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1.
Rev. bras. ter. intensiva ; 33(2): 325-325, abr.-jun. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1289082

ABSTRACT

RESUMO A COVID-19 foi declarada pandemia pela Organização Mundial de Saúde no dia 11 de março de 2020. O quadro clínico apresenta predominantemente sintomatologia respiratória, no entanto, na literatura atual, têm sido descritas diversas manifestações neurológicas associadas à infeção por SARS-CoV-2. Os autores apresentam o caso clínico de um homem de 45 anos internado por pneumonia com resultado positivo para SARS-CoV-2, sem antecedentes neurológicos, que, ao décimo sexto dia de internamento, apresentou alteração súbita do estado de consciência acompanhada de desvio conjugado do olhar para a direita e mioclonias da face e da região torácica à esquerda, seguidas de crise convulsiva tônico-clônica generalizada, associadas à hemiparesia esquerda persistente. Do estudo realizado salienta-se a existência de RT-PCR para SARS-CoV-2 no líquido cefalorraquidiano positiva. O doente apresentou evolução clínica com melhoria gradual, tendo o desfecho sido favorável.


ABSTRACT COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020. The clinical presentation is predominantly respiratory symptoms; however, in the current literature, several neurological manifestations associated with SARS-CoV-2 infection have been described. The authors present the clinical case of a 45-year-old man hospitalized for pneumonia with a positive test result for SARS-CoV-2, without a neurological history, who, on the sixteenth day of hospitalization, presented a sudden change in his state of consciousness accompanied by conjugated right gaze deviation and myoclonus of the face and thoracic region to the left, followed by generalized tonic-clonic seizures associated with persistent left hemiparesis. The present study highlights a positive RT-PCR test for SARS-CoV-2 in cerebrospinal fluid. The patient progressed with gradual improvement, and the outcome was favorable.


Subject(s)
Humans , Male , Middle Aged , SARS-CoV-2/isolation & purification , COVID-19/complications , Nervous System Diseases/virology , Pneumonia, Viral/diagnosis , Seizures/virology , Hospitalization , Nervous System Diseases/physiopathology
4.
Guatemala; MSPAS; 3 feb. 2021. 28 p. graf.
Non-conventional in Spanish | LILACS, LIGCSA | ID: biblio-1224546

ABSTRACT

En los antecedentes, brinda detalles técnicos de enfermedades previas al COVID-19 y sigue esta consigna internacional: "Sin embargo, a la luz de la posible introducción de un caso sospechoso relacionado con el 2019-nCoV en la Región de las Américas, la Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS / OMS) recomienda a los Estados Miembros garantizar su identificación oportuna, el envío de las muestras a laboratorios Nacionales o de referencia y la implementación del protocolo de detección molecular para 2019-nCoV, según la capacidad del laboratorio." Aborda las tres mutaciones del virus conocidas hasta la fecha del documento y las tres variantes conocidas: Reino Unido e Irlanda del Norte, República de Sudáfrica y Brasil, siendo la de mayor transmisibilidad, según el documento, la del Reino Unido. El primero de los objetivos del documento es: "Brindar los lineamientos generales para la toma de muestra, conservación, transporte y diagnóstico del SARS-Cov-2 en los laboratorios descentralizados bajo la técnica de Reacción en Cadena de la Polimerasa (PCR) en tiempo Real, en atención a pacientes que cumplen con la definición de caso y se tipifica como "sospechoso inusitado"." Incluye como anexo 2 el documento: "Lineamientos para el abordaje de casos positivos para SARS-COV-2 de viajeros que ingresan al país por el aeropuerto internacional "La Aurora" (AILA)"


Subject(s)
Humans , Male , Female , Pneumonia, Viral/diagnosis , Specimen Handling/standards , Coronavirus Infections/diagnosis , Betacoronavirus , Containment of Biohazards/methods , Epidemiological Monitoring , Personal Protective Equipment/standards , Guatemala , Indicators and Reagents/administration & dosage , Laboratories/standards
7.
Medwave ; 20(11)dic. 2020.
Article in English, Spanish | LILACS | ID: biblio-1146022

