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[新冠后综合征:一篇反思与观点文章]

[Post-COVID syndrome: A reflection and opinion paper].

作者信息

Bouza E, Cantón Moreno R, De Lucas Ramos P, García-Botella A, García-Lledó A, Gómez-Pavón J, González Del Castillo J, Hernández-Sampelayo T, Martín-Delgado M C, Martín Sánchez F J, Martínez-Sellés M, Molero García J M, Moreno Guillén S, Rodríguez-Artalejo F J, Ruiz-Galiana J, De Pablo Brühlmann S, Porta Etessam J, Santos Sebastián M

机构信息

Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.

出版信息

Rev Esp Quimioter. 2021 Aug;34(4):269-279. doi: 10.37201/req/023.2021. Epub 2021 Apr 20.

Abstract

A high proportion of people who have suffered from COVID-19 report, after recovery from the acute phase of the disease, clinical manifestations, both subjective and objective, that continue beyond 3 weeks or even 3 months after the original clinical disease. There is still no agreed nomenclature to refer to this condition, but perhaps the most commonly used is post-COVID syndrome. The Scientific Committee on COVID of the Madrid College of Physicians (ICOMEM) has discussed this problem with a multidisciplinary approach in which internists, infectious disease specialists, psychiatrists, pneumologists, surgeons, geriatricians, pediatricians, microbiologists, family physicians and other specialists have participated, trying to gather the existing information and discussing it in the group. The clinical manifestations are very variable and range from simple fatigue to persistent fibrosing lung lesions with objective alterations of pulmonary function. Post-COVID syndrome seems to be particularly frequent and severe in adults who have required admission to Intensive Care Units and has a peculiar behavior in a very small group of children. The post-COVID syndrome, which undoubtedly exists, is at first sight not clearly distinguishable from clinical manifestations that which occur after other acute viral diseases and after prolonged stays in ICUs due to other diseases. Therefore, it offers excellent research opportunities to clarify its pathogenesis and possibly that of other related entities. It is possible that progressively there will be an increased demand for care among the millions of people who have suffered and overcome acute COVID for which the health authorities should design mechanisms for the agile management of care that will possibly require well-coordinated multidisciplinary groups. This paper, structured in questions on different aspects of the post-COVID syndrome, attempts to stage the current state of this problem.

摘要

很大一部分新冠肺炎患者在从疾病急性期康复后,报告称在最初临床疾病发生后的3周甚至3个月后仍存在主观和客观的临床表现。目前对于这种情况尚无统一的命名,但最常用的可能是新冠后综合征。马德里医师学院(ICOMEM)的新冠科学委员会采用多学科方法讨论了这个问题,内科医生、传染病专家、精神科医生、肺科医生、外科医生、老年病专家、儿科医生、微生物学家、家庭医生和其他专家都参与其中,试图收集现有信息并在小组中进行讨论。临床表现差异很大,从简单的疲劳到伴有肺功能客观改变的持续性肺纤维化病变。新冠后综合征在需要入住重症监护病房的成年人中似乎尤为常见和严重,在一小部分儿童中表现出特殊情况。毫无疑问存在的新冠后综合征,乍一看与其他急性病毒性疾病后以及因其他疾病在重症监护病房长期停留后出现的临床表现没有明显区别。因此,它为阐明其发病机制以及可能的其他相关实体的发病机制提供了绝佳的研究机会。在数百万感染并战胜急性新冠的人群中,对护理的需求可能会逐渐增加,卫生当局应为可能需要协调良好的多学科团队的护理敏捷管理设计机制。本文围绕新冠后综合征的不同方面以问题的形式构建,试图梳理该问题的现状。

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