Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
Rev Esp Quimioter. 2022 Oct;35(5):421-434. doi: 10.37201/req/028.2022. Epub 2022 Apr 21.
Two years after the COVID-19 pandemic, many uncertainties persist about the causal agent, the disease and its future. This document contains the reflection of the COVID-19 working group of the Official College of Physicians of Madrid (ICOMEM) in relation to some questions that remain unresolved. The document includes considerations on the origin of the virus, the current indication for diagnostic tests, the value of severity scores in the onset of the disease and the added risk posed by hypertension or dementia. We also discuss the possibility of deducing viral behavior from the examination of the structure of the complete viral genome, the future of some drug associations and the current role of therapeutic resources such as corticosteroids or extracorporeal oxygenation (ECMO). We review the scarce existing information on the reality of COVID 19 in Africa, the uncertainties about the future of the pandemic and the status of vaccines, and the data and uncertainties about the long-term pulmonary sequelae of those who suffered severe pneumonia.
新冠疫情大流行两年后，关于致病因子、疾病及其未来仍存在诸多不确定性。本文载录了马德里医师学院官方学会（ICOMEM）新冠工作组对一些悬而未决问题的思考。本文涉及病毒来源、当前诊断检测指征、疾病发病时严重程度评分的价值、高血压或痴呆症带来的附加风险等方面的考量。我们还讨论了从完整病毒基因组结构检查推断病毒行为的可能性、一些药物联合应用的未来以及皮质类固醇或体外氧合（ECMO）等治疗资源的当前作用。我们回顾了关于非洲新冠疫情实际情况、大流行未来以及疫苗现状的有限信息，以及关于曾罹患严重肺炎者的长期肺部后遗症的数据和不确定性。