ABSTRACT

INTRODUCCIÓN: El SARS-CoV-2 tiene una rápida expansión por todo el mundo, sin embargo, su capacidad para causar enfermedad grave no es homogénea según sexo y edad. OBJETIVO: Determinar las características perinatales, morbilidad, mortalidad y resultados serológicos en neonatos de gestantes seropositivas para SARS-CoV-2. MÉTODOS: Estudio transversal, descriptivo y retrospectivo. Participaron todos los neonatos cuyas madres presentaron resultado seropositivo para SARS-CoV-2 antes del parto, entre el 15 de abril y 10 de mayo de 2020 en el Instituto Nacional Materno Perinatal de Perú. Se recogió información materna y neonatal a partir de sus historias clínicas. En el análisis se usó estadística descriptiva y prueba exacta de Fisher. RESULTADOS: Se identificaron 114 neonatos, el 36,8% presentó inmunoglobulinas M y G positivas para SARS-CoV-2; el 7% inmunoglobulinas G y 56,2% fue no reactivo. Las complicaciones obstétricas más frecuentes fueron rotura prematura de membranas (14,9%) y parto pretérmino (8,8%). El 8,8% de los neonatos presentaron un puntaje Apgar al minuto menor o igual a seis, y de ellos solo uno persistió a los cinco minutos; tres neonatos fallecieron. Se evidenció asociación entre el tipo de inmunoglobulina materna y la serología de su recién nacido (p < 0,05). No se observó asociación entre resultados perinatales y el tipo de inmunoglobulinas materna (p > 0,05), ni con los resultados serológicos en el neonato para SARS-CoV-2 (p > 0,05). CONCLUSIÓN: El 43,9% de neonatos de madre seropositiva a SARS-CoV-2 tuvo un resultado serológico positivo, siendo más frecuente de tipo Inmunoglobulinas M e Inmunoglobulinas G. El 10,5% de los neonatos presentó alguna morbilidad, siendo más frecuente prematuridad y bajo peso al nacer y el 2,6% falleció. Los resultados perinatales no estuvieron asociadas al tipo de inmunoglobulina de las madres seropositivas a SARS-CoV-2. De igual modo, los resultados perinatales no estuvieron asociados a los resultados serológicos en el neonato.


INTRODUCTION: SARS-CoV-2 has spread rapidly throughout the world. However, its ability to cause severe disease is not homogeneous according to sex and the different age groups. OBJECTIVE: To determine perinatal characteristics, morbidity, mortality, and serological results in neonates from seropositive pregnant women to SARS-CoV-2. METHODS: We did a retrospective, descriptive, cross-sectional study. We included all newborns from positive pregnant women to SARS-CoV-2, between April 15 and May 10, 2020, who delivered in the National Perinatal Maternal Institute of Peru. The study extracted maternal and neonatal variables collected from the medical charts. The data were analyzed using descriptive statistics and Fischer's exact test. RESULTS: One hundred fourteen neonates were identified, 36.8% IgM/IgG positive for SARS-CoV-2, 7% IgG, and 56.2% had negative serology. The obstetric complications were premature rupture of membranes (14.9%) and preterm birth (8,8%). 8.8% of newborns had an Apgar score of less than or equal to six minutes, and of those, only one persisted after five minutes; three newborns died. There was an association between the type of maternal immunoglobulin and the serology of the newborn (p < 0.05). No association was observed between perinatal results and maternal immunoglobulin type (p > 0.05) or serological results in the newborn for SARS-CoV-2 (p > 0.05). CONCLUSION: 43.9% of seropositive mothers' neonates to SARS-CoV-2 had a positive serological result, more frequently type IgM/IgG. 10.5% of the neonates had some morbidity, more frequent prematurity, low birth weight, and 2.6% died. Perinatal results were not associated with the type of immunoglobulin of mothers seropositive to SARS-CoV-2; similarly, perinatal results were not associated with serological results in the newborn.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Young Adult , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies , Clinical Laboratory Techniques
8.
Washington; Organización Panamericana de la Salud; nov. 19, 2020. 2 p.
Non-conventional in Spanish | LILACS | ID: biblio-1129646

