肥胖COVID-19病人之早期治療與照護

Abstract

嚴重特殊傳染性肺炎（COVID-19）造成整個世界健康與經濟重大衝擊與危機，尤其是高齡和慢性病患者更容易產生預後合併症、重症和死亡。然而流行病學證據顯示肥胖者，即使年輕（< 65歲），不論有無慢性疾病史，較非肥胖者易感染SARS-CoV-2病毒和發生感染後的重症與死亡。因此本文整理肥胖者較易感染SARS-CoV-2 的生病理機轉、口服抗病毒藥物（Paxlovid & Molnupiravir）使用相關知識、慢性病藥物調整和居家照護時的生活型態，包括營養攝取及運動方式建議，期待第一線的專科護理師對「肥胖」這個危險因子具有敏感性，可以收集相關病史與身體檢查評估資料，不論在口服抗病毒或慢性病藥物（尤其是高血壓、高血脂和抗凝劑等）使用與生活型態調整、營養補充都能與醫師討論做出最有利的建議，以期早期治療COVID-19，避免重症和死亡的發生。

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The COVID-19 pandemic severely impacted the health and economics of the entire world since De&shy;cember 2019, particularly to the elderly and people with chronic diseases for a higher possibility of aggravations, complications and even death. However, the epidemiological evidence showed that obese people are prone to SARS-CoV-2 infection and post-COVID complications. This review reported the mechanism of SARS-CoV-2 entry into fat cells, COVID-19 medications (Paxlovid & Molnupiravir) and treatments, chronic disease (e.g. hypertension, hyperlipidemia, and anticoagulation etc.) manage&shy;ment, and lifestyle (diet and exercise) modification. Nurse practitioners should consider obese as a significant risk factor while designing management plans with doctors and initiate the anti-COVID-19 treatment plan as soon as possible for complication prevention among obese cases.

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