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新型冠状病毒病(COVID-19)所致急性呼吸窘迫综合征(ARDS):实用综合文献复习。

Acute respiratory distress syndrome (ARDS) caused by the novel coronavirus disease (COVID-19): a practical comprehensive literature review.

机构信息

Unidad de Cuidados Intensivos, Hospital de Especialidades José Carrasco Arteaga , Cuenca, Ecuador.

Grupo de Trabajo Respiratorio, Fisiología Aplicada al Cuidado Crítico (Facc.ec) , Quito, Ecuador.

出版信息

Expert Rev Respir Med. 2021 Feb;15(2):183-195. doi: 10.1080/17476348.2020.1820329. Epub 2020 Oct 18.

Abstract

INTRODUCTION

The exponential growth of SARS-CoV-2 virus transmission during the first months of 2020 has placed substantial pressure on most health systems around the world. The complications derived from the novel coronavirus disease (COVID-19) vary due to comorbidities, sex and age, with more than 50% of the patients requiring some level of intensive care developing acute respiratory distress syndrome (ARDS). The authors carried out an extensive and comprehensive literature review on SARS-CoV-2 infection, the clinical, pathological, and radiological presentation as well as the current treatment strategies.

AREAS COVERED

Various complications caused by SARS-CoV-2 infection have been identified, the most lethal being the acute respiratory distress syndrome, caused most likely by the presence of severe immune cell response and the concomitant alveolus inflammation. The new treatment strategies are updated, and the analysis of the physiopathology is included in this review.

EXPERT OPINION

ARDS is one of the most frequent complications in patients with COVID-19. Information regarding the etiology and physiopathology are still unfolding and for the prevention and amelioration, good clinical management, adequate ventilatory support and the use of systemic corticoids seem to be the most efficient way to reduce mortality and to reduce hospital lengths.

摘要

简介

2020 年的前几个月,SARS-CoV-2 病毒的传播呈指数级增长,给世界上大多数卫生系统带来了巨大压力。由于合并症、性别和年龄的不同,新型冠状病毒病(COVID-19)的并发症也有所不同,超过 50%的患者需要一定程度的重症监护,从而发展为急性呼吸窘迫综合征(ARDS)。作者对 SARS-CoV-2 感染、临床、病理和放射学表现以及当前的治疗策略进行了广泛而全面的文献回顾。

涵盖领域

已经确定了由 SARS-CoV-2 感染引起的各种并发症,最致命的是急性呼吸窘迫综合征,很可能是由于严重的免疫细胞反应和随之而来的肺泡炎症引起的。本文更新了新的治疗策略,并对病理生理学进行了分析。

专家意见

ARDS 是 COVID-19 患者最常见的并发症之一。关于病因和病理生理学的信息仍在不断发展,为了预防和改善,良好的临床管理、适当的通气支持和全身皮质激素的使用似乎是降低死亡率和减少住院时间的最有效方法。

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