Recently, the journal Nature (Nature) announced the top ten scientific influence figures in 2022, associate researcher of the Center for Biomedical Frontier Innovation (BIOPIC) and leading scientist of Beijing Changping Laboratory, Cao Yunlong was selected as the "new coronavirus predictor", he introduced that there are several infection peaks every year.
Extensive infections have also followed, and a medical run has already taken place. In response to severe medical resources "supply" tensions, expanding beds, as of December 25, the national ICU beds totaled 181000, equivalent to 12.8 / 100000 people, although half a month beds get great adjustment, but for the overall trend is still "a bed is hard to find", emergency, severe, breathing and other mainstream department situation is still anxious.
Recently, the word "white lung" has been reported by major media networks, and the popularity has not been reduced for a time. Although the clinical proportion is not high, it is undeniable that the mortality rate of severe white lung patients is as high as more than 40%.
On December 27, Jiao Yahui, director of the medical administration department of the National Health Commission, said at the meeting that it is not just lung inflammation, but white lung should be a serious manifestation of pneumonia. Generally speaking, the inflammation of the lung is more heavy, when the exudation is more, that is, the white image area reaches 70% -80%, in clinical oral called white lung. At this stage, patients will develop hypoxemia or respiratory distress, especially in the current wave of outbreaks, older patients with severe underlying diseases may appear.
"White lung" is a typical imaging manifestation of acute respiratory distress syndrome (ARDS), which generally refers to the severe pneumonia under the X-ray or CT examination. The clinical manifestations are chest tightness, short breath and poor breathing, which is one of the most common and serious respiratory complications of COVID-19 (COVID-19).
Clinical study data found that among the 417 positive patients with COVID-19, ARDS patients accounted for 21%. Another study from Zhongnan Hospital of Wuhan University showed that 26.1% of positive patients were transferred to ICU due to complications, and 61.1% of them developed ARDS. The mortality rate in patients with moderate to severe ARDS in COVID-19 was as high as 81.3%, and another study published in the Lancet showed that the incidence of ARDS was higher in COVID-19 deceased patients compared with survivors (81% vs 45%).
CDE annual report evaluation of west vestat sodium (inflammatory storm core link-neutrophil elastase-targeted inhibitors) is the world's only used in ALI / ALARDS (acute lung injury / acute respiratory distress syndrome) drug, its approved to fill the blank of ALI / ARDS drug therapy in China, since March 2020 in COVID-19 at the beginning of the global epidemic, since the NMPA approval rapid marketing, after more than 2 years national respiratory, emergency, ICU and other fields doctors clinical use.
Clinical data show that cilililostat sodium can improve the respiratory status and pulmonary imaging changes in severe COVID-19 patients, prompting its successful weaning from ventilator. In addition, the first evidence-based results of sepsis showed that, civelicostat sodium could reduce the ICU stay by 4.56 days and shorten the mechanical ventilation time by 52 hours. Meanwhile, civelicostat sodium could improve the oxygenation index 37.1mmHg, reduce the APACHE II score by 3.89 points and SOFA score by 3 points.
The results of the Japanese phase III trial showed that civerilostat sodium can significantly improve the lung function of patients and shorten the median ICU time by 12.5 days, which is equivalent to improving the ICU bed turnover rate by 71.4%. Another retrospective analysis with a large sample size of 4276 ALI / ARDS showed that civerilostat significantly improved survival at 30,60 and 90 days (p=0.0022); and the 90-day risk of death decreased by 17%.
China's population aging is serious, but the vaccination rate of the elderly population is not high. At the time of the peak of severe infection, the society has begun to panic buying drugs, expand medical resources, and take up medical care with illness.
There are signs that even though the majority of the patients are mild, the challenges of critical care forces cannot be ignored due to China's large population base.
