RESUMEN
Patients with chronic obstructive pulmonary disease (COPD) may experience exacerbations. During severe exacerbations, nutritional and endocrinological comorbidities can play an important role in the clinical and functional aspects of these patients. The aim of this study was to analyse the influence of the presence of diabetes mellitus (DM) and nutritional parameters on the deterioration of symptoms and quality of life during a severe exacerbation in patients with COPD. An observational study was conducted on COPD patients admitted due to an exacerbation. The COPD Assessment Test (CAT) questionnaire was administered, and clinical and functional parameters were compared based on the presence of nutritional and endocrinological alterations. A total of 50 patients were included, of whom 30 (60%) were male. The mean age was 70.5 years (standard deviation (SD) 9.6). The median CAT score during exacerbation was 25 (interquartile range (IQR) 17.5-30), and the baseline score was 13.5 (IQR 7-19), which represented a statistically significant difference (p < 0.001). Patients with iron deficiencies had a lower total CAT score (p = 0.041), specifically for items related to daily activity (p = 0.009) and energy (p = 0.007). Diabetic patients exhibited a greater decline in pulmonary function during exacerbation (p = 0.016), while patients with high thyroid-stimulating hormone (TSH) levels had a shorter hospital stay (p = 0.016). For COPD patients admitted due to an exacerbation, the metabolic assessment is useful and relevant in the clinical set-up, as endocrinological comorbidities negatively affect clinical and functional aspects of these patients.
RESUMEN
La infección por el nuevo coronavirus (SARS-CoV2) tuvo un tratamiento debatido debido a la incógnita sobre su patogenia,que con el pasar del tiempo se aclaró evidenciándose un componente inflamatorio, siendo la corticoterapia una opciónterapéutica. En pacientes con corticoides es primordial conocer las posibles reacciones colaterales por su efecto inmuno-supresor. Presentamos el caso de un varón de origen ecuatoriano, de 48 años, que tras infección por SARS-CoV-2 tratadacon corticoides presentó exantema serpiginoso que tras serología para Strongyloides stercoralis se confirmó el diagnósticode larva currens.(AU)
The infection by the new coronavirus (SARS-CoV-2) had in its beginnings a debated treatment, due to the unknown aboutits pathogenesis, which with the passage of time was clarified evidencing an inflammatory component. Corticosteroid the-rapy showed as a therapeutic option. In patients with corticosteroids it is essential to know the possible side reactions dueto their immunosuppressive effect. We present the case of a 48-year-old male from Ecuador, who after infection by SARS-CoV-2 treated with corticosteroids, suffering as a complication the appearance of a serpiginous rash in the lumbar region.Due to its migratory history, serology for Strongyloides stercoralis, the diagnosis of currens larva was confirmed.(AU)
