Recently, several provinces released survey data, and the positive infection rate in some places in COVID-19 exceeded 60%. On February 29th, 2022, at 65438, Xuefeng Tang, secretary of the Party Committee and researcher of Sichuan Provincial Center for Disease Control and Prevention, said in an interview, "We completed the online questionnaire survey twice from June 5438+February 17 to June 5438+09 and from 25th to 28th, with 480,000 people and more than 230,000 people participating in the survey respectively." Xuefeng Tang said that according to the survey results, the overall infection rate of Sichuan residents has exceeded 80%.

In many places, the first wave of COVID-19 infected people who have suffered from the peak of infection have turned negative one after another, and gradually returned to normal work and life. At the same time, the physical condition after "Yang Kang" has also been widely concerned and discussed, and related topics such as "Beware of viral myocarditis after Yang Kang", "Recovering Yang" and "Yang Kang's brain fog" have rushed to hot search.

"Don't be too afraid and anxious. Under the premise of a huge infection base, due to individual physical differences, it will show various symptoms. " Guo Wei, deputy director of the Department of Infectious Diseases, tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, told China Newsweek that "Yang Kang" doesn't mean you can be unscrupulous. Even after Yang Kang, you should rest for at least 2-3 weeks and avoid strenuous exercise during this period. At the same time, strengthen personal protection, improve your immunity and try to avoid multiple infections.

COVID-19 infection is a risk factor for myocarditis.

Myocarditis is a non-ischemic, inflammatory myocardial disease, which will reduce the pumping ability of the heart. This kind of inflammation can cause the heart to beat rapidly or irregularly, which will lead to arrhythmia.

According to a study published in Chinese Journal of Internal Medicine on June 1 1 2022, the number of myocarditis patients, new cases and deaths in China in 20 19 were 234,900, 275 10,1.3655 respectively. The morbidity and mortality were16.94/10,000 and 0.92/10,000, which were 6.06% and 16.04% lower than 190, respectively.

"Compared with 1990, the disease burden of myocarditis in China showed a downward trend in 20 19 years. The disease burden of myocarditis in male population is higher than that in female population, and attention should be paid to the disease burden of myocarditis in the elderly population in China, the study wrote.

A study published by the Centers for Disease Control and Prevention (CDC) in September, 20021included data from more than 900 hospitals, * * * included more than 36 million patients, 4.0% of whom were diagnosed with COVID-19 infection from March to June, 2020, 20021,0.0/kloc.

The results showed that from March 2020 to 202 1 and 1 month, the risk of myocarditis in COVID-19 patients was nearly 16 times that in non-COVID-19 patients. In addition, about 40% patients with myocarditis in this study cohort have a history of COVID-19 infection. "These findings indicate that there is a correlation between COVID-19 infection and myocarditis, although it is impossible to infer causality from the observed data." This study points out that COVID-19 infection is a risk factor for myocarditis, and its risk varies with age groups.

Many infectious diseases doctors told China Newsweek that myocarditis was not only caused by COVID-19, but also by all respiratory pathogens. Because there are a large number of infected people in this epidemic, even though the incidence of myocarditis itself is very low, some related cases can still be seen.

Zhao Lan, deputy chief physician of infection department of a 3A hospital in Xi, told the reporter of China Newsweek that the probability of myocarditis after COVID-19 infection is far lower than that of severe cases. Before the outbreak in COVID-19, influenza virus, adenovirus, coxsackie virus and other virus infections always existed. These infections may induce myocarditis, but the probability is very low.

"According to published data, the proportion of myocarditis diagnosed after infection with Omicron strains is 2 ‰ ~ 3 ‰. When the number of infected people is large, attention should be paid to the problem of myocardial injury. " Xue, deputy director and chief physician of Cardiovascular Department of Guangdong Provincial People's Hospital, spoke in an expert interview on February 30th, 65438.

"In the recent diagnosis and treatment process, many patients were found to have symptoms such as increased heart rate after Yang Kang. After checking troponin and other indicators, it was found that the myocardium was slightly damaged. " Guo Wei said that in the past, some patients had a resting heart rate of 50-70 beats/min when they slept at night, but after being infected with COVID-19, this value increased to 80- 100 beats/min. Among the COVID-19 patients admitted to Guo Wei, the patients with these symptoms were not finally diagnosed as myocarditis, but only had chest tightness, rapid heart rate, palpitation and other symptoms during the recovery period.

A chief physician from the Department of Critical Care Medicine of a 3A hospital in Wuhan told the reporter of China Newsweek that the diagnosis of myocarditis cannot be determined by a single index, and besides blood test, it also needs the help of imaging examination. Many people find that the increase of some indexes such as myocardial enzymes does not mean that they have myocarditis. However, when the body has symptoms such as increased heart rate, shortness of breath and chest tightness, it will attract attention.

"After Yang Kang, we should pay attention to the daily heart rate changes of individuals." In Guo Wei's view, if the heartbeat is obviously accelerated, especially if it is too fast for a long time, it is necessary to seek medical advice in time. Speaking of heart problems, the condition is more urgent than pneumonia in the lungs. If it is really serious, arrhythmia, myocardial ischemia and even sudden death may suddenly occur, so we should not take it lightly.

"After being infected with COVID-19 virus, the probability of heart failure is very low. Generally, for patients with mild symptoms, more rest in daily life will restore myocardial injury. " Guo Wei added.