ABSTRACT

Las pruebas de antígenos, que examinan si una persona está infectada en este momento, utilizan normalmente muestras obtenidas con hisopos nasofaríngeos, en las que luego se analiza la presencia de proteínas del virus (antígenos). Se obtienen los resultados en un plazo de 15 a 30 minutos.


Subject(s)
Humans , Pneumonia, Viral/diagnosis , Coronavirus Infections/diagnosis , Pandemics/prevention & control , Polymerase Chain Reaction/methods , Epidemiological Monitoring
10.
Säo Paulo med. j ; 138(5): 422-432, Sept.-Oct. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1139724

ABSTRACT

ABSTRACT BACKGROUND: A positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS CoV-2, from nasopharyngeal swabs, is the current gold standard diagnostic test for this virus and has sensitivity of 60-70%. Some studies have demonstrated a significant number of false-negative RT-PCR tests while displaying significant tomographic findings, in the early days of symptoms of COVID-19. OBJECTIVE: To compare accuracy between RT-PCR and computed tomography (CT) for detecting COVID-19 in the first week of its symptoms during the pandemic. DESIGN AND SETTING: Systematic review of comparative studies of diagnostic accuracy within the Evidence-based Health Program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL and LILACS databases, for articles published up to June 6, 2020, relating to studies evaluating the diagnostic accuracy of RT-PCR and chest CT for COVID-19 diagnoses. The QUADAS 2 tool was used for methodological quality evaluation. RESULTS: In total, 1204 patients with COVID-19 were evaluated; 1045 had tomographic findings while 755 showed positive RT-PCR for COVID-19. RT-PCR demonstrated 81.4% sensitivity, 100% specificity and 92.3% accuracy. Chest CT demonstrated 95.3% sensitivity, 43.8% specificity and 63.3% accuracy. CONCLUSION: The high sensitivity and detection rates shown by CT demonstrate that this technique has a high degree of importance in the early stages of the disease. During an outbreak, the higher prevalence of the condition increases the positive predictive value of CT. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/UNGHA in the Open Science Framework.


Subject(s)
Humans , Pneumonia, Viral/diagnosis , Tomography, X-Ray Computed , Coronavirus Infections/diagnosis , Reverse Transcriptase Polymerase Chain Reaction , Brazil , Sensitivity and Specificity , Clinical Laboratory Techniques/methods , Pandemics , Betacoronavirus , COVID-19 Vaccines , COVID-19 Testing , SARS-CoV-2 , COVID-19
11.
Säo Paulo med. j ; 138(5): 385-392, Sept.-Oct. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1139712

ABSTRACT

ABSTRACT BACKGROUND: The COVID-19 pandemic has led to an immense need to develop training on case recognition and management, with a focus on patients' and health professionals' safety at several levels of healthcare settings in Brazil. Different simulation strategies can be included in the diverse clinical care phases for these patients. OBJECTIVE: To suggest a complete simulation-based training program for Brazilian hospitals and/or academic institutions at this moment of the pandemic. DESIGN AND SETTING: Descriptive analysis on possible simulated clinical cases using different methodologies, thereby supporting suspected or confirmed COVID-19 patients. METHODS: This was a reflective theoretical descriptive study on an educational program based on clinical simulation, with four practical phases at different performance and complexity levels. Wearing, handling and adequately disposing of personal protective equipment, along with specific respiratory procedures in different healthcare settings up to intensive care for seriously infected patients were addressed. RESULTS: This program was designed for application at different Brazilian healthcare levels through different clinical simulation strategies. Summaries of expected performance were suggested in order to standardize technical capacity within these simulation settings, so as to serve these levels. CONCLUSIONS: Developing training programs for situations such as the current COVID-19 pandemic promotes safety not only for patients but also for healthcare workers. In the present context, clear definition of which patients need hospital outpatient or inpatient care will avoid collapse of the Brazilian healthcare system. Institutions that do not have simulated environments can, through the examples described, adopt procedures to promote didactic information in order to help healthcare professionals during this time.


