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What happens to the patient with the new crown? How to interpret the results of serum IgG and IGM
Release time: 2020-08-05 10:14:11  Hits: 10

In many places, patients who have been cured have recovered Yang,

is it worse? Is it contagious?

The news of Fuyang after discharge from the Hospital of patients with NCP is of great concern. Many people are worried that the cured discharged patients are still infectious, or that they may become ill again? At present, the phenomenon of recovery of Yang in cured patients has been reported. The People's Hospital of Wuhan University and Zhongnan Hospital of Wuhan University found many cases of patients returning to Yang, Guangdong Province first reported on February 25,14% of patients returning to Yang; On March 3, Tianjin reported two new confirmed cases of reactivation of nucleic acid after discharge from hospital, and Tianjin has reported a total of five cases of reactivation of nucleic acid; on March 7, Beijing reported that several patients tested negative for nucleic acid, but two weeks later, the viral nucleic acid test came back positive. There are more than 80,000 cases in China, and about 0.1% of them tested positive for Fuyang after discharge from hospital.

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There are many reasons to cure a patient to recover Yang

1. SAMPLING ERROR:

The pharyngeal specimen examination itself has the flaw. "It's not in the throat, it's in the lungs. Pharynx samples may be tested negative, after two days a cough inhalation, (sputum) test is positive. It is also possible."Some of the Fuyang patients in Guangdong were found to be anal swab positive for nucleic acid.

With the increase of Fuyang cases, the defect of pharyngeal specimen detection has been noticed. The seventh edition of the latest National Health Council of the new diagnosis and treatment of pneumonia proposed, etiological examination, detection of respiratory specimens (sputum or airway extract) more accurate. In the discharge standard, the contents of "sputum, nasopharyngeal swab and so on" were added, which were negative for two times continuously, and the sampling time was at least 24 hours apart.

2. INTERMITTENT DETOX:

May Be the patient lung inflammation is still in the absorption process, has not yet reached clinical cure, so there may be intermittent detoxification phenomenon, and appear positive.

3. At different stages of the disease, the positive site of the virus may be different

For example, in the early stages, the virus may be confined to the upper respiratory tract, at which point it is more likely to be positive by sampling the upper respiratory tract, the odds of a positive nucleic acid test are slightly higher. After a period of time may be transferred to the digestive tract, when the positive rate of anal swabs will be higher.

Can the symptom of patient of Fu Yang aggravate?

Is it contagious?

Whether the patient is still infectious remains to be determined. Most patients do not get worse and are not found to be infectious. According to the clinical features, none of the follow-up patients in Guangdong province had their lung condition aggravated. According to the follow-up data from the hospital, compared with the CT at the time of discharge, 42% of the discharged patients had better lung absorption, and 42% haven't changed, which means it's not getting worse, but it's getting slower.

The virus detected by nucleic acid is not necessarily a live virus, "The cells are dead, the virus is dead, and the nucleic acid can still be detected. The nucleic acid is just the presence of a virus, but it doesn't mean it's alive. Of course, the epidemic is still in the prevention and control stage, in order to prevent infection, nucleic acid Fuyang patients to be quarantined, but does not necessarily mean that these patients are infectious. Since most recovered patients have more protective antibodies in their bodies, most patients do not develop symptoms. As long as enough antibodies against the new coronavirus are produced in the body, the patient will not become infected again and the chance of relapse in fully recovered patients is very low.

Huazhong University of Science and Technology, Department of respiratory and Critical Care Medicine of Tongji Hospital, and others, in a paper entitled "analysis of the causes of "relapse" in discharged COVID-19 patients and treatment strategies, divided the newly-crowned patients into four categories:

(1) general type patients who have not used hormones;

(2) general type patients with history of steroid use;

(3) elderly patients over 60 years of age;

(4) critically ill or critically ill patients to the general type.

It is suggested that different discharge criteria should be established according to different levels of management for four types of patients. When a patient is discharged from hospital, his or her temperature should return to normal for at least one week, regardless of the type mentioned above. For patients who have used Glucocorticoid, they should be discharged with complete withdrawal of the hormone and return to normal body temperature for a full week. After discharge, the patient should continue to be isolated for at least 2 weeks and tested again for viral nucleic acid.


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