On February 29th, 2022, at 65438, official website, the Beijing Municipal Health and Health Commission issued the Expert Guide for Health Management of novel coronavirus Infected Persons in Recovery Period (First Edition), which mentioned that some patients had symptoms of palpitation and palpitation during the recovery period of COVID-19 infection. At this time, it was suggested that we should pay more attention to rest, adjust our daily routine, keep enough sleep, strengthen our own nutrition, eat more foods rich in protein and vitamins, and improve our body's disease resistance. If the symptoms of palpitation are obvious, the pulse lasts more than 60 times per minute 100, or irregular pulse occurs, we should be alert to the occurrence of viral myocarditis, and suggest going to the hospital for examination in time to find out the reasons and take measures.

Can COVID-19 infection cause kidney damage?

"The high season of respiratory and intestinal infectious diseases is also the high season of myocarditis. The affected population covers all ages. Usually healthy, young people without basic diseases also have the possibility of myocarditis. " Zhao Lan said that myocarditis is also divided into mild and severe. Mild viral myocarditis is mostly just a high marker of myocardial injury, with slight changes in ECG, but no obvious symptoms of myocarditis. In severe cases, if fulminant myocarditis occurs, sudden death will occur seriously, but rarely.

According to the report of the Central Broadcasting Network on June 5438+February 3, 2022/KLOC-0, the team of Professor Apollo, Dean of Cardiovascular Hospital of the Second Affiliated Hospital of Harbin Medical University, successfully treated two patients with sudden fulminant myocarditis due to COVID-19 infection by using extracorporeal membrane oxygenation technology.

"From a medical point of view, the pathogenesis of fulminant myocarditis is not very clear at present, and it may also be related to the patient's specific constitution and COVID-19 infection. This is a small probability event." Zhao Wei said. When fulminant myocarditis occurs, the heart rate is particularly fast, and symptoms such as severe fatigue, chest tightness and chest pain may occur. The gold standard for the diagnosis of myocarditis is myocardial biopsy, but many fulminant myocarditis are acute, and the disease progresses rapidly within a day or two or even hours. Once the patient has severe heart failure, extracorporeal membrane oxygenation should be used urgently for supportive treatment.

"Some patients with COVID-19 infection will have chest tightness and shortness of breath. These symptoms do not necessarily mean that there is a problem with the heart, but may also be related to respiratory symptoms, personal depression and anxiety. " Zhao Wei said.

In addition to myocarditis, most patients with "Yang Kang's disease" also have symptoms such as persistent cough, loss of smell and taste. "Most of the COVID-19 patients hospitalized in the hospital are severe, and most of them go to the general outpatient clinic for mild symptoms. The latter has symptoms such as persistent dry cough." Guo Wei said that the number of people who come to the outpatient department of the hospital for CT scanning has increased a lot recently. According to the hospital's CT results, except for patients with chronic cough, CT results suggest that there are scattered small lesions in the lungs, and most outpatient patients do not have obvious pneumonia. "If you continue to cough, accompanied by coughing and coughing yellow-green sputum, you need to go to the hospital in time." Guo Wei suggested.

"After being infected with COVID-19 virus, some people's symptoms may last for about two weeks." Zhao Lan said that for most people, the sense of smell and taste can generally be restored within three months after being infected with COVID-19 virus.

A few days ago, after "Yang Kang" appeared "brain fog" symptoms, rushed to the hot search. Wang * * * Qiang, chief physician of Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Traditional Chinese Medicine, said in an interview with the media that the causal relationship between COVID-19 and' brain fog' has not been studied yet. However, we can infer that physical and mental fatigue and weakness caused by COVID-19 infection will also cause us to have symptoms of' brain fog' to some extent.

Studies have shown that COVID-19 is infected mainly through the binding of spike protein on its surface with ACE2 receptor on human cells. From 202 1 to 10, a study in Nature mentioned that although COVID-19's infection is mainly respiratory tract, the highest level of ACE2 receptor is also found in small intestine, testis, kidney, myocardium, colon and thyroid.

Can COVID-19 infection cause kidney damage? The chief physician of the Department of Critical Care Medicine of Wuhan 3A Hospital said that this is related to the severity of the patient's own condition. The incidence of renal injury is very low in patients with mild COVID-19's disease. "If you are a COVID-19 patient with severe or basic diseases in COVID-19, the probability of kidney injury is relatively high, which can reach 20% ~ 30%".

"Checking renal damage mainly depends on whether some renal function indicators have increased, and the correlation with urinary protein indicators is not very close." The chief physician of the Department of Critical Care Medicine said.

COVID-19's mutation continues. According to the data predicted by the Centers for Disease Control and Prevention (CDC), from February 25, 2022 to February 25, 2022, the proportion of mutant branch XBB. 1.5 of Omicron was 40.5%, almost doubled from 2 1.7% in the previous week.

Jin Dongyan, a professor and virologist at the School of Biomedicine, Li Ka-shing Medical College of the University of Hong Kong, told China Newsweek that at present, the virus strain has only caused a slight increase in the number of confirmed cases in the United States, and the number of hospitalizations and deaths has not changed significantly. "Even XBB. 1.5 has not changed the fact that COVID-19 has become an endemic disease in the United States." Jin Dongyan stressed.

Dong Li, the chief physician of the Department of Respiratory and Infectious Diseases of Beijing You 'an Hospital, once reminded the public that after being infected with BA.5 for a period of time, the level of protection will drop, and the risk of reinfection will increase when encountering a strain with strong immune escape ability. But reinfection mainly occurs in some people with low immunity. People with normal immune function have less risk of reinfection in a short time, and the symptoms after infection are usually lighter than the first time.

Guo Wei suggested that personal protection should be actively carried out in daily life, and protective measures should be taken, such as wearing masks in public places, keeping social distance and avoiding places where people gather.

(Zhao Lan is a pseudonym in the text)

Author: Niuhe