RESUMEN
PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19) has produced an extraordinary amount of literature in a short time period. This review focuses on what the new literature has provided in terms of more general information about the management of community-acquired pneumonia (CAP). RECENT FINDINGS: Measures taken to reduce the spread of COVID-19 have caused a significant drop in influenza worldwide. Improvements in imaging, especially ultrasound, and especially in the application of rapid molecular diagnosis are likely to have significant impact on the management of CAP. Therapeutic advances are so far limited. SUMMARY: COVID-19 has taught us that we can do far more to prevent seasonal influenza and its associated mortality, morbidity and economic cost. Improvements in imaging and pathogen diagnosis are welcome, as is the potential for secondary benefits of anti-COVID-19 therapies that may have reach effect on respiratory viruses other than severe acute respiratory syndrome coronavirus 2. As community-transmission is likely to persist for many years, recognition and treatment of severe acute respiratory syndrome coronavirus 2 will need to be incorporated into CAP guidelines moving forward.
Asunto(s)
COVID-19/diagnóstico , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/terapia , Técnicas de Laboratorio Clínico , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/prevención & control , Infecciones Comunitarias Adquiridas/terapia , Diagnóstico por Imagen , Humanos , Control de Infecciones , Neumonía/diagnóstico , Neumonía/prevención & control , Neumonía/terapia , SARS-CoV-2Asunto(s)
Corticoesteroides/uso terapéutico , Tratamiento Farmacológico de COVID-19 , Factores Inmunológicos/uso terapéutico , SARS-CoV-2 , Esteroides/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Dexametasona/uso terapéutico , Humanos , Hidrocortisona/uso terapéutico , Interleucina-6/antagonistas & inhibidores , Ensayos Clínicos Controlados Aleatorios como Asunto , Síndrome de Dificultad Respiratoria/tratamiento farmacológicoRESUMEN
COVID-19 is a new infectious disease causing severe respiratory failure and death for which optimal treatment is currently unclear. Many therapies have been proven to be ineffective; however, promising findings related to corticosteroid therapy have been published. Analysis of published data including in this issue suggests that therapy with corticosteroids in the range of 6 mg of dexamethasone (or equivalent) per day likely has a positive effect in patients requiring mechanical ventilation but there remains considerable doubt in patients over the age of 70, in patients with diabetes and patients with milder disease. Clinicians must consider the individual potential risks and benefits of corticosteroid in patients with COVID-19 rather than routinely using them until more data is available.