會死亡。”

That's what seems to be happening in the most severe cases. About 3% to 5% of patients end up in intensive care, according to the WHO. And many hospitalized patients require supplemental oxygen.

這似乎就是在最嚴(yán)重的情況下發(fā)生的事情。根據(jù)世界衛(wèi)生組織的數(shù)據(jù)，大約3%到5%的患者最終進(jìn)入了重癥監(jiān)護(hù)。而且許多住院病人需要補充氧氣。

In extreme cases, they need mechanical ventilation — including the use of a sophisticated technology known as ECMO(extracorporeal membrane oxygenation), which basically acts as the patient's lungs, adding oxygen to their blood and removing carbon dioxide. The technology "allows us to save more severe patients," Dr. Sylvie Briand, director of the WHO's pandemic and epidemic diseases department, said at a press conference Monday.

在極端情況下，他們需要機械通氣-包括使用一種名為ECMO(體外膜氧合)的復(fù)雜技術(shù)，這種技術(shù)基本上充當(dāng)患者的肺部，為他們的血液增加氧氣，并清除二氧化碳。世衛(wèi)組織流行病和流行病部主任塞爾維布利陽博士在周一的新聞發(fā)布會上說，這項技術(shù)“允許我們拯救更多的危重患者”。

Many of the more serious cases have been in people who are middle-aged and elderly — Furuya notes that our immune system gets weaker as we age. She says for long-term smokers, it could be even worse because their airways and lungs are more vulnerable. People with other underlying medical conditions, such as heart disease, diabetes or chronic lung disease, have also proved most vulnerable. Furuya says those kinds of conditions can make it harder for the body to recover from infections.

許多更嚴(yán)重的病例發(fā)生在中老年人身上-古屋指出，隨著年齡的增長，我們的免疫系統(tǒng)會變得更弱。她說，對于長期吸煙者來說，情況可能更糟，因為他們的氣道和肺部更容易受到傷害。患有其他潛在疾病的人，如心臟病、糖尿病或慢性肺病，也被證明是最脆弱的。古屋說，這種情況會使身體更難從感染中恢復(fù)。

"Of course, you have outliers — people who are young and otherwise previously healthy who are dying," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently told NPR's 1A show. "But if you look at the vast majority of the people who have serious disease and who will ultimately die, they are in that group that are either elderly and/or have underlying conditions."

美國國家過敏和傳染病研究所所長安東尼·福奇博士最近在接受NPR的1A節(jié)目采訪時表示：“當(dāng)然，也有異常--那些年輕的、原本健康的人，他們正在死去，”但如果你看看絕大多數(shù)患有嚴(yán)重疾病并最終將死亡的人，他們要么是老年人和/或有潛在疾病的人。

The WHO has said most deaths so far appear to be from multi-organ failure and has calculated the case fatality rate at about 2% or less, based on earlier data from China. However, infectious disease experts note that it's hard to know the true numbers at this point in the epidemic.

世衛(wèi)組織表示，到目前為止，大多數(shù)死亡似乎是由多器官衰竭造成的，并根據(jù)中國早先的數(shù)據(jù)計算出病死率約為2%或更低。然而，傳染病專家指出，目前很難知道疫情的真實數(shù)字。