Seguimiento de los pacientes luego de una neumonía por COVID-19.
Secuelas pulmonares.
Palabras clave:
seguimiento, neumonía, COVID-19, secuelas, pruebas de función pulmonarResumen
La enfermedad por coronavirus 2019 (COVID-19) es una infección causada por el virus SARS-CoV-2. La COVID-19 ha ocasionado una pandemia sin precedentes, con una gran cantidad de infectados y muertos a nivel mundial. Aunque la mayoría de los casos son leves, existe una cantidad considerable de pacientes que desarrollan una neumonía o incluso un síndrome de distrés respiratorio agudo (SDRA). Luego de recuperarse del cuadro inicial, muchos pacientes continúan con diversos síntomas (fatiga, tos seca, fiebre, disnea, anosmia, dolor torácico, entre otras.) lo que ha llevado a considerar la posible existencia del “síndrome post COVID-19”. Aunque la definición y validez de este síndrome aún no son claras, varios estudios reportan que los individuos recuperados de la COVID-19 pueden tener persistencia de síntomas, anormalidades radiológicas y compromiso en la función respiratoria. La evidencia actual sugiere que existe una gran cantidad de secuelas pulmonares luego de una neumonía por COVID-19 (engrosamiento intersticial, infiltrado en vidrio esmerilado, patrón en empedrado, bronquiectasias, entre otras.). De igual forma parece ser que las pruebas de función pulmonar (espirometría, DLCO, PC6M y la medición de las presiones respiratorias máximas) además de la tomografía axial computarizada de alta resolución son útiles para la evaluación de estas secuelas pulmonares post COVID-19. En esta revisión se pretende describir las posibles secuelas a nivel pulmonar luego de una neumonía por COVID-19, además de sugerir procedimientos diagnósticos para su correcta evaluación y seguimiento; permitiendo un manejo adecuado por parte de un equipo médico multidisciplinario.
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