The corona virus has had Germany under control for weeks. In most cases, the symptoms are no more serious than with a flu-like infection, but it can be dangerous for patients with previous illnesses. Martin Witzenrath, professor of pulmonary medicine and deputy head of the clinic for infectious diseases and pneumology at the Berlin Charité, explains what the course of the disease of corona-infected people looks like in an interview with ntv.de.
ntv.de: Mr. Witzenrath, can one speak of a “typical” course of the disease in coronavirus patients? If so, what does it look like?
Martin Witzenrath: Yes, you can do that. An infected person does not notice anything at first. After a few days, the first symptoms in the upper airways begin. It feels like a mild cold. In the course of the disease, most people have a fever and a dry cough. There are also general symptoms such as fatigue, fatigue, sore throat, less often muscle or joint pain and chills. Most people are then through with the disease, but about 20 percent of them are more seriously ill, mainly older people. In the further course they develop a deep respiratory infection in the sense of pneumonia. And a few of them develop lung failure a few days later.
An Italian doctor had recently described his experience in dealing with Covid 19 patients in a well-received Facebook entry. He named bilateral pneumonia as the leading cause of death. Does this match your experience?
Patients who die from the coronavirus either die from bilateral pneumonia or develop so-called sepsis, i.e. blood poisoning. In some cases, patients get and die from cardiovascular problems. However, these are often patients who have had cardiovascular problems before.
What we know so far is that approximately three quarters of corona patients who actually develop pneumonia also develop bilateral pneumonia. But that also means that about a quarter of the patients have unilateral pneumonia. One-sided pneumonia does not rule out the diagnosis of coronavirus.
How are bilateral pneumonia treated? These are not all unknown symptoms.
Right, of course we know bilateral pneumonia, usually from other pathogens, such as bacteria or viruses, for example the influenza virus. We can give antibiotics to the bacteria. With the influenza virus, we have a drug that we can use. But there is none yet with the corona virus. We are then only given measures such as oxygen and, in an emergency, artificial ventilation.
Do we have enough ventilation places in German hospitals?
We are fortunate in Germany that we have a relatively large number of intensively inpatient beds or places per inhabitant. But of course the situation can arise that so many people are ill at the same time and places could therefore become scarce. We have to prevent this and we are doing that at the moment.
Nevertheless, artificial ventilation does not help in all cases, as can be seen from the many deaths, for example in Italy. The seriously ill corona patients are also artificially ventilated there, right?
It is true that sometimes you die of pneumonia despite ventilation. The particular problem in Italy is that there are significantly fewer ventilation places per inhabitant. And the resources there are simply completely used up, we hear that from our colleagues in Italy time and time again. Apparently there are also patients who actually no longer have space. This means that in some cases, patients with clearly pre-existing conditions no longer get a place in an intensive care unit because the places are simply too few and far between.
Kevin Schulte spoke to Martin Witzenrath
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