RESUMO
SARS-CoV-2 is the pathogen responsible for COVID-19, an infectious disease that can evolve from a mild viral illness to multiple organ failure and death. This disease is characterized by a high transmissibility rate, which has lead to its spread throughout the world. There are no clear prognostic markers to guide the severity of the condition; however, some clinical elements could be considered possible predictors of severity. Knowing its viral structure and pathogenesis has allowed to recognize specific molecular pathways candidates as therapeutic targets for various drugs, which are still under investigation and will set the guidelines for future protocols.
Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , COVID-19 , Infecções por Coronavirus/diagnóstico , Humanos , Pneumonia Viral/diagnóstico , SARS-CoV-2RESUMO
Resumen El SARS-CoV-2 es el agente patógeno responsable del COVID-19, enfermedad infecciosa que puede evolucionar desde un cuadro viral leve hasta la falla multiorgánica y muerte. Esta enfermedad se caracteriza por tener una tasa de transmisibilidad elevada, lo que ha permitido su diseminación por el mundo. No existen marcadores pronósticos claros que guíen la gravedad del cuadro; no obstante, hay elementos clínicos que podrían considerarse posibles predictores de gravedad. Conocer su estructura viral y patogenia ha posibilitado objetivar los pasos moleculares específicos que pueden ser blancos terapéuticos de variados fármacos, los cuales se mantienen en investigación y marcarán las directrices de futuros protocolos.
Abstract SARS-CoV-2 is the pathogen responsible for COVID-19, an infectious disease that can evolve from a mild viral illness to multiple organ failure and death. This disease is characterized by a high transmissibility rate, which has lead to its spread throughout the world. There are no clear prognostic markers to guide the severity of the condition; however, some clinical elements could be considered possible predictors of severity. Knowing its viral structure and pathogenesis has allowed to recognize specific molecular pathways candidates as therapeutic targets for various drugs, which are still under investigation and will set the guidelines for future protocols.
Assuntos
Humanos , Pneumonia Viral/diagnóstico , Infecções por Coronavirus/diagnóstico , Pandemias , BetacoronavirusRESUMO
SARS-CoV-2 is the agent responsible for COVID-19, the current pandemic, which is characterized by developing respiratory disturbances that are associated with severe hypoxemia associated with symptoms of non-bacterial pneumonia, ARDS up to multi-organ failure. It has been characterized by presenting 2 different phenotypes (phenotype L and phenotype H), with phenotype H being a stage of progressive deterioration of phenotype L, which depends on the earliness with which ventilatory management begins and the degree of inflammatory compromise. However, since VMI can generate VILI, the use of protective ventilation has been recommended as a ventilatory strategy for COVID-19. This review aims to comment on the available evidence of the essential aspects of protective IMV in the context of ARDS associated with COVID-19, in addition to the use of neuromuscular blockade and prone strategies.
El SARS-CoV-2 es el agente responsable del COVID-19, actual pandemia, que se caracteriza por desarrollar alteraciones respiratorias que cursan con hipoxemia severa asociada a cuadros de neumonía no bacteriana, SDRA hasta la falla multiorgánica. Se ha caracterizado por presentar 2 fenotipos distintos (fenotipo L y fenotipo H), siendo el fenotipo H un estadío de deterioro progresivo del fenotipo L, que depende de la precocidad con la que se inicia el manejo ventilatorio y del grado de compromiso inflamatorio. Sin embargo, dado que la VMI puede generar VILI, se ha recomendado el uso de una ventilación protectora como estrategia ventilatoria para COVID-19. La presente revisión tiene como objetivo comentar la evidencia disponible de los aspectos esenciales de la VMI protectora en el contexto del SDRA asociado a COVID-19, además del uso de bloqueo neuromuscular y las estrategias de prono.
