Palabras clave
SARS-CoV-2
COVID-19
Resumen
La pandemia de COVID-19 ha colapsado los sistemas de salud de muchos países del mundo y las comorbilidades en adultos han incrementado exponencialmente su mortalidad; respecto al asma, no se ha podido establecer una relación determinante en la mortalidad. Las manifestaciones clínicas del paciente con asma y SARS-CoV-2 se presentan con una amplia gama, desde asintomáticas hasta las que experimentan insuficiencia respiratoria aguda. El método más sensible para el diagnóstico de la infección por SARS-CoV-2 es la RT-PCR. Las pruebas de antígeno y serológicas son más rápidas que la RT-PCR, pero menos sensibles. Los estudios radiológicos y la tomografía computarizada de tórax auxilian en el diagnóstico y seguimiento de la infección por SARS-CoV-2. El uso de la espirometría se restringe para el diagnóstico y seguimiento debido al alto riesgo de contagio. Se ha demostrado que la eosinofilia y la inflamación TH2, debido a su efecto inmunológico antivírico, son factores protectores contra SARS-CoV-2/COVID-19 severo. Los pacientes con asma leve expresan menos receptores de la enzima convertidora de angiotensina (ECA2) y aquellos con asma neutrofílica expresan mayor proporción, lo que sugiere presentaciones más severas de COVID-19. El tratamiento convencional del asma modula la respuesta inmunitaria del SARS-CoV-2/COVID-19, por lo cual, los pacientes con asma controlados tienen manifestaciones no graves de COVID-19, aunque los mecanismos no están claros.
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