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.
Citas
Muertes por COVID19 en América Latina y el Caribe. Statista. Accessed November 30, 2020. https://es.statista.com/estadisticas/1105336/covid-19-numero-fallecidos-america-latina-caribe/
Machhi J, Herskovitz J, Senan AM, et al. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol. Published online July 21, 2020:1-28. doi:10.1007/s11481-020-09944-5
Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061. doi:10.1001/jama.2020.1585
Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. Published online August 11, 2020:m3026. doi:10.1136/bmj.m3026
Hui DS, Joynt GM, Wong KT, et al. Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax. 2005;60(5):401-409. doi:10.1136/thx.2004.030205
Das KM, Lee EY, Singh R, et al. Follow-up chest radiographic findings in patients with MERS-CoV after recovery. Indian J Radiol Imaging. 2017;27(3):342-349. doi:10.4103/ijri.IJRI_469_16
Hui DS, Wong KT, Ko FW, et al. The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivors. Chest. 2005;128(4):2247-2261. doi:10.1378/chest.128.4.2247
Ong K-C, Ng AW-K, Lee LS-U, et al. 1-Year Pulmonary Function and Health Status in Survivors of Severe Acute Respiratory Syndrome. Chest. 2005;128(3):1393-1400. doi:10.1378/chest.128.3.1393
Zhang P, Li J, Liu H, et al. Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome: a 15-year follow-up from a prospective cohort study. Bone Res. 2020;8(1):1-8. doi:10.1038/s41413-020-0084-5
Xie L, Liu Y, Xiao Y, et al. Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge. Chest. 2005;127(6):2119-2124. doi:10.1378/chest.127.6.2119
Ngai JC, Ko FW, Ng SS, To K-W, Tong M, Hui DS. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirol Carlton Vic. 2010;15(3):543-550. doi:10.1111/j.1440-1843.2010.01720.x
Huang Y, Tan C, Wu J, et al. Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase. Respir Res. 2020;21(1):163. doi:10.1186/s12931-020-01429-6
Frija-Masson J, Debray M-P, Gilbert M, et al. Functional characteristics of patients with SARS-CoV-2 pneumonia at 30 days post-infection. Eur Respir J. 2020;56(2). doi:10.1183/13993003.01754-2020
Mo X, Jian W, Su Z, et al. Abnormal pulmonary function in COVID-19 patients at time of hospital discharge. Eur Respir J. 2020;55(6). doi:10.1183/13993003.01217-2020
Zhao Y, Shang Y, Song W, et al. Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery. EClinicalMedicine. 2020;25:100463. doi:10.1016/j.eclinm.2020.100463
Tabernero Huguet E, A UG, La RI, et al. Pulmonary Function in Early Follow-up of patients with COVID-19 Pneumonia. Arch Bronconeumol. Published online August 1, 2020. doi:10.1016/j.arbres.2020.07.017
Tenforde MW. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020. MMWR Morb Mortal Wkly Rep. 2020;69. doi:10.15585/mmwr.mm6930e1
Carvalho-Schneider C, Laurent E, Lemaignen A, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect. 2020;0(0). doi:10.1016/j.cmi.2020.09.052
Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;0(0). doi:10.1016/j.jinf.2020.08.029
Halpin SJ, McIvor C, Whyatt G, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. n/a(n/a). doi:https://doi.org/10.1002/jmv.26368
Hwang DM, Chamberlain DW, Poutanen SM, Low DE, Asa SL, Butany J. Pulmonary pathology of severe acute respiratory syndrome in Toronto. Mod Pathol Off J U S Can Acad Pathol Inc. 2005;18(1):1-10. doi:10.1038/modpathol.3800247
Kligerman SJ, Franks TJ, Galvin JR. From the Radiologic Pathology Archives: Organization and Fibrosis as a Response to Lung Injury in Diffuse Alveolar Damage, Organizing Pneumonia, and Acute Fibrinous and Organizing Pneumonia. RadioGraphics. 2013;33(7):1951-1975. doi:10.1148/rg.337130057
Wang Y, Jin C, Wu CC, et al. Organizing Pneumonia of COVID-19: Time-Dependent Evolution and Outcome in CT Findings. Radiology and Imaging; 2020. doi:10.1101/2020.05.22.20109934
Copin M-C, Parmentier E, Duburcq T, Poissy J, Mathieu D, Lille COVID-19 ICU and Anatomopathology Group. Time to consider histologic pattern of lung injury to treat critically ill patients with COVID-19 infection. Intensive Care Med. 2020;46(6):1124-1126. doi:10.1007/s00134-020-06057-8
Kory P, Kanne JP. SARS-CoV-2 organising pneumonia: ‘Has there been a widespread failure to identify and treat this prevalent condition in COVID-19?’ Open Access.:4.
Awulachew E, Diriba K, Anja A, Getu E, Belayneh F. Computed Tomography (CT) Imaging Features of Patients with COVID-19: Systematic Review and Meta-Analysis. Radiology Research and Practice. doi:https://doi.org/10.1155/2020/1023506
Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel. Radiology. 2020;296(2):E113-E114. doi:10.1148/radiol.2020200527
Yang W, Sirajuddin A, Zhang X, et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19). Eur Radiol. Published online April 15, 2020:1-9. doi:10.1007/s00330-020-06827-4
Guan C-S, Wei L-G, Xie R-M, et al. CT findings of COVID-19 in follow-up: comparison between progression and recovery. Diagn Interv Radiol. 2020;26(4):301-307. doi:10.5152/dir.2019.20176
Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020;395(10234):1417-1418. doi:10.1016/S0140-6736(20)30937-5
Molina-Molina M. Secuelas y consecuencias de la COVID-19. :7.
