新冠病毒|料冬季再掀新一波疫情 重症高危族群達20類人遠超你所想

新冠病毒在過去數年為全球帶來巨大影響，隨着社會復常，不少人已脫下口罩生活一段時間，但千萬不要忘記，新冠病毒仍然存在於社區之中，高風險人士一旦受感染，更有機會出現重症，嚴重影響健康甚至威脅性命。¹感染及傳染病科專科林緯遜醫生表示：「高風險患者應把握治療黃金期，盡快接受適切治療，以預防出現重症。²」

料冬季將有新一波新冠感染高峰

不同專家均指出，在天氣轉冷的季節，新冠病毒會變得更為活躍，可能引發新一波疫情。³'⁴林緯遜醫生指原因有數個，包括病毒在低溫環境下存活的時間較長，且冬天有較多人在室內聚集，亦會加速呼吸道疾病的傳播。³'⁴此外，經過數年新冠疫情，不論期間有否接種疫苗、有否受感染，其實抗體水平均會隨着時間下降，⁵林緯遜醫生說：「香港大約在數個月前曾出現一次感染高峰，隨着市民整體抗體水平下降，預料在冬季會有另一波新冠感染高峰。³'⁵⁻⁷」

新冠與流感部分症狀相似

天氣轉涼轉冷，容易著涼，到底我們能否分辨自己是患上流感抑或感染新冠病毒？林緯遜醫生解釋，流感及新冠病毒感染有相似及相異之處，相似在於兩者均會入侵上呼吸道，因此上呼吸道感染的病徵會非常相似，例如發燒、喉嚨痛及流鼻水等。⁸⁻¹¹林緯遜醫生補充：「不過新冠病毒相比流感，可能較高機會出現下呼吸道病徵，如呼吸困難、咳嗽且帶有黃痰。¹²⁻¹⁵另外有部分病徵是感染新冠病毒獨有，如嗅覺及味覺減退。¹³'¹⁴」

長者及多類慢性病患者屬重症高風險族群

經歷數年疫情，不少市民都經不同渠道，如政府宣傳、醫生及專家訪問，知道重症新冠肺炎的高危一族，包括60歲或以上長者或長期病患者等。¹⁶林緯遜醫生指出，年紀越大，出現重症的比率越高，因此年紀大（60歲或以上）是其中一個最主要的因素。¹⁶'¹⁷其次，有否接種新冠疫苗亦是關鍵因素之一，雖然疫苗不能百分百預防感染，但對於預防重症及死亡的效能非常高。¹⁸'¹⁹另外，患有慢性疾病，以及因其他疾病導致免疫系統受損，均會增加重症風險。¹參考美國疾控中心（CDC）的資料，有超過20種身體狀況或疾病，均會在感染新冠後較易得到重症，包括有情緒或精神障礙、缺乏運動、阿茲海默症、癌症、慢性腎病、慢性肝病、慢性肺病、糖尿病、殘障、心臟病、愛滋病毒感染、免疫系統減弱、肥胖、懷孕、地中海貧血、吸煙、曾進行器官移植、中風、酗酒等。¹

高危人士不論症狀輕重　均應考慮新冠口服抗病毒藥物

香港自第五波疫情開始，向新冠患者處方兩款新冠口服抗病毒藥物。²⁰根據政府指引，醫生可向60歲或以上，又或未滿60歲但患有慢性病的人士，免費處方新冠口服抗病毒藥物，合資格患者可向公營醫療機構如醫管局轄下普通科門診等，又或向超過660位私家醫生求診及免費獲得處方藥物。²⁰⁻²²至於其他有需要人士，經醫生診斷後，亦可選擇自費服用新冠口服抗病毒藥物。²²

林緯遜醫生強調，新冠口服抗病毒藥物的主要作用並非紓緩患者的病徵及不適，而是預防重症，因此高風險患者即使發病初期病徵輕微，亦應考慮服用此類藥物。²他解釋：「根據本地指引，患者應在病發後5天內服用。²³高風險患者應把握治療黃金期，盡快接受適切治療，因為即使初始症狀輕微，患者亦無法預視病情會否在數日後惡化。²'²⁴」根據林緯遜醫生的觀察，病徵不明顯便毋須就診及服藥是不少人的謬誤，過往亦有年長患者在求診時對藥物抱懷疑態度，但只要向他們解釋清楚藥物的作用，大部分患者仍會遵循建議服藥。

勿自行停藥　患長期病應向醫生說明

服用新冠口服抗病毒藥物有數點需要注意，首先是必須依照醫生指示服藥及完成療程。²⁵'²⁶林緯遜醫生提醒：「即使快速測試呈陰性亦不應自行停藥，因為快測不一定能準確量化病毒量，陰性亦不代表體內沒有病毒。²⁶'²⁷另外，過早停藥有機會增加抗藥性風險，情況並不理想。²⁸」此外，患者在求診時應向醫生說明自己有否藥物敏感、慢性疾病、長期服用其他藥物，因為部分藥物有機會與新冠口服抗病毒藥物相沖，林緯遜醫生補充：「所謂相沖並不一定屬禁忌症，不能服用新冠口服抗病毒藥物。有機會只需作出調整，患者便可非常安全地完成抗病毒藥物療程。²⁷'²⁹⁻³¹」有部分市民或擔心新冠口服抗病毒藥物有副作用，又或對這類藥物的安全性有懷疑，不過林緯遜醫生指出，短期服用這類藥物的安全性甚高，基本上亦不會構成嚴重副作用。³⁰'³¹

以上資訊由輝瑞香港提供

PP-C1D-HKG-0018 FEB 2024

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