Subject(s)
Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Health Knowledge, Attitudes, Practice , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Education, Continuing , Brazil , Pandemics , Simulation Training , Betacoronavirus , SARS-CoV-2 , COVID-19
13.
Arq. bras. cardiol ; 115(4): 660-666, out. 2020. tab, graf
Article in Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131337

ABSTRACT

Resumo Fundamento: A COVID-19 causa grave acometimento pulmonar, porém o sistema cardiovascular também pode ser afetado por miocardite, insuficiência cardíaca e choque. A elevação de biomarcadores cardíacos tem sido associada a um pior prognóstico. Objetivos: Avaliar o valor prognóstico da Troponina T (TnT) e do peptídeo natriurético tipo B (BNP) em pacientes internados por Covid-19. Métodos: Amostra de conveniência de pacientes hospitalizados por COVID-19. Foram coletados dados dos prontuários com o objetivo de avaliar a relação da TnT e o BNP medidos nas primeiras 24h de admissão com o desfecho combinado (DC) óbito ou necessidade de ventilação mecânica. Análise univariada comparou os grupos com e sem DC. Modelo multivariado de Cox foi utilizada para determinar preditores independentes do DC. Resultados: Avaliamos 183 pacientes (idade=66,8±17 anos, sendo 65,6% do sexo masculino). Tempo de acompanhamento foi de 7 dias (1 a 39 dias). O DC ocorreu em 24% dos pacientes. As medianas de TnT e BNP foram 0,011 e 0,041 ng/dl (p<0,001); 64 e 198 pg/dl (p<0,001) respectivamente para os grupos sem e com DC. Na análise univariada, além de TnT e BNP, idade, presença de doença coronariana, saturação de oxigênio, linfócitos, dímero-D, proteína C reativa titulada (PCR-t) e creatinina, foram diferentes entre os grupos com e sem desfechos. Na análise multivariada boostraped apenas TnT (1,12[IC95%1,03-1,47]) e PCR-t (1,04[IC95%1,00-1,10]) foram preditores independentes do DC. Conclusão: Nas primeiras 24h de admissão, TnT, mas não o BNP, foi marcador independente de mortalidade ou necessidade de ventilação mecânica invasiva. Este dado reforça ainda mais a importância clínica do acometimento cardíaco da COVID-19. (AArq Bras Cardiol. 2020; 115(4):660-666)


Abstract Background: COVID-19 causes severe pulmonary involvement, but the cardiovascular system can also be affected by myocarditis, heart failure and shock. The increase in cardiac biomarkers has been associated with a worse prognosis. Objectives: To evaluate the prognostic value of Troponin-T (TNT) and natriuretic peptide (BNP) in patients hospitalized for Covid-19. Methods: This was a convenience sample of patients hospitalized for COVID-19. Data were collected from medical records to assess the association of TnT and BNP measured in the first 24 hours of hospital admission with the combined outcome (CO) of death or need for mechanical ventilation. Univariate analysis was used to compare the groups with and without the CO. Cox's multivariate model was used to determine independent predictors of the CO. Results: We evaluated 183 patients (age = 66.8±17 years, 65.6% of which were males). The time of follow-up was 7 days (range 1 to 39 days). The CO occurred in 24% of the patients. The median troponin-T and BNP levels were 0.011 and 0.041ng/dL (p <0.001); 64 and 198 pg/dL (p <0.001), respectively, for the groups without and with the CO. In the univariate analysis, in addition to TnT and BNP, age, presence of coronary disease, oxygen saturation, lymphocytes, D-dimer, t-CRP and creatinine, were different between groups with and without outcomes. In the bootstrap multivariate analysis, only TnT (1.12 [95% CI 1.03-1.47]) and t-CRP (1.04 [95% CI 1.00-1.10]) were independent predictors of the CO. Conclusion: In the first 24h of admission, TnT, but not BNP, was an independent marker of mortality or need for invasive mechanical ventilation. This finding further reinforces the clinical importance of cardiac involvement in COVID-19. (Arq Bras Cardiol. 2020; 115(4):660-666)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Pneumonia, Viral/diagnosis , Troponin/blood , Coronavirus Infections/diagnosis , Natriuretic Peptide, Brain/blood , Pneumonia, Viral/mortality , Prognosis , Biomarkers/blood , Cardiovascular System/physiopathology , Cardiovascular System/virology , Coronavirus Infections , Coronavirus Infections/mortality , Pandemics , Betacoronavirus
14.
Washington; Organización Panamericana de la Salud; Oct. 27, 2020. 4 p.
Non-conventional in Spanish | LILACS | ID: biblio-1127580

