海外マルファン情報

米国マルファン症候群患者団体The Marfan Foundationからの情報を中心に、マルファン症候群や関連疾患についての海外情報を翻訳して発信します。

COVID-19とマルファン関連疾患 ~ハイリスクな肺疾患~


COVID-19 and Marfan/VEDS/LDS: Your Questions Answered

 

21:49-26:31

 

So you know, many patients even though we have all of these subgroups of whom is at higher risk are asking about certain features that they have, so maybe we can just go through this list to see which ones do you think maybe at some higher risk.

では、このリストにある具体的な疾患について、重症化リスクが高いと思われるものを見ていきたいと思います。

 

So if a patient has a pectus deformities that, decreases lung capacity, so Enid?

では、Enid先生、胸骨の変形からお願いします。

 

Oh, of course. Pectus deformities or scoliosis that are associated with reduced lung function or a reduced lung capacity that is what we call a high-risk group because if you're unable to expand your lungs kind of as much as a normal person or a person who did not have these underlying disorders could expand them, then that means that your reserve is, is compromised and so it's not simply whether you have pectus but it's whether you have pectus that's associated with reduced lung function.

胸骨の変形や側弯症があると、肺機能つまり肺の予備能力が低下し、高リスクとなります。というのは、健康な人や基礎疾患のない人と同じくらいに肺を膨らませることができない場合、肺の予備能力が低下しているということになるからです。単に胸骨に問題があるといっても、肺機能の低下が起きていない場合には問題とはなりません。

 

And if you've been evaluated by a pulmonologist or a primary care physician who said that your lung function is reduced, then you should assume that you fall into what we would call a high-risk group for COVID complications.

肺の専門医やかかりつけ医に肺機能の低下を指摘された場合には、新型コロナウイルス感染症にかかった場合の合併症リスクが高くなります。

 

The other group that you've listed here complete or partial lung collapse that's basically tethered to a diagnosis of pneumothorax when air is able to enter that space between the chest wall and the lung pleura if that is persistent and in a certain subset of patients even though their pneumothorax is treated, the lung doesn't completely expand that typically is associated with some diminishment of the lung function and so that would be sufficient for placing someone into a higher risk category.

肺虚脱にも重症化リスクがあります。肺虚脱は通常、気胸により生じます。気胸では空気が胸壁と肺胸膜の間の胸腔に入り込みます。この状態が続いた場合、あるいは一部の方では気胸が治ったあとでも、肺の機能が完全に戻らないことがありますので、高リスクに分類されます。

 

The pleural effusion that very much depends on one what caused the pleural effusion because sometimes it's associated with the pneumothorax event but it could also be associated with cardiac disease or a lung infection.

胸水が重症化リスクにつながるかについては、原因が何であるかに尽きます。気胸が原因の場合もありますが、心臓や肺の感染症が原因の場合もあります。

 

But if it's associated with the pneumothorax, then if it's resolved or, or if it's removed with the placement of a catheter and there's no evidence that the fluid has recurred or that the fluid is persistent, then that may well not represent a persistent risk factor unless there is an associated reduction in the lung function.

胸水の原因が気胸の場合ですが、カテーテルの留置などによって胸水がなくなり、その後び胸水がたまったり、胸水が残っていないというエビデンスがあるならば、肺機能の低下がない限りは高リスクとはならないと思います。

 

Mild asthma we talked about and I should say that asthma is one of those diagnoses that we typically thought might fall into a high-risk group with older persons, however, it looks like that those cases that are being mentioned now in the United States are young adults that are having more difficulty with hospitalizations, needing ICU care or even ultimately dying that this is one of the diagnoses that they found associated with those adverse outcomes and so we're taking a much harder look at those patients who have this even if it's very well managed.

軽度の喘息は、高齢者では高リスク疾患となる可能性があります。ですが、現在アメリカでは、入院できなかったり、ICUでの治療が受けられないなどして亡くなる若者について、喘息が原因の一つであるという指摘があります。そのため、喘息のある方については経過が良好であっても、注意深く観察しています。

 

And scoliosis is the last one and, and that is what we need to kind of consider especially if you've had scoliosis and it was severe and you've had pulmonary function tests that show that there is some reduction in your lung capacity secondary to this particular complication.

最後は側弯症です。重度の側弯症があり、肺機能検査で肺機能の低下が認められた場合には注意が必要です。

 

What I can say very comfortably is that if you have these diagnoses, your physician should know that you're aware that you fall into a high-risk group and that The Marfan Foundation has designated you as falling into a high-risk group and you may ask well, "what does that do?" "what does that mean?" It means that when you develop any of the symptoms of concern and those are high fevers, shortness of breath or cough that you need to alert the medical system and there will be some heightened evaluation that will proceed from there because there is a concern that if you develop an infection, you may well have much more serious complications than someone who doesn't have these underlying disorders.

これらの肺疾患がある場合には、重症化リスクが高く、The Marfan Foundationによるとハイリスク群に分類されるということを、あなたの担当医が理解しておく必要があります。ではどうすればいいのかというと、高熱や息切れ、咳などの症状が出た場合には医療機関に伝えてください。そうすることで、精密な検査が行われます。基礎疾患のない人よりも、より重篤な合併症が生じる可能性が高いからです。

 

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。