RESUMO
BACKGROUND: It is not clear whether patients with some degree of immunosuppression have worse outcomes in SARS-CoV-2 infection, compared to healthy people. OBJECTIVE: To carry out a narrative review of the information available on infection by SARS-CoV-2 in immunosuppressed patients, especially patients with cancer, transplanted, neurological diseases, primary and secondary immunodeficiencies. RESULTS: Patients with cancer and recent cancer treatment (chemotherapy or surgery) and SARS-CoV-2 infection have a higher risk of worse outcomes. In transplant patients (renal, cardiac and hepatic), with neurological pathologies (multiple sclerosis [MS], neuromyelitis optica [NMODS], myasthenia gravis [MG]), primary immunodeficiencies and infection with human immunodeficiency virus (HIV) in association with immunosuppressants, studies have shown no tendency for worse outcomes. CONCLUSION: Given the little evidence we have so far, the behaviour of SARS-CoV-2 infection in immunosuppressed patients is unclear, but current studies have not shown worse outcomes, except for patients with cancer.
RESUMO
BACKGROUND: It is not clear whether patients with some degree of immunosuppression have worse outcomes in SARS-CoV-2 infection, compared to healthy people. OBJECTIVE: To carry out a narrative review of the information available on infection by SARS-CoV-2 in immunosuppressed patients, especially patients with cancer, transplanted, neurological diseases, primary and secondary immunodeficiencies. RESULTS: Patients with cancer and recent cancer treatment (chemotherapy or surgery) and SARS-CoV-2 infection have a higher risk of worse outcomes. In transplant patients (renal, cardiac and hepatic), with neurological pathologies (multiple sclerosis (MS), neuromyelitis optica (NMODS), myasthenia gravis (MG)), primary immunodeficiencies and infection with human immunodeficiency virus (HIV) in association with immunosuppressants, studies have shown no tendency for worse outcomes. CONCLUSION: Given the little evidence we have so far, the behaviour of SARS-CoV-2 infection in immunosuppressed patients is unclear, but current studies have not shown worse outcomes, except for patients with cancer.
Assuntos
COVID-19/imunologia , Hospedeiro Imunocomprometido , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , Saúde Global , Humanos , Terapia de Imunossupressão/efeitos adversos , Imunossupressores/efeitos adversos , Prognóstico , Índice de Gravidade de DoençaRESUMO
La tuberculosis es una enfermedad infecciosa de gran prevalencia en países en vía de desarrollo como el nuestro. Aunque el compromiso pulmonar es el más frecuente y de impacto en la salud pública, existen varias formas extrapulmonares con diversas presentaciones clínicas y de difícil diagnóstico, recalcando la importancia de sospechar estas patologías para intervenciones oportunas y que impacten en la morbimortalidad. En este artículo se presentan cuatro casos clínicos donde se sospechó tuberculosis extrapulmonar (pericárdica, peritoneal, pleural y meníngea) en el Hospital de San José de Bogotá, describiendo la forma en que se realizó o se descartó la tuberculosis extrapulmonar y haciendo una breve descripción del rendimiento de diferentes pruebas diagnósticas.
Tuberculosis (TB) is an infectious disease with high-prevalence in developing countries as ours. Although pulmonary involvement is most common and is associated with greater impact on public health, there are various forms of extrapulmonary TB (EPTB) exhibiting various often difficult to diagnose clinical presentations, highlighting the importance of suspecting these pathologies in order to conduct timely interventions that impact their morbidity and mortality rates. This article presents four clinical cases at San José Hospital in Bogotá where EPTB disease was suspected (pericardium, peritoneum, pleura and meninges), describing the way EPTB disease was diagnosed or ruled out and briefly defining the diagnostic performance of various tests.