ABSTRACT

Este documento brinda consideraciones prácticas para la implementación de la prueba rápida de detección de antígenos (Ag-RDT) para COVID-19 en la Región de las Américas. Se han publicado consideraciones generales para el uso de las Ag-RDT en el diagnóstico de la infección por SARS-CoV-2 (1, 2), y varios ensayos se han evaluado de forma independiente y / o se han incluido en el Listado de Uso de Emergencia de la OMS. La evidencia científica y técnica sobre la detección de la infección por SARS-CoV-2 está evolucionando con rapidez; este documento se actualizará según sea necesario.


Subject(s)
Pneumonia, Viral/diagnosis , Polymerase Chain Reaction/methods , Coronavirus Infections/diagnosis , Pandemics/prevention & control , Betacoronavirus/isolation & purification
15.
Washington; Organización Panamericana de la Salud; Oct. 27, 2020. 6 p.
Non-conventional in Spanish | LILACS | ID: biblio-1127581

ABSTRACT

A través de este documento, la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) alienta a los Estados Miembros a recopilar evidencia sobre los casos de reinfección por el SARS-CoV-2, con el fin de contribuir a ampliar el conocimiento de la COVID-19 y en consecuencia con su prevención, control y manejo clínico.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pandemics/prevention & control , Epidemiological Monitoring , Betacoronavirus/isolation & purification
16.
Washington; Organización Panamericana de la Salud; Oct. 2020. 44 p.
Non-conventional in Spanish | LILACS | ID: biblio-1127582

ABSTRACT

La Representación en la República Dominicana trabajó en coordinación con las autoridades nacionales desde la emisión de la alerta de emergencia sanitaria internacional emitida por la OMS el 30 de enero, colaborando en las acciones de preparación ante lo que en ese momento era una eventual epidemia. Para el 1 de marzo de 2020, el país reportó el primer caso de COVID-19, convirtiéndose en el cuarto país de América Latina en confirmar un caso en su territorio. Diez días después, el 11 de marzo, la OMS caracteriza la COVID-19 como una pandemia debido al incremento de casos confirmados y fallecidos en más de 100 países. En este contexto, los esfuerzos de cooperación técnica se concentraron en la elaboración del Plan de Contingencia ante Enfermedad por Coronavirus (COVID-19), el cual tuvo como referencia las líneas de acción planteadas en el Plan estratégico de preparación y respuesta para la enfermedad por coronavirus 2019 (COVID-19).


