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Italian Journal of Medicine ; 15(3):71, 2021.
Article in English | EMBASE | ID: covidwho-1567763

ABSTRACT

Background and Aim: Pulmonary involvement from CoViD-19 is frequent, after acute phase dyspnoea, cough, desaturation, respiratory insufficiency, can persist, pneumonia leads to interstitial disease (ground- glass) and to pulmonary fibrosis (honeycomb lung). A diagnostic algorithm can be a simple way for differential diagnoses (pulmonary embolism, PE) and to set up therapies in a systematic way. Our objective was to propose a simple and easy diagnostic algorithm, to identify with chest CT scan, excluding PE in high dimer- D patients, suggestive gait test and compatible objectivity. Methods: Prescription of: blood tests, radiological (CT chest CMC or High Resolution), respiratory physiopathology (Walking test, Global spirometry, Plethysmography, DLCO). Set drug therapies in case of PE, oral steroid (OCS) in case of extensive interstitial disease, long-acting beta 2 agonist bronchodilators (LABA), antimuscarinics (LAMA), inhaled steroids (ICS). For fibrosis and a honeycomb pattern, treatment with dipalmitoylethanolamide (PEA). Results: 258 outpatients, average 60.68 years, 115 women, 143 men, with an urgent request for pneumological visit and treated on an outpatient basis. 1 pt died during treatment, 4 pts were diagnosed with pulmonary embolism. 4 pts required a prescription for oxygen therapy. 228 pts presented ground-glass, 30 pts showed normal chest CT. Conclusions: DLCO shows progressive improvement in values after ICS treatment. Small pathway deficiency evidenced by spirometry can be treated with LABA-LAMA especially in patients with a previous history of cigarette smoking or COPD.

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