COVID-19 and Marfan, VEDS, Loeys-Dietz: Your Questions Answered
5:50-10:54
Hello everyone, and we are tasked to give you as much information as you could possibly want tonight.
皆さん、こんちには。今回のセミナーでは皆さんが知りたいと思っている情報をできる限り提供したいと思っています。
And the first issue is how do we create these designations of who is at high risk. I feel the best way to look at this is the realization that about 20% of persons who are infected with this virus will develop serious disease that they will require hospitalization and so when you look at that 20% number, you should recognize that those are not exclusively people who are older. They're disproportionately older but not exclusively older, so what is represented in that 20% are people who have underlying disorders that makes them less able to tolerate a more severe manifestation of this viral infection.
まず、どのようにしてリスクの高い患者さんの分類を行ったかということについてです。新型コロナウイルス感染者の約2割が重症化し入院が必要になる、ということを理解することが必要です。その2割の方の構成を見ると高齢者ばかりではないことがわかります。高齢者の方が多いものの、高齢者だけが重症化しているというわけではありません。つまり、この2割の感染者の中には、基礎疾患があることで重症化する方が含まれていることになります。
And so we constructed this list of lung disorders that are seen among our Marfan, Loeys-Dietz, and vEDS patients that should place them in what's considered a higher risk group.
マルファン症候群、ロイス・ディーツ症候群、血管型エーラス・ダンロス症候群の患者さんにみられる肺疾患で、重症化するリスクが高いと思われるものをリスト化しました。
And this includes restrictive lung disease because, as I always say, when you can't take a deep breath that means you don't have as much of a reserve as someone who can take a deep breath and restriction in Marfan syndrome is often attributable to chest wall deformities or scoliosis or respiratory muscle weakness and we see all of those in Marfan syndrome and they are not uncommon.
まず、拘束性肺疾患についてですが、深呼吸ができないということは、正常な人よりもためておける酸素の量が少ないということです。マルファン症候群の場合には、胸壁の変形、側弯症、呼吸筋の筋力低下などが原因となることが多く、いずれもマルファン症候群ではみられる所見で、珍しいものではありません。
The other disorders that place our patients at higher risk include emphysema. This is especially true when you have blebs and when you have a history of pneumothoraces that are recurrent and so a single pneumothorax does not mean that you have underlying lung disease, but if you have recurrent or multiple pneumothoraces, that is a very strong indicator that your lung tissue is not normal and that it is somewhat vulnerable.
肺気腫も高リスク疾患ですが、ブレブ（気泡）があったり、気胸を繰り返している場合などは特に重症化しやすくなります。一度の気胸では基礎疾患があることにはなりませんが、再発性気胸や多発性気胸の場合には肺組織が正常とは考えられないので、リスクは高まります。
Obviously, when you have significant asthma that requires medication and sometimes antibiotics and inhaler treatments, that, that is a risk factor, again because there's less reserve.
重度の喘息で、投薬治療や抗生物質、吸入器によるの治療を受けている方では、やはり肺にためておける酸素量が少なくなるためリスクが高まります。
If you have a diagnosis of chronic obstructive pulmonary disease with or without a history of smoking, that places one at higher risk
慢性拘束性肺疾患の診断を受けた方では、喫煙歴の有無によらず高リスクとなります。
And if you have respiratory insufficiency of any kind and what I mean by that is if you require some respiratory support, be it oxygen, be it frequent treatment for pneumonias or if you are under the care of a lung specialist, then that also should place you in the high-risk group.
種類によらず呼吸不全のみられる方、つまり、酸素吸入や何度も肺炎の治療を行っている方、呼吸器科を受診している方など、呼吸支援の必要な方ではやはりリスクは高くなります。
So, I hope it's clear that the idea is that an underlying disorder of the lungs that will compromise your ability to bounce back or responds efficiently to a serious viral infection is why we've designated these groups as high-risk and what does that mean in terms of management of a possible viral infection, well, it means that you have to assume a protective posture and the first person who protected is yourself, second group that you protect is your family, and the third group that you protect is your community.
基本的に、重いウイルス感染症に対する抵抗力が落ちてしまうような肺疾患を高リスク疾患に分類しています。ウイルス感染症の管理という観点では、予防対策をしっかり行うということです。守るべき優先順としては、まず自分、次に家族、そして、最後にコミュニティメンバーです。
And when it comes to protecting yourself that means monitoring your status. If you have a cold that is persistent with a high fever, then you need to contact your health care providers. They need to know so that they can put you in a queue to either be tested or to tell you to monitor yourself for further symptoms in order to be tested, but the idea of being in a high-risk group means that you reach out to your health care protector, your health care provider early when you have these symptoms.
自分を守るということは、自分の体調に注意するということです。風邪を引いて高熱が続く場合には、病院を受診する必要があります。病院ではそういった患者さんを検査対象とするのか、もっと症状が出てから検査するのかを判断します。高リスクの患者さんの場合には、そのような症状が出た場合には、すぐに医療機関にかかってください。
The second issue is that you want to minimize your potential exposure to persons who might, in fact, have the viral infection and that means, of course, knowing your community but also not placing yourself in a high-risk situation such as with, with crowds or in groups where you're not, where you're exposed to the public and you cannot control the people that you encounter.
2番目に皆さんにお知らせしたいことは、感染の可能性のある人との接触を最低限に抑えるということです。もちろん、ご近所のことを知っておく必要がありますが、人混みなど感染の可能性のある場所を避けてください。
And the last thing is being especially careful in terms of personal hygiene. You have to have your bottles of Purell and you have to have your, your antibacterial wipes and you carry them around with you and you wipe off all the surfaces and if you need to set an alarm on your phone so that it reminds you to use these approaches every hour, then you should do that, but the main thing to think about is that you assume a protective posture of yourself, your loved ones, and your community.
最後に、身の回りを清潔に保つよう、特に気を付けてください。手指消毒剤や除菌ティッシュなどを持ち歩き、見えている部分を拭きましょう。忘れないようにアラームをセットしてもいいでしょう。重要なのは、自分や大切な人、コミュニティに対して感染防止の意識を持つことです。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
