人體的免疫系統(tǒng)可能會導(dǎo)致一些COVID-19病人崩潰

人體的免疫系統(tǒng)可能會導(dǎo)致一些COVID-19病人崩潰

It's a strange and tragic pattern in some cases of COVID-19: The patient struggles through the first week of illness, and perhaps even begins to feel a little better.

在一些COVID-19病例中，這是一個奇怪而悲慘的模式：病人掙扎度過生病的第一周，甚至可能開始感覺好一點(diǎn)。

Then suddenly they crash.

然后突然他們崩潰了。

"We've seen some patients rapidly worsen," says Dr. Pavan Bhatraju, an assistant professor at the University of Washington who works in the intensive care unit at Harborview Medical Center in Seattle. "They initially were just requiring a little bit of oxygen. In 24 hours they're on a ventilator."

華盛頓大學(xué)助理教授帕萬·巴特拉朱博士在西雅圖港景醫(yī)療中心的重癥監(jiān)護(hù)室工作，他說:“我們看到一些病人的病情迅速惡化。”“他們最初只是需要一點(diǎn)氧氣。24小時后他們就得靠呼吸機(jī)了。”

A recent study by Bhatraju and others found that the patients' lungs appeared to deteriorate quickly. The crash typically happens seven days into the disease and can occur in young, otherwise healthy victims of COVID-19.

巴特拉朱和其他人最近的一項研究發(fā)現(xiàn)，病人的肺似乎迅速惡化。這種疾病通常發(fā)生在發(fā)病后7天，也可能發(fā)生在年輕、健康的COVID-19患者身上。

Now doctors and researchers are increasingly convinced that, in some cases at least, the cause is the body's own immune system overreacting to the virus.

現(xiàn)在醫(yī)生和研究人員越來越相信，至少在某些情況下，其原因是人體自身的免疫系統(tǒng)對病毒反應(yīng)過度。

The problem, known broadly as a "cytokine storm," can happen when the immune system triggers a runaway response that causes more damage to its own cells than to the invader it's trying to fight.

這個問題通常被稱為“細(xì)胞因子風(fēng)暴”，當(dāng)免疫系統(tǒng)觸發(fā)失控反應(yīng)時，它會對自身細(xì)胞造成比它試圖對抗的入侵者更大的傷害。

Cytokines are a wide cast of small molecules in the body that are released by certain cells to help coordinate the battle against infection.

細(xì)胞因子是一種廣泛存在于體內(nèi)的小分子，由特定的細(xì)胞釋放出來，以幫助對抗感染。

Although there's limited data on how the release of too many of these molecules (the cytokine storm) affects COVID-19 patients, some doctors are already treating people who have the disease with powerful anti-inflammatory drugs to try and slow or stop the process. Anecdotally, they say that the approach appears to be helping.

盡管關(guān)于這些分子(細(xì)胞因子風(fēng)暴)的釋放如何影響COVID-19患者的數(shù)據(jù)有限，但一些醫(yī)生已經(jīng)在用強(qiáng)效消炎藥治療患者，試圖減緩或停止這一過程。有趣的是，他們說這種方法似乎有幫助。

"The impact was dramatic," says Dr. Daniel Griffin, chief of infectious disease for ProHEALTH Care Associates, a group of physicians that serves the New York City area. The first six patients he treated all appear to be improving, at least for now, he says. "Yesterday was a good day."

“這種影響是巨大的，”丹尼爾·格里芬博士說，他是ProHEALTH Care協(xié)會的傳染病主管，該協(xié)會是一個服務(wù)于紐約市地區(qū)的醫(yī)生組織。他說，他治療的前6名患者似乎都在好轉(zhuǎn)，至少目前是這樣。”昨天是個好日子。”

But other researchers caution that the untested treatments carry significant risks. Suppressing the body's immune system at the exact moment it's trying to fight off the deadly coronavirus could have all sorts of unintended consequences, warns Dr. Tobias Hohl, the chief of infectious disease at Memorial Sloan Kettering Cancer Center in New York City. "The infection could get worse," Hohl says.

但其他研究人員警告說，未經(jīng)測試的治療方法有很大的風(fēng)險。紐約市紀(jì)念斯隆-凱特琳癌癥中心傳染病科主任托拜厄斯·霍爾博士警告說，在人體免疫系統(tǒng)試圖擊退致命的冠狀病毒的時候，抑制免疫系統(tǒng)可能會產(chǎn)生各種意想不到的后果。“感染可能會變得更嚴(yán)重，”霍爾說。

Collateral damage

附帶損害

The body's immune system is, at the moment, the most effective weapon people have against COVID-19. The majority of patients can cure themselves of the disease simply by resting at home — enabling a small army of their own cells to attack the infection.

目前，人體的免疫系統(tǒng)是對抗COVID-19最有效的武器。大多數(shù)患者只需在家休息就能治愈這種疾病，使得他們自己的一小群細(xì)胞能夠攻擊這種感染。

Those cells make it harder for the virus to replicate, and help to develop antibodies that prevent it from infecting new cells. Those antibodies also likely help provide some protection against reinfection by the COVID-19 virus further down the road.

這些細(xì)胞使病毒更難復(fù)制，并有助于產(chǎn)生抗體，防止病毒感染新的細(xì)胞。這些抗體也可能有助于提供一些保護(hù)，防止再次感染COVID-19病毒。

But the army of the immune system can also do collateral damage, Jessica Hamerman, an immunologist at Benaroya Research Institute in Seattle, explains. When immune cells try to fight an infection, "they make a lot of toxic molecules, and those toxic molecules can cause a lot of tissue damage."

但是，免疫系統(tǒng)也會造成附帶損害。西雅圖貝納羅亞研究所的免疫學(xué)家杰西卡·哈默曼解釋說，當(dāng)免疫細(xì)胞試圖對抗感染時，“它們會產(chǎn)生很多有毒分子，這些有毒分子會造成很多組織損傷。”