Ako ste\niste postrehli, \u013eudsk\u00e9 zdravie ohrozuje nov\u00e9 v\u00edrusov\u00e9 ochorenie, pri\u010dom jeho\n\u0161\u00edrenie pred nieko\u013ek\u00fdmi d\u0148ami WHO ozna\u010dila za pand\u00e9miu. Vzh\u013eadom na to, \u017ee sa\njedn\u00e1 o nov\u00fd v\u00edrus, je m\u00e1lo presk\u00faman\u00fd a s\u00fa o \u0148om obmedzen\u00e9 vedeck\u00e9 poznatky.\nZatia\u013e nie je k dispoz\u00edci\u00ed vakc\u00edna ani kauz\u00e1lna lie\u010dba. Po\u010det pr\u00edpadov, \u017eia\u013e,\nve\u013emi r\u00fdchlo rastie v celej Eur\u00f3pe, vr\u00e1tane Slovenska. Je \u010d\u00edm \u010falej t\u00fdm v\u00e4\u010d\u0161ia\npravdepodobnos\u0165, \u017ee sa s n\u00edm stretn\u00fa aj pacienti s cystickou fibr\u00f3zou. Zo\nzn\u00e1mych poznatkov je zrejm\u00e9, \u017ee t\u00fdmto v\u00edrusov\u00fdm ochoren\u00edm s\u00fa viac ohrozen\u00ed\n\u013eudia s in\u00fdmi zdravotn\u00fdmi probl\u00e9mami a osobitne ochoreniami respira\u010dn\u00e9ho\nsyst\u00e9mu (zv\u00fd\u0161en\u00e9 riziko tie\u017e predstavuje diabetes a hypertenzia). <\/p>\n\n\n\n
Je\nd\u00f4le\u017eit\u00e9 pozna\u0165 pr\u00edznaky ochorenia, ako aj dodr\u017eiava\u0165 v\u0161eobecn\u00e9\nprotiepidemiologick\u00e9 z\u00e1sady, pri\u010dom na t\u00fato t\u00e9mu n\u00e1jdete u\u017e mno\u017estvo kvalitn\u00fdch\n\u010dl\u00e1nkov (\u00darad verejn\u00e9ho zdravotn\u00edctva,<\/a> Centers for Disease Control and\nPrevention<\/a>, slovenskypacient.sk<\/a>, klubcf.sk<\/a>). Na tomto\nmieste by sme radi zhrnuli niektor\u00e9 inform\u00e1cie, ktor\u00e9 maj\u00fa v\u00fdznam z poh\u013eadu cystickej\nfibr\u00f3zy. V prvom rade je potrebn\u00e9 podotkn\u00fa\u0165, \u017ee zatia\u013e nie s\u00fa klinick\u00e9\npoznatky o tom, ako prebieha infekcia u CF pacientov. S\u00fa v\u0161ak napr.\npoznatky o priebehu pri podobn\u00fdch ochoreniach (chronick\u00e1 ob\u0161truk\u010dn\u00e1 choroba\np\u013e\u00fac) alebo komplik\u00e1ci\u00e1ch CF (diabete), na z\u00e1klade \u010doho je mo\u017en\u00e9 vyvodi\u0165\nniektor\u00e9 klinick\u00e9 predpoklady. P\u00f4vodca s\u00fa\u010dasn\u00e9ho ochorenia je bl\u00edzko pr\u00edbuzn\u00fd\nv\u00edrusu, ktor\u00fd vyvolal epid\u00e9miu SARSu v rokoch 2002-2003.<\/p>\n\n\n\n COVID-19\nm\u00e1 v 80% pr\u00edpadov mierny priebeh a e\u0161te\nv\u00fdraznej\u0161ie to plat\u00ed u mlad\u00fdch \u013eud\u00ed a u det\u00ed. Deti patria medzi t\u00fdch pacientov,\nktor\u00ed ochorenie zn\u00e1\u0161aj\u00fa najlep\u0161ie, aj ke\u010f pre\u010do to tak je, zatia\u013e nie je zn\u00e1me.