With Influenza and RSV, even multiple waves are burdening the hospitals, emphasized lung specialist Arschang Valipour in an APA interview.

Thousands Hospitalised with Corona

There were 979 hospital admissions due to severe respiratory diseases with the diagnosis of Covid-19 in the 41st calendar week of the previous year, 38 of them in intensive care. Including the weeks before and after, thousands with Corona ended up in the hospital last autumn and this winter. This is shown by the SARI dashboard (Severe Acute Respiratory Infections) of the umbrella organisation of social insurance carriers, which has been providing an overview of the distribution of such diseases in clinics since the end of the reporting obligation for a SARS-CoV-2 infection in the summer of 2023. A closer look at the peak of this Covid wave reveals that about 2,000 people with various SARI diseases were admitted that week, Valipour explained.

"The health system is no longer acutely burdened," said the doctor working at the Vienna Floridsdorf clinic. But such waves naturally have effects. "A not insignificant part of the beds were occupied by the case numbers in the fall." Covid-19 has joined the already known respiratory diseases, "but it is an addition to the disease patterns that did not exist five years ago". The Corona wave is already flatter, "but not to be neglected", now there is the Influenza wave and according to the SARI dashboard, increasing RSV numbers (Respiratory Syncytial Virus) in the hospitals since the turn of the year.

What is often "not taken into account in the hospital sector is that high infection numbers bring two waves of disease," Valipour emphasized. One is the acute wave of infection, the other so-called secondary infections one to three months later, for example people who then get bacterial pneumonia. It does not necessarily have to have been a severe Covid infection before, but the protection against further infections is temporarily suspended.

The risk of ending up in the hospital with subsequent infections or with worsening of any underlying diseases is increased in the first 90 days after an infection. Covid can, for example, lead to a derailment of an existing diabetes disease or to a heart attack. Especially older people are weakened after an infection and often need home care or admission to a nursing home.

Especially Older People in Hospital

Due to acute Covid-19 illness, it is primarily the elderly who continue to be hospitalised. The risk "increases with advancing age - significantly at 60 years, with over 80 almost three times as many as those over 60 are affected," said Valipour. The SARI dashboard also shows slightly increased hospitalisation numbers for those under four years old. Very small children generally have more frequent respiratory infections and their lung protection is not yet fully developed, explained the doctor. People with comorbidities such as severe obesity, cancer, cardiovascular and lung diseases, high blood pressure, diabetes or a weakened immune system are still more frequently hospitalised with Corona.

What has "changed since the SARS-CoV-2 outbreak five years ago is the likelihood of a severe infection," said Valipour. "The vast majority of infections do not lead to hospitalisation." Here, vaccination plays a role, although its protection in the elderly "rapidly decreases after three to four months". Mortality has also significantly decreased and is one to three percent for those who need to be hospitalised, reported the pulmonologist and intensive care physician. In addition to immunisation in the population, this is also due to the administration of antiviral drugs.

In severe cases of Covid-19, according to Valipour, "classic pneumonia" is still possible. This can be accompanied by increased temperature or fever, shortness of breath, and the worsening of pre-existing conditions. When hospitalised, Covid-19 is often seen as the primary cause.

The treatment in the hospital has not changed significantly in the past two years. There are the known antiviral drugs against inflammation in the respiratory tract, which are approved for Covid-19, and "a multitude of new developments, but no new ones that are approved and available in clinical everyday life". In total, good effectiveness can be achieved. If a patient also has too little oxygen saturation, oxygen is administered and antibiotics are given in case of an additional bacterial infection.

Hygiene Measures

In dealing with Corona-infected patients, hygiene measures continue to apply in the hospital. However, routine has set in and the disease is treated just like the flu. "You protect yourself from an aerosol-transmitted disease," said Valipour. Patients are isolated and - if possible - not brought into contact with others and ideally accommodated in a single room or with another infected person in a double room.

People who have an increased risk of severe courses due to their age or pre-existing conditions should still get vaccinated and take medication against Covid-19 in case of infection, advises Valipour. "From the age of 60, I would recommend it regardless of comorbidities," he said.

(APA/Red)

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