2023-05-09 05:00:00
Although many risk factors such as gender, age, frailty, pregnancy or obesity are now known, it is still not completely clear why some people develop a severe and others a mild course of Covid-19.
A very small study from Germany last year substantiated the theory of a so-called cytokine storm: the immune system overshoots the target and with this exaggerated reaction sometimes causes more damage than the virus itself.
A recent US study analyzed the health data of 585 patients in the intensive care unit at Northwestern Memorial Hospital in Chicago: All were diagnosed with severe pneumonia and respiratory failure, 190 patients were infected with the corona virus. And came to another realization.
The result: Bacterial secondary infections of the lungs (pneumonia) were extremely common in patients with Covid-19 and affected almost half of the patients who required mechanical ventilation. If this does not subside, secondary bacterial infection has been a major cause of death in patients with Covid-19. The scientists could not find any evidence that Covid-19 causes a “cytokine storm” that leads to death.
The study was recently published in Journal of Clinical Investigation published. (You can read the study in English here.)
Bacterial superinfection
The importance of bacterial superinfection of the lungs as a risk factor in patients with Covid-19 has been underestimated because most centers have not looked for it, the study authors said. “Our study underscores the importance of preventing, screening for, and aggressively treating secondary bacterial pneumonia in critically ill patients with severe pneumonia, including those with Covid-19,” says pulmonary and critical care physician Benjamin Singer, lead author of the study and Professor of Medicine at Northwestern University Feinberg School of Medicine.
“Those who recovered from their secondary pneumonia had a high probability of survival, while those whose pneumonia did not resolve were more likely to die,” Singer said. “Our data suggest that mortality associated with the virus itself is relatively low, but that other factors encountered during the ICU stay, such as secondary bacterial pneumonia, offset this.”
The results of the study would disprove the cytokine storm theory, according to Singer: “The term ‘cytokine storm’ means overwhelming inflammation that leads to organ failure in the lungs, kidneys, brain and other organs. If the cytokine storm is the cause of the long If the length of stay was what we see in patients with Covid-19, we would expect multi-organ failure to occur frequently, but we haven’t seen that.”
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