\nVe\u013ek\u00fa \u010das\u0165 CF popul\u00e1cie tvoria deti a mlad\u00ed \u013eudia, \u010do prin\u00e1\u0161a n\u00e1dej, \u017ee aspo\u0148\nmlad\u0161ia \u010das\u0165 pacientov m\u00e1 priazniv\u00fa perspekt\u00edvu. Ke\u010f hodnot\u00edme v\u0161etk\u00fdch\npacientov (v\u0161etky vekov\u00e9 kateg\u00f3rie), u 19% chor\u00fdch sa\nprejavia v\u00e1\u017enej\u0161ie probl\u00e9my s d\u00fdchan\u00edm, u nie\u010do nad 50% je mo\u017en\u00e9 na\nCT skenoch identifikova\u0165 patologick\u00e9 zmeny v p\u013e\u00facach. \u00damrtnos\u0165 na toto\nochorenie meran\u00e1 ako CFR (pomer \u00famrt\u00ed na ur\u010dit\u00e9 ochorenie v porovnan\u00ed s\ncelkov\u00fdm po\u010dtom \u013eud\u00ed s diagn\u00f3zou) je okolo 3%, u \u013eud\u00ed s\n\u010fal\u0161\u00edmi zdravotn\u00fdmi probl\u00e9mami je ale v\u00fdrazne vy\u0161\u0161ia. U pacientov s diabetom\n7,3%, s chronick\u00fdm p\u013e\u00facnym ochoren\u00edm 6,3%, s kardiovaskul\u00e1rnym ochoren\u00edm 10,5%. Je\npochopite\u013en\u00e9, \u017ee \u010d\u00edm m\u00e1 osoba viac zdravotn\u00fdch komplik\u00e1ci\u00ed, t\u00fdm sa riziko smrti\n\u010falej zvy\u0161uje. V \u010c\u00edne sa vyskytlo ve\u013ea pr\u00edpadov, ke\u010f mali pacienti spolu\ns COVID-19 z\u00e1rove\u0148 chr\u00edpku resp. aj\n\u010fal\u0161ie bakteri\u00e1lne p\u013e\u00facne infekcie. To nie je prekvapuj\u00faca situ\u00e1cia, ke\u010f\u017ee\ninfekcia oslabuje imunitn\u00fd syst\u00e9m, \u010do otv\u00e1ra priestor pre \u010fal\u0161ie patog\u00e9ny a\ndoch\u00e1dza k tzv. superinfekcii. Z toho vypl\u00fdva, \u017ee jedn\u00fdm z mo\u017en\u00fdch\nprevent\u00edvnych opatren\u00ed je o\u010dkovanie proti chr\u00edpke, ke\u010f\u017ee to m\u00f4\u017ee zabr\u00e1ni\u0165 komplikovanej\u0161ej\ndvojitej infekcii. <\/p>\n\n\n\n Typick\u00fdm prejavom naj\u0165a\u017e\u0161\u00edch foriem je\npneum\u00f3nia (z\u00e1pal p\u013e\u00fac). Iba mal\u00e1 \u010das\u0165 pacientov sa dostane do tohto \u0161t\u00e1dia, pri\nv\u00e4\u010d\u0161ine sa prejav\u00ed iba z\u00e1pal horn\u00fdch d\u00fdchac\u00edch ciest. Tento stav je jednozna\u010dne\n\u017eivot ohrozuj\u00faci. V s\u00fa\u010dasnosti nie je zn\u00e1me, \u010do presne predisponuje pacienta k tomu,\naby sa u\u0148ho rozvinula pneum\u00f3nia. Ke\u010f to ale u\u017e nastane, tak stav p\u013e\u00fac je\nkritick\u00fd pre jeho pre\u017eitie. \u010c\u00edm m\u00e1 