Seguimiento de los pacientes después de neumonía por COVID-19. Secuelas pulmonares
DOI:
https://doi.org/10.29262/ram.v67i4.847Palabras clave:
seguimiento, neumonía, COVID-19, secuelas, pruebas de función pulmonarResumen
COVID-19 es la enfermedad causada por el virus SARS-CoV-2, la cual ha ocasionado una pandemia sin precedentes, con gran cantidad de infectados y muertos en el mundo. Aunque la mayoría de los casos son leves, existe una cantidad considerable de pacientes que desarrollan neumonía o, incluso, 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 pos-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 gran cantidad de secuelas pulmonares despues 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, prueba de difusión pulmonar de monóxido de carbono, prueba de caminata de seis minutos y la medición de las presiones respiratorias máximas), además de la tomografía axial computarizada de alta resolución, son útiles para evaluar las secuelas pulmonares pos-COVID-19. En esta revisión se pretende describir las posibles secuelas a nivel pulmonar posteriores a neumonía por COVID-19, así como sugerir procedimientos diagnósticos para su correcta evaluación y seguimiento, que permitan el manejo adecuado por parte de un equipo médico multidisciplinario.
Citas
Muertes por COVID19 en América Latina y el Caribe [Internet]. Statista; c2021. Disponible en: https://es.statista.com/estadisticas/1105336/covid-19-numero-fallecidos-america-latina-caribe/
Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. The natural history, pathobiology, and clinical manifestations of SARS-CoV-2 infections. J Neuroimmune Pharmacol. J Neuroimmune Pharmacol. 2020;15(Suppl 2):1-28. DOI: 10.1007/s11481-020-09944-5
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, 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. 2020;370:m3026. DOI: 10.1136/bmj.m3026
Hui DS, Joynt GM, Wong KT, Gommersall CD, Li ST, Antonio G, 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, Langer RD, Larsson SG, Enani MA, 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, Tam LS, Chan DP, Woo J, 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 KC, Ng AWK, Lee LSU, Kaw G, Kwek SK, Earnest A, 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, Ju J, Kou Y, Jiang M, 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, Tian Q, Fan B, Zhao H, 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 KW, Tong M, Hui DS. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology. 2010;15(3):543-550. DOI: 10.1111/j.1440-1843.2010.01720.x
Huang Y, Tan C, Wu J, Chen M, Wang Z, Luo L, 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 MP, Gilbert M, Lescure FX, Travert F, Borie R, et al. Functional characteristics of patients with SARS-CoV-2 pneumonia at 30 days post-infection. Eur Respir J. 2020;56(2):2001754. 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):2001217. DOI: 10.1183/13993003.01217-2020
Zhao Y, Shang Y, Song W, Li Q, Xie H, Li L, 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, Urrutia-Gajarte A, Ruiz-Iturriaga LA, Serrano-Fernandez L, Marina-Malanda N, Iriberri-Pascual M, et al. Pulmonary function in early follow-up of patients with COVID-19 Pneumonia. Arch Bronconeumol. 2021;57(Suppl 1):75-76. 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(30):993-998. DOI: 10.15585/mmwr.mm6930e1
Carvalho-Schneider C, Laurent E, Lemaignen A, Beaufils E, Laribi S, Stefic K, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect. 2020. DOI: 10.1016/j.cmi.2020.09.052
Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A, Gouze H, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;81(6):e4-e6. DOI: 10.1016/j.jinf.2020.08.029
Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J Med Virol. 2021;93(2):1013-1022. DOI: 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. 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, Zhao H, Liang T, Liu Z, et al. Organizing pneumonia of COVID-19: time-dependent evolution and outcome in CT findings. PLoS One. 2020;15(11):e0240347. DOI: 10.1101/2020.05.22.20109934
Copin MC, Parmentier E, Duburcq T, Poissy J, Mathieu D, et al. 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?” BMJ Open Respir Res. 2020;7(1):e000724. DOI: 10.1136/bmjresp-2020-000724
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. Radiol Res Pract. 2020;2020:1023506. DOI: 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, Liu G, Teng Z, Zhao S, et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19). Eur Radiol. 2020:1-9. DOI: 10.1007/s00330-020-06827-4
Guan CS, Wei LG, Xie RM, Lv ZB, Yan S, Zhang ZX, 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, Andermatt R, Mehra MR, Moch H, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-1418. DOI: 10.1016/S0140-6736(20)30937-5
Molina-Molina M. Secuelas y consecuencias de la COVID-19. Neumonol Salud. 2020;13(2):71-77. Disponible en: http://www.neumologiaysalud.es/descargas/R13/R132-8.pdf
Sibila O, Molina-Molina M, Valenzuela C, Ríos-Cortés A, Arbillaga-Etxarri A, Díaz-Pérez D, 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. 2020;2(4):278-283. DOI: 10.1016/j.opresp.2020.09.002
George PM, Barratt SL, Condliffe R, Desai SR, Devaraj A, Forrest I, 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, Crapo RO, Burgos F, Coates A, 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, Guzmán-Valderrábano C, Silva-Cerón M, et al. Functional respiratory evaluation in the COVID-19 era: the role of pulmonary function test laboratories. Rev Investig Clin. 2020;73(4). DOI: 10.24875/RIC.20000250
Graham BL, Steenbruggen I, Miller MR, Cooper BG, Hall GL, Oropez CE, 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 UJ, Gochicoa-Rangel L, Guerrero-Zúñiga S, Cid-Juárez S, Silva-Calderón M, Salas-Escamilla I, et al. Presiones inspiratoria y espiratoria máximas: recomendaciones y procedimiento. Neumol Cir Torax. 2019;78(S2):135-141. DOI: 10.35366/NTS192F
Graham BL, Brusasco V, Burgos F, Cooper BG, Jensen R, Kendrick A, et al. 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J. 2017;49(1):1600016. DOI: 10.1183/13993003.00016-2016
Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, 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, Silva-Cerón M, Cid-Juárez S, et al. Prueba de caminata de 6 minutos: recomendaciones y procedimientos. Neumol Cir Torax. 2015;74(2):10. Disponible en: https://www.medigraphic.com/pdfs/neumo/nt-2015/nt152h.pdf
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. Neumol Cir Torax. 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, van Ufford HQ, Stöger L, 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, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19). Radiology. 2020;295(3):715-721. 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):2001808. 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. 2020. DOI: 10.1155/2020/6175964
Mazza MG, de Lorenzo R, Conte C, Poletti S, Furlan R, Ciceri F, 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. 2020;56(6):2002197. DOI: 10.1183/13993003.02197-2020
Bai C, Chotirmall SH, Rello J, Alba GA, Ginns LC, Krishnan JA, Rogers R, 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):200287. 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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Esta obra está bajo una Licencia Creative Commons Atribución-NoComercial 4.0 Internacional