Subject(s)
Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Social Isolation , Quarantine/organization & administration , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pandemics/prevention & control , Epidemiological Monitoring , Betacoronavirus , Intensive Care Units/statistics & numerical data , Dominican Republic/epidemiology
17.
Rev. bras. ginecol. obstet ; 42(10): 669-671, Oct. 2020. graf
Article in English | LILACS | ID: biblio-1144154

ABSTRACT

Abstract The present report describes the case of a 31-year-old primigravida, with dichorionic twins at 31 weeks. She presented with history of myalgia, jaundice, and abdominal discomfort. No flu-like symptoms as fever or cough. She was not aware of exposure to COVID-19. Normal blood pressure and O2 saturation. Laboratory tests showed platelet count of 218,000 mm3, alanine aminotransferase (ALT) 558 IU and serum creatinine 2.3 mg/dl. Doppler ultrasound in one twin was compatible with brain sparing. Partial hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome was the hypothesis, and a cesarean section was performed. On day 2, the white-cell count reached 33,730, with decreased consciousness and mild respiratory distress. Tomography revealed both lungs with ground-glass opacities. Swab for COVID-19 polymerase chain reaction (PCR) was positive. Thrombocytopenia in patients with COVID-19 appears to be multifactorial, similar to what occurs in preeclampsia and HELLP syndrome. We assume that the synergism of these pathophysiological mechanisms could accelerate the compromise of maternal conditions and could be a warning to the obstetric practice.


Resumo O presente relato descreve o caso de uma gestante de 31 anos, gemelar dicoriônica com 31 semanas, com queixa de mialgia, icterícia e desconforto abdominal. A paciente não apresentava sintomas gripais como febre ou tosse e não tinha conhecimento de exposição ao COVID-19. Pressão arterial e saturação de oxigênio normais. Os exames laboratoriais apresentaram contagem de plaquetas de 218,000 mm3, ALT 558 IU e creatinina 2.3 mg/dl. Doppler compatível com centralização de um dos fetos. Síndrome de hemolysis, elevated liver enzymes, low platelet count (HELLP) parcial foi a hipótese diagnóstica inicial e a cesariana foi realizada. No segundo dia, a paciente apresentou leucócitos de 33.730 com queda do nível de consciência e desconforto respiratório leve. A tomografia revelou opacidade pulmonar em vidro fosco bilateralmente. A pesquisa de COVID-19 por polymerase chain reaction (PCR)/swab teve resultado positivo. Trombocitopenia em pacientes com COVID-19 é multifatorial, semelhante ao que ocorre na pré-eclâmpsia e na síndrome HELLP. Acreditamos que o sinergismo da fisiopatologia das doenças em questão pode acelerar o comprometimento materno e deve servir de alerta para a prática obstétrica.


Subject(s)
Humans , Female , Pregnancy , Adult , Pneumonia, Viral/diagnosis , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , HELLP Syndrome/diagnosis , Coronavirus Infections/diagnosis , Thrombocytopenia/diagnosis , Cesarean Section/methods , Ultrasonography, Prenatal , Gestational Age , Clinical Laboratory Techniques , Diagnosis, Differential , Pandemics , Pregnancy, Twin , COVID-19 Testing , COVID-19
19.
Rev. Hosp. Ital. B. Aires (2004) ; 40(3): 117-125, sept. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1129078

ABSTRACT

En diciembre de 2019 se identificó el virus SARS-CoV-2, cuya rápida propagación global puso en estado de emergencia al mundo entero, llevando al ser humano a una situación sin antecedente cercano. El objetivo de esta revisión es describir los métodos diagnósticos utilizados actualmente para identificar la infección por SARS-CoV-2. Las manifestaciones clínicas y el espectro imagenológico de la enfermedad son muy inespecíficos y no permiten realizar un diagnóstico certero. Por esta razón, es esencial una apropiada toma de muestra respiratoria en el momento y sitio anatómico adecuado para un diagnóstico preciso de COVID-19. La técnica de muestreo más utilizada es el hisopado nasofaríngeo y la prueba diagnóstica más fiable se basa en la retrotranscripción seguida por reacción en cadena de la polimerasa en tiempo real (RT-PCR). No obstante, existen otras técnicas moleculares, como también tests serológicos para detectar anticuerpos o fragmentos antigénicos del SARS-CoV-2. Más allá de la precisión diagnóstica, es importante tener en cuenta la probabilidad basal (pretest) para interpretar correctamente el resultado obtenido y aislar aquellos posibles falsos negativos. Con el objetivo de evitar la saturación del sistema de salud es imprescindible contar con información y métodos diagnósticos precisos para detectar tempranamente los focos de infección y reducir la transmisión comunitaria, utilizando eficazmente los diferentes recursos diagnósticos. (AU)