lep\u0161ie zachovan\u00e9 p\u013e\u00facne funkcie, t\u00fdm s\u00fa jeho\n\u0161ance lep\u0161ie. Ve\u013ea pacientov v kritickom stave vy\u017eadovalo pr\u00edsun kysl\u00edku a\nrespira\u010dn\u00e9 zlyhanie je pri tomto ochoren\u00ed naj\u010dastej\u0161ou pr\u00ed\u010dinou smrti. Zatia\u013e\nnie je objasnen\u00e9, ak\u00fd v\u00fdznam v patogen\u00e9ze maj\u00fa procesy imunitn\u00e9ho syst\u00e9mu. Bola\npozorovan\u00e1 ve\u013emi siln\u00e1 z\u00e1palov\u00e1 imunitn\u00e1 reakcia (\u201ecytokine storm\u201c), ktor\u00e1 m\u00e1\npo\u0161kodzuj\u00faci vplyv na organizmus a vedie k zhor\u0161eniu zdravotn\u00e9ho stavu (resp.\nm\u00f4\u017ee prispie\u0165 k smrti pacienta). Okrem po\u0161kodenia p\u013e\u00fac viedol COVID-19 v niektor\u00fdch pr\u00edpadoch aj k po\u0161kodeniu\npe\u010dene, obli\u010diek alebo kardiovaskul\u00e1rneho syst\u00e9mu. Po\u0161kodenie obli\u010diek m\u00f4\u017ee by\u0165\naj pr\u00ed\u010dinou smrti, omnoho \u010dastej\u0161ou pr\u00ed\u010dinou je ale zlyhanie p\u013e\u00fac.<\/p>\n\n\n\n Organizmus\nza\u010d\u00edna po napadnut\u00ed v\u00edrusom proti nemu tvori\u0165 protil\u00e1tky a ak ochorenie\nzvl\u00e1dne, mal by ma\u0165 vo\u010di nemu imunitu. U malej \u010dasti pacientov ale po vylie\u010den\u00ed\nznovu prepukla choroba (podobne to bolo pri SARSe). V\u00edrus zrejme v organizme\ne\u0161te zotrv\u00e1va nieko\u013eko t\u00fd\u017ed\u0148ov po \u00fastupe pr\u00edznakov a za v\u00fdnimo\u010dn\u00fdch okolnost\u00ed\n(ako oslabenie imunity) sa m\u00f4\u017ee ochorenie vr\u00e1ti\u0165. V s\u00fa\u010dasnosti sa ale\npredpoklad\u00e1, \u017ee pacient by mal (podobne ako pri ostatn\u00fdch koronav\u00edrusoch)\nz\u00edska\u0165 po vylie\u010den\u00ed aspo\u0148 nieko\u013ekoro\u010dn\u00fa imunitu.<\/p>\n\n\n\n Zatia\u013e\nje ve\u013emi m\u00e1lo poznatkov o dlhodob\u00fdch n\u00e1sledkoch po prekonan\u00ed COVID-19. To, \u017ee\nsa vyskytli u pacientov, ktor\u00ed prekonali SARS nazna\u010duje, \u017ee sa jedn\u00e1 o nemal\u00e9\nriziko a potvrdzuje to aj najnov\u0161\u00ed v\u00fdskum pri s\u00fa\u010dasnej epid\u00e9mii. \u0160t\u00fadia 12\npacientov z Hong-Kongu, ktor\u00e1 sledovala pacientov po prekonan\u00ed COVID-19 zistila,\n\u017ee 3 z 12 pacientov maj\u00fa aj po prekonan\u00ed ochorenia zn\u00ed\u017een\u00fd p\u013e\u00facny objem o\n20-30 %. Z\u00e1rove\u0148 je zn\u00e1my prinajmen\u0161om jeden pr\u00edpad z \u010c\u00edny, ke\u010f sa\npacient