Apical pulmonary injury by SARS-COV-2 and mild clinical profile manifestation. A case report

Revista GICOS

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Title Apical pulmonary injury by SARS-COV-2 and mild clinical profile manifestation. A case report
Lesión pulmonar apical por SARS-COV-2 y manifestación de cuadro clínico leve. Reporte de un caso. Apical pulmonary injury by SARS-COV-2 and mild clinical profile manifestation. A case report
 
Creator Bratta, Diego
Peña, Wilmer
Newman, Oriana
 
Subject
COVID-19; ventilation / perfusion; tomography.

COVID-19; ventilación/perfusión; tomografía. COVID-19; ventilation / perfusion; tomography.
 
Description The coronavirus is a viral agent, responsible for the current pandemic, declared a public health emergency by the WHO, which began in Wuhan, China. COVID-19 is causing severe lung involvement in some patients. Computerized axial tomography has proven to be a sufficiently sensitive diagnostic method to complement the diagnosis of coronavirus pneumonia, supporting the RT-CPR test. The compromise of the ventilation / perfusion ratio in some cases can help to guide the severity of the lung compromise, and in others, it can serve as a prognosis. The ventilation / perfusion relationship can be calculated through the formula of the Alveolar-arterial Oxygen Difference (DA-a02), together with this, the Kirby index is an indirect measure that allows evaluating the degree of respiratory failure as a product of a pulmonary inflammatory process, intrapulmonary shunt. The results of both calculations, added to the CT imaging findings and the semiological elements, can be indicative of the pulmonary functional status and the risk of having an unfavorable evolution. Applying these principles of lung physiology in the pathophysiological context of COVID-19 lung infection may be useful in medical practice. In our case, the distribution of the injuries observed in the CT scan by COVID-19 could be related to the areas of affectation in the lung parenchyma observed and the commitment that the pulmonary inflammatory process has in unbalancing the gas exchange zones, the ventilation ratio / perfusion (V / Q).
El coronavirus es un agente viral, responsable de la pandemia actual, declarada como una emergencia de salud pública por la OMS, que inició en Wuhan, China. El COVID-19 está causando un compromiso pulmonar severo en algunos pacientes. La tomografía axial computarizada ha demostrado ser un método diagnóstico lo suficientemente sensible para complementar el diagnóstico de neumonía por coronavirus, apoyando a la prueba de RCP-RT. El compromiso de la relación ventilación/perfusión en algunos casos puede ayudar a orientar sobre la gravedad del compromiso pulmonar, y en otros, puede servir de pronóstico. La relación ventilación/perfusión pude ser calculada a través de la fórmula de la Diferencia Alveolo-arterial de oxígeno (DA-a02), junto a esta, el índice de Kirby es una medida indirecta que permite evaluar el grado de insuficiencia respiratoria como producto de un proceso inflamatorio pulmonar, shunt intrapulmonar. Los resultados de ambos cálculos sumados a los hallazgos de imagen de la TAC y los elementos semiológicos, pueden ser orientadores del estado funcional pulmonar, y el riesgo de tener una evolución no favorable. La aplicación de estos principios de la fisiología pulmonar en el contexto fisiopatológico de la infección pulmonar por COVID-19 puede ser de utilidad en la práctica médica. En nuestro caso la distribución de las lesiones observadas en la TAC por COVID-19 pudiera estar en relación con las áreas de afectación en el parénquima pulmonar observadas y el compromiso que tiene el proceso inflamatorio pulmonar en desequilibrar las zonas de intercambio gaseoso, la relación ventilación/perfusión (V/Q).The coronavirus is a viral agent, responsible for the current pandemic, declared a public health emergency by the WHO, which began in Wuhan, China. COVID-19 is causing severe lung involvement in some patients. Computerized axial tomography has proven to be a sufficiently sensitive diagnostic method to complement the diagnosis of coronavirus pneumonia, supporting the RT-CPR test. The compromise of the ventilation / perfusion ratio in some cases can help to guide the severity of the lung compromise, and in others, it can serve as a prognosis. The ventilation / perfusion relationship can be calculated through the formula of the Alveolar-arterial Oxygen Difference (DA-a02), together with this, the Kirby index is an indirect measure that allows evaluating the degree of respiratory failure as a product of a pulmonary inflammatory process, intrapulmonary shunt. The results of both calculations, added to the CT imaging findings and the semiological elements, can be indicative of the pulmonary functional status and the risk of having an unfavorable evolution. Applying these principles of lung physiology in the pathophysiological context of COVID-19 lung infection may be useful in medical practice. In our case, the distribution of the injuries observed in the CT scan by COVID-19 could be related to the areas of affectation in the lung parenchyma observed and the commitment that the pulmonary inflammatory process has in unbalancing the gas exchange zones, the ventilation ratio / perfusion (V / Q).
 
Publisher GICOS
 
Contributor

 
Date 2021-09-06
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion



 
Format application/pdf
 
Identifier http://erevistas.saber.ula.ve/index.php/gicos/article/view/17369
 
Source GICOS; Vol. 6, Núm. 3 (2021): Especial 2; 85-93
2610-797X
 
Language spa
 
Relation http://erevistas.saber.ula.ve/index.php/gicos/article/view/17369/21921928538
 
Rights Copyright (c) 2021 GICOS
 

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