Sibila O, Molina-Molina M, Valenzuela C, et al. Documento de consenso de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) para el seguimiento clínico post-COVID-19. Open Respir Arch. Published online October 2020:S2659663620300771. doi:10.1016/j.opresp.2020.09.002
George PM, Barratt SL, Condliffe R, et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax. 2020;75(11):1009-1016. doi:10.1136/thoraxjnl-2020-215314
Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948-968. doi:10.1183/09031936.05.00035205
Gochicoa-Rangel L, Torre-Bouscoulet L, Salles Rojas A, et al. Functional Respiratory Evaluation in the COVID-19 Era: The Role of Pulmonary Function Test Laboratories. Rev Investig Cl�nica. Published online October 21, 2020:4444. doi:10.24875/RIC.20000250
Graham BL, Steenbruggen I, Miller MR, et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019;200(8):e70-e88. doi:10.1164/rccm.201908-1590ST
Mora-Romero U de J, Gochicoa-Rangel L, Guerrero-Zúñiga S, et al. Presiones inspiratoria y espiratoria máximas: Recomendaciones y procedimiento. NCT Neumol Cir Tórax. 2019;78(S2):135-141. doi:10.35366/NTS192F
Graham BL, Brusasco V, Burgos F, et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J. 2017;49(1). doi:10.1183/13993003.00016-2016
Holland AE, Spruit MA, Troosters T, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428-1446. doi:10.1183/09031936.00150314
Gochicoa-Rangel L, Mora-Romero U, Guerrero-Zúñiga S, et al. Prueba de caminata de 6 minutos: recomendaciones y procedimientos. Neumol Cir Torax. 2015;74(2):10.
Vargas-Domínguez C, Mejía-Alfaro R, Martínez-Andrade R, Silva-Cerón M, Vázquez-García JC, Torre-Bouscoulet L. Prueba de desaturación y titulación de oxígeno suplementario. Recomendaciones y procedimientos. NCT Neumol Cir Tórax. 2019;78(S2):187-197. doi:10.35366/NTS192L
Hani C, Trieu NH, Saab I, et al. COVID-19 pneumonia: A review of typical CT findings and differential diagnosis. Diagn Interv Imaging. 2020;101(5):263-268. doi:10.1016/j.diii.2020.03.014
Jalaber C, Lapotre T, Morcet-Delattre T, Ribet F, Jouneau S, Lederlin M. Chest CT in COVID-19 pneumonia: A review of current knowledge. Diagn Interv Imaging. 2020;101(7-8):431-437. doi:10.1016/j.diii.2020.06.001
Han R, Huang L, Jiang H, Dong J, Peng H, Zhang D. Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. AJR Am J Roentgenol. 2020;215(2):338-343. doi:10.2214/AJR.20.22961
Liu K-C, Xu P, Lv W-F, et al. CT manifestations of coronavirus disease-2019: A retrospective analysis of 73 cases by disease severity. Eur J Radiol. 2020;126:108941. doi:10.1016/j.ejrad.2020.108941
Caruso D, Zerunian M, Polici M, et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):E79-E85. doi:10.1148/radiol.2020201237
Kaufman AE, Naidu S, Ramachandran S, Kaufman DS, Fayad ZA, Mani V. Review of radiographic findings in COVID-19. World J Radiol. 2020;12(8):142-155. doi:10.4329/wjr.v12.i8.142
Prokop M, van Everdingen W, van Rees Vellinga T, et al. CO-RADS: A Categorical CT Assessment Scheme for Patients Suspected of Having COVID-19—Definition and Evaluation. Radiology. 2020;296(2):E97-E104. doi:10.1148/radiol.2020201473
Pan F, Ye T, Sun P, et al. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology. Published online February 13, 2020. doi:10.1148/radiol.2020200370
Combet M, Pavot A, Savale L, Humbert M, Monnet X. Rapid onset honeycombing fibrosis in spontaneously breathing patient with COVID-19. Eur Respir J. 2020;56(2). doi:10.1183/13993003.01808-2020
Kayhan S, Kocakoç E. Pulmonary Fibrosis Due to COVID-19 Pneumonia. Korean J Radiol. 2020;21(11):1273. doi:10.3348/kjr.2020.0707
Ojo AS, Balogun SA, Williams OT, Ojo OS. Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies. Pulm Med.:10.
Mazza MG, De Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun. 2020;89:594-600. doi:10.1016/j.bbi.2020.07.037
Cuijpers P, Vogelzangs N, Twisk J, Kleiboer A, Li J, Penninx BW. Comprehensive meta-analysis of excess mortality in depression in the general community versus patients with specific illnesses. Am J Psychiatry. 2014;171(4):453-462. doi:10.1176/appi.ajp.2013.13030325
Spruit MA, Holland AE, Singh SJ, Tonia T, Wilson KC, Troosters T. COVID-19: Interim Guidance on Rehabilitation in the Hospital and Post-Hospital Phase from a European Respiratory Society and American Thoracic Society-coordinated International Task Force. Eur Respir J. Published online January 1, 2020. doi:10.1183/13993003.02197-2020
Bai C, Chotirmall SH, Rello J, et al. Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020). Eur Respir Rev. 2020;29(157). doi:10.1183/16000617.0287-2020
Chérrez-Ojeda I, Vanegas E, Felix M. The unusual experience of managing a severe COVID-19 case at home: what can we do and where do we go? BMC Infect Dis. 2020;20(1):862. doi:10.1186/s12879-020-05608-0
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