vylie\u010dil z COVID-19 (bol prepusten\u00fd z nemocnice), ale n\u00e1sledne zomrel\nna n\u00e1sledky org\u00e1nov\u00e9ho po\u0161kodenia. <\/p>\n\n\n\n Asi\nnajz\u00e1sadnej\u0161ia ot\u00e1zka s\u00fa\u010dasnosti je, ako sa bude epid\u00e9mia \u010falej vyv\u00edja\u0165. Je\n\u00faplne nerealistick\u00e9 o\u010dak\u00e1va\u0165, \u017ee by sa epid\u00e9mia mohla skon\u010di\u0165 v priebehu\nt\u00fd\u017ed\u0148ov. Singap\u00farska vl\u00e1da predpoklad\u00e1, \u017ee epid\u00e9mia bude trva\u0165 prinajmen\u0161om jeden rok<\/a>. Nemeck\u00e1 kancel\u00e1rka Angela Merkelov\u00e1\nvarovala, \u017ee 60-70<\/a>% obyvate\u013eov<\/a> sa m\u00f4\u017ee nakazi\u0165 nov\u00fdm v\u00edrusom (v\u00e4\u010d\u0161ina epidemiol\u00f3gov predpoklad\u00e1\nni\u017e\u0161iu \u00farove\u0148) a n\u00e1sledne napriek tvrdeniam, \u017ee Nemecko je dobre\npripraven\u00e9, odmietla prija\u0165 z\u00e1sadn\u00e9 opatrenia proti \u0161\u00edreniu epid\u00e9mie. Pozit\u00edvne je, \u017ee Slovensko (ako aj \u010cR)\nprijalo jedny z najpr\u00edsnej\u0161\u00edch opatren\u00ed v Eur\u00f3pe. V boji proti epid\u00e9mii je\nd\u00f4le\u017eit\u00e1 nie len vl\u00e1da, ale rovnako ob\u010dianska zodpovednos\u0165, informovanos\u0165 a\nkonkr\u00e9tne \u010diny be\u017en\u00fdch \u013eud\u00ed. S\u00fa tu samozrejme tie\u017e \u00faspe\u0161n\u00e9 pr\u00edklady kraj\u00edn, ktor\u00e9 si\nved\u00fa ve\u013emi dobre. Okrem toho, \u017ee je minimum nov\u00fdch pr\u00edpadov v \u010c\u00edne, po\u010det sa\nzni\u017euje aj v K\u00f3rei. V Singap\u00fare, na Taiwane ani v Hong-Kongu zatia\u013e nedo\u0161lo k\nmasov\u00e9mu \u0161\u00edreniu infekcie a situ\u00e1ciu sa dar\u00ed dr\u017ea\u0165 pod kontrolou. Tieto krajiny\nv minulosti za\u017eili epid\u00e9miu SARSu a vedia, ak\u00fa de\u0161trukciu dok\u00e1\u017ee prinies\u0165.<\/p>\n\n\n\n Pomerne dobre spracovan\u00e9 odpor\u00fa\u010dania pre CF pacientov m\u00e1\nnapr\u00edklad Cystic Fibrosis Foundation (CFF) https:\/\/www.cff.org\/Life-With-CF\/Daily-Life\/Germs-and-Staying-Healthy\/What-Are-Germs\/COVID-19-Community-Questions-and-Answers\/<\/a> <\/p>\n\n\n\n COVID-19 predstavuje pre CF pacientov (osobitne pre\npacientov s \u0165a\u017e\u0161ou p\u013e\u00facnou ob\u0161trukciou) mimoriadne nebezpe\u010dn\u00fa a potenci\u00e1lne\n\u017eivot ohrozuj\u00facu infekciu a odpor\u00fa\u010da sa, aby sa podnikli opatrenia na svoju\nochranu.<\/p>\n","protected":false},"excerpt":{"rendered":"