In December 2019, the SARS-CoV-2 virus was identified for the first time, whose rapid global spread put the entire world in a state of emergency, leading humans to an unprecedented situation with no immediate history. The main purpose of this review is to describe the diagnostic methods currently used to identify SARS-CoV-2 infection. The clinical manifestations and the imaging spectrum of the disease are nonspecific and do not allow an accurate diagnosis to be made. For this reason, an appropriate respiratory sampling at the right time and anatomical site is essential for an accurate diagnosis of COVID-19. The most widely used sampling technique is nasopharyngeal swab, and the most reliable diagnostic test is by reverse transcription followed by real-time polymerase chain reaction (RT-PCR). However, there are other molecular techniques, as well as serological tests to detect antibodies or antigenic fragments of SARS-CoV-2. Beyond the diagnostic precision, it is important to take into account the baseline probability (pre-test) to correctly interpret the result obtained and isolate those possible false negatives. In order to avoid saturation of the health system, it is essential to have accurate information and diagnostic methods to detect outbreaks of infection in early stages and to reduce communitary transmission, making effective use of the various diagnostic resources. Coronavirus infections/diagnosis, viral/diagnosis, pandemics, clinical laboratory techniques, real-time polymerase chain reaction, antigens, viral/analysis. (AU)


Subject(s)
Humans , Serologic Tests/methods , Coronavirus Infections/diagnosis , Real-Time Polymerase Chain Reaction/methods , Argentina , Pneumonia, Viral/diagnosis , Serologic Tests/statistics & numerical data , Polymerase Chain Reaction/methods , Polymerase Chain Reaction/statistics & numerical data , Coronavirus Infections/physiopathology , Coronavirus Infections/prevention & control , Coronavirus Infections/diagnostic imaging , False Negative Reactions , False Positive Reactions , Real-Time Polymerase Chain Reaction/statistics & numerical data , Betacoronavirus
20.
Rev. Hosp. Ital. B. Aires (2004) ; 40(3): 144-150, sept. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1129376

ABSTRACT

El cuadro clínico de la enfermedad conocida como COVID-19, causada por el nuevo coronavirus SARS-CoV-2 puede variar desde síntomas respiratorios leves hasta una insuficiencia respiratoria severa. Sus efectos en el organismo, especialmente la afección pulmonar, pueden ser visualizados a través de los estudios por imágenes. Si bien el diagnóstico de certeza se confirma mediante la reacción en cadena de la polimerasa con transcriptasa reversa (RT-PCR), los estudios por imágenes, especialmente la radiografía y la tomografía computarizada (TC) de tórax, desempeñan un papel fundamental en el manejo clínico de estos pacientes. Conocer su utilidad, casos de uso y hallazgos esperables brinda herramientas para el equipo de salud, temas que serán abordados en esta actualización y guía práctica. (AU)


The clinical pattern of the disease known as COVID-19, caused by the new coronavirus SARS-Cov-2 can range from mild respiratory symptoms to severe respiratory failure. Its effects on the body, especially the lung condition, can be visualized through imaging studies. While the diagnosis of certainty is confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR), imaging studies, especially chest xray and computed tomography (CT), play a critical role in the clinical management of these patients. Knowing their usefulness, use cases, and expected findings provides tools for the health care team, topics that will be addressed in this update, and practical guide. (AU)


Subject(s)
Humans , Pneumonia, Viral/diagnostic imaging , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnosis , Radiography, Thoracic/methods , Tomography, X-Ray Computed/methods , Polymerase Chain Reaction , Ultrasonography/methods , Coronavirus Infections/diagnosis , Pandemics , Betacoronavirus
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