Covid and Aortic Conditions: The Latest Research
8:13-12:31
So to get started, let's, you know, tackle the question about who is at high risk of bad outcomes if they get COVID-19. So having Marfan, LDS or vEDS or most of the other genetic aortic conditions really doesn't put you at a higher risk for a bad outcome with COVID-19.
COVID-19を発症した場合に重症化リスクが高くなるのはどのような人かという質問ですが、マルファン症候群（MFS）やロイス・ディーツ症候群（LDS）、血管型エーラス・ダンロス症候群（vEDS）の方、あるいはその他の遺伝性大動脈疾患の方の大部分は、COVID-19による重症化リスクが高くなるわけではありません。
However, there are those high risk categories that may put you at a higher risk and those of you that, that is if you have certain lung conditions and so Enid Neptune is our pulmonologist and she's going to go over some of these lung conditions listed here briefly.
ですが、高リスクに分類される疾患もあり、一部の肺疾患がそれに該当します。では、呼吸器科医であるEnid先生に高リスクな肺疾患を説明していただきます。
Great, thank you Joe and so the the important point to understand in terms of which lung conditions place you at a high risk is the idea of pulmonary reserve, or the reserve in your breathing capacity that you have.
ご紹介ありがとうございます。高リスクの肺疾患とはどのような肺疾患かというと、肺の予備能、つまり肺活量にどれだけ余裕があるかということに関係します。
And most people who don't have any underlying lung disease have what we call a great deal of pulmonary reserve and that means that if you get like a pneumonia or you get some major allergic reaction or you have some inhaled toxic exposure, that you may get somewhat symptomatic but you're not going to be so compromised that you wind up needing to be hospitalized or you need supplemental oxygen or you need to have ICU care or at the most extreme you need to be placed on a ventilator.
肺に基礎疾患のない方の多くは、肺の予備能が非常に高くなっています。そういう方が肺炎や重いアレルギーなどを発症したり、有害物質を吸い込んだ場合には、多少の症状は出るかもしれませんが、入院や酸素補給、ICUでの治療、最も重篤なケースでは人工呼吸器などが必要となるほど、大きく肺機能が障害されるということはありません。
So the conditions that we're listing here are those underlying conditions that may or may not be related to the Marfan, Loeys-Dietz, vEDS or other disorders but that reduce your underlying pulmonary reserve.
ここに挙げた肺疾患は、MFSやLDS、vEDSといった疾患に関係することもあれば、しないこともありますが、肺の予備能を下げてしまいます。
And those include first restrictive lung disease and this reflects a reduced capacity to take a deep breath in and it's usually revealed on pulmonary function testing and we see this in patients who have severe scoliosis or severe pectus deformities and this is not something that would be reflected in mild impairment on pulmonary function testing but very significant impairment.
まず拘束性肺疾患ですが、深呼吸の能力が低下します。通常は、肺機能検査でわかり、重度の側弯症や胸骨の重度の変形のある患者さんでみられます。軽度の場合は肺機能検査では見つかりませんが、非常に重篤なケースではわかります。
Emphysema is what we often see in patients who have neonatal Marfan syndrome in which you have deterioration of the tissue in the lungs, which can result in kind of large holes or what we call bulla or blebs in the lungs and this again will reduce the overall lung tissue and therefore will reduce your pulmonary reserve.
肺気腫は新生児マルファン症候群の患者さんに多くみられます。肺気腫では肺の組織が劣化し、肺に大きな穴が空いたり、気泡などができます。肺全体の組織が障害されますので、やはり肺の予備能が低下します。
A significant number of our patients also have coexistent asthma, especially those with Loeys-Dietz, but the, the type of asthma that we're concerned about and that places you on a high risk group is asthma that requires chronic medication where you have to use an inhaler every day or you have to use what we call systemic steroids or steroids peel, steroid pills on a frequent basis. And lastly if you've had asthma flares that require hospitalization, that puts you in a high risk asthma group.
マルファン関連疾患の患者さんの非常に多くの方、特にLDSの方は、喘息も合併します。我々が気にする喘息は、毎日吸入器を使うなど、慢性的に薬が必要な方、あるいは頻繁にステロイドの全身投与やステロイド剤を必要とする方です。最後に、入院が必要となるような喘息発作のある方は、高リスクとなります。
COPD either caused by chronic smoking history of smoking or that's an extension of underlying Marfan syndrome or other disorders that also places you at high risk.
慢性的な喫煙歴やマルファン関連疾患が原因となっているCOPDも高リスクです。
Now respiratory insufficiency can reflect any or all of these conditions if severe enough and often will reflect the combination of these different conditions.
呼吸不全がみられる場合は、これらの肺疾患の全てあるいは一部が重度であることを示しており、多くの場合、これらの肺疾患が複数存在することを意味します。
And lastly recurrent pneumothoraces and that's because as I tell all my patients with pneumothoraxis is that when you have each event, you lose some pulmonary tissue that can be replaced by scar. So with a number of these types of events you're losing the reserve that we talked about and that's what places you at a higher risk if you have a COVID-19 infection.
最後は再発性の気胸です。気胸のある患者さんにはお伝えしていていることですが、再発の度に肺の組織が損傷し、瘢痕に置き換わります。そのため、再発が多くなると肺の予備能が低下し、COVID-19に感染するリスクが高まります。
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。
