新型冠状病毒是如何致死的

新型冠状病毒是如何致死的

More than 1.300 people, almost all in China, have now died from COVID-19 — the newly minted name for the coronavirus disease first identified in Wuhan, China, that has infected more than 55.000 people.

目前已有1300多人死于COVID-19.几乎所有人都在中国。COVID-19是在中国武汉首次发现的冠状病毒病的新名称，已感染超过5.5万人。

Yet according to the World Health Organization, the disease is relatively mild in about 80% of cases, based on preliminary data from China.

然而，根据世界卫生组织的数据，根据中国的初步数据，大约80%的病例病情相对较轻。

What does mild mean?

(病情)较轻是什么意思?

And how does this disease turn fatal?

这种疾病是如何致命的?

The first symptoms of COVID-19 are pretty common with respiratory illnesses — fever, a dry cough and shortness of breath, says Dr. Carlos del Rio, a professor of medicine and global health at Emory University who has consulted with colleagues treating coronavirus patients in China and Germany.

埃默里大学医学和全球卫生教授卡洛斯·德尔里奥博士表示，COVID-19的首批症状在呼吸道疾病中相当常见-发烧、干咳和呼吸急促。他曾与中国和德国治疗冠状病毒患者的同事进行过咨询。

"Some people also get a headache, sore throat," he says. Fatigue has also been reported — and less commonly, diarrhea. It may feel as if you have a cold.

“有些人还会头疼，喉咙痛，”他说。疲劳也有报道-但不太常见的是腹泻。可能会觉得你好像感冒了。

Doctors say these patients with milder symptoms should check in with their physician to make sure their symptoms don't progress to something more serious, but they don't require major medical intervention.

医生说，这些症状较轻的患者应该咨询他们的医生，以确保他们的症状不会发展到更严重的程度，但他们不需要重大的医疗干预。

But the new coronavirus attacks the lungs, and in about 20% of patients, infections can get more serious. As the virus enters lung cells, it starts to replicate, destroying the cells, explains Dr. Yoko Furuya, an infectious disease specialist at Columbia University Irving Medical Center.

但这种新的冠状病毒会攻击肺部，在大约20%的患者中，感染可能会变得更严重。哥伦比亚大学欧文医学中心的传染病专家古屋洋子博士解释说，当病毒进入肺细胞时，它开始复制，破坏细胞。

"Because our body senses all of those viruses as basically foreign invaders, that triggers our immune system to sweep in and try to contain and control the virus and stop it from making more and more copies of itself," she says.

她说：“因为我们的身体感觉到所有这些病毒基本上都是外来入侵者，这就触发了我们的免疫系统，试图控制病毒，阻止它复制越来越多的病毒。”

But Furuya says that this immune system response to this invader can also destroy lung tissue and cause inflammation. The end result can be pneumonia. That means the air sacs in the lungs become inflamed and filled with fluid, making it harder to breathe.

但古屋说，这种免疫系统对这种入侵者的反应也会破坏肺组织，引起炎症。最终结果可能是肺炎。这意味着肺部的气囊会发炎并充满液体，使呼吸变得困难。

Del Rio says that these symptoms can also make it harder for the lungs to get oxygen to your blood, potentially triggering a cascade of problems. "The lack of oxygen leads to more inflammation, more problems in the body. Organs need oxygen to function, right? So when you don't have oxygen there, then your liver dies and your kidney dies," he says.

德尔里奥说，这些症状还会使肺部更难将氧气输送到血液中，可能会引发一系列问题。他说：“缺氧会导致更多的炎症，更多的身体问题。器官需要氧气才能发挥作用，对吧?所以当你没有氧气的时候，你的肝脏和肾脏就会死亡。”

That's what seems to be happening in the most severe cases. About 3% to 5% of patients end up in intensive care, according to the WHO. And many hospitalized patients require supplemental oxygen.

这似乎就是在最严重的情况下发生的事情。根据世界卫生组织的数据，大约3%到5%的患者最终进入了重症监护。而且许多住院病人需要补充氧气。

In extreme cases, they need mechanical ventilation — including the use of a sophisticated technology known as ECMO(extracorporeal membrane oxygenation), which basically acts as the patient's lungs, adding oxygen to their blood and removing carbon dioxide. The technology "allows us to save more severe patients," Dr. Sylvie Briand, director of the WHO's pandemic and epidemic diseases department, said at a press conference Monday.

在极端情况下，他们需要机械通气-包括使用一种名为ECMO(体外膜氧合)的复杂技术，这种技术基本上充当患者的肺部，为他们的血液增加氧气，并清除二氧化碳。世卫组织流行病和流行病部主任塞尔维布利阳博士在周一的新闻发布会上说，这项技术“允许我们拯救更多的危重患者”。

Many of the more serious cases have been in people who are middle-aged and elderly — Furuya notes that our immune system gets weaker as we age. She says for long-term smokers, it could be even worse because their airways and lungs are more vulnerable. People with other underlying medical conditions, such as heart disease, diabetes or chronic lung disease, have also proved most vulnerable. Furuya says those kinds of conditions can make it harder for the body to recover from infections.

许多更严重的病例发生在中老年人身上-古屋指出，随着年龄的增长，我们的免疫系统会变得更弱。她说，对于长期吸烟者来说，情况可能更糟，因为他们的气道和肺部更容易受到伤害。患有其他潜在疾病的人，如心脏病、糖尿病或慢性肺病，也被证明是最脆弱的。古屋说，这种情况会使身体更难从感染中恢复。

"Of course, you have outliers — people who are young and otherwise previously healthy who are dying," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently told NPR's 1A show. "But if you look at the vast majority of the people who have serious disease and who will ultimately die, they are in that group that are either elderly and/or have underlying conditions."

美国国家过敏和传染病研究所所长安东尼·福奇博士最近在接受NPR的1A节目采访时表示：“当然，也有异常--那些年轻的、原本健康的人，他们正在死去，”但如果你看看绝大多数患有严重疾病并最终将死亡的人，他们要么是老年人和/或有潜在疾病的人。

The WHO has said most deaths so far appear to be from multi-organ failure and has calculated the case fatality rate at about 2% or less, based on earlier data from China. However, infectious disease experts note that it's hard to know the true numbers at this point in the epidemic.

世卫组织表示，到目前为止，大多数死亡似乎是由多器官衰竭造成的，并根据中国早先的数据计算出病死率约为2%或更低。然而，传染病专家指出，目前很难知道疫情的真实数字。