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Intervenc= ión sobre Covid19 en pacientes con cáncer de pulmón y sus familiares  

 

 

Intervention on Covid19 in patients with lung cancer and their relatives

 

= 1

Lisandry Alonso Lemus

https://orcid.org/0000-0002-2986-1790

 

 

Hospital Comandante Faustino Pérez, Matanzas, Cub= a

lisa= ndryalonso@gmail.com

= 2

Kirenia Camacho Sosa

 

https://orcid.org/= 0000-0002-7353-0227

 

 

Hospital Comandante Faustino Pérez, Matanzas, Cuba

kireniac.mtz@infomed.sld.cu

3=

Esteban Carlos Valenzuela Cordero                         https://orcid.o= rg/0000-0001-9856-9761

Hospital Comandante Faustino Pérez, Matanzas, Cuba

esteban.valenzuela@nauta.cu

4

Luís Enrique Curbelo Gutiérez                                 https:= //orcid.org/0000-0002-7761-9595

Hospital Comandante Faustino Pérez, Matanzas, Cub= a

luis= .curbelo@icloud.com

 

 

 

&nb= sp;

 

Artículo de Investiga= ción Científica y Tecnológica

Enviado: 16= /12/2021

Revisado:<= span style=3D'font-size:10.0pt;font-family:"Times New Roman",serif;mso-fareast= -font-family: "Times New Roman";mso-ansi-language:ES-EC;mso-fareast-language:EN-US'> 05= /01/2022

Aceptado:<= span style=3D'font-size:10.0pt;font-family:"Times New Roman",serif;mso-fareast= -font-family: "Times New Roman";mso-ansi-language:ES-EC;mso-fareast-language:EN-US'> 19= /01/2022

Publicado:= 04/= 04/2022

     <= /span>DOI: https://doi.org/10.3326= 2/anatomiadigital.v5i2.1.2122

 

 

 

 

Cítese:

 

 

Alonso Lemus, L., Camacho Sosa, K., Valenzuela Cordero, E. C., &am= p; Curbelo Gutiérez, L. E. (2022). Intervención sobre Covid19 en pacientes c= on cáncer de pulmón y sus familiares . Anatomía Digital, 5(2.1), 17-31. https://doi= .org/10.33262/anatomiadigital.v5i2.1.2122

 

 

 

ANA= TOMÍA DIGITAL, es una Revista Electónica, Trimestral, que se publicará en sopor= te electrónico tiene como misión contribuir a la   formación de&nb= sp; profesionales competentes con visión humanística y crítica que sean capac= es de  exponer  sus resultados  investigativos y científicos = en la misma medida que se promueva mediante su intervención cambios positivos en  la sociedad. https://anatomiadigital.org=  

La revista es editada por la Editorial Ciencia Digital (Editorial de prestig= io registrada en la Cámara Ecuatoriana de Libro con No de Afiliación 663) www.celibro.org.ec

 

 

 

Esta revista está protegida bajo una licencia Creative Commons AttributionNonCommercialNoDerivatives 4.0 International. Copia de la licencia: http://creati= vecommons.org/licenses/by-nc-nd/4.0/

 

Pal= abras claves: : Covid-19; Cáncer de Pulmón; Intervención educativa; Prevención.<= /span>

 

Resumen

Introdu= cción: La COVID 19 es una enfermedad pandémica produci= da por el virus SARS-CoV-2, con varios grupos vulnerables a las complicacion= es de la infección como lo son los pacientes con cáncer de pulmón, asociados= a la inmunodepresión por el tratamiento oncoespecífico impuesto. Objetiv= o: determinar la efectividad de una intervención educativa sobre la Covid-19= en pacientes con cáncer de pulmón y sus familiares. Metodología: Se realizó un estudio cuasi-experimental, tipo antes-después, mediante una intervención educativa durante el período comprendido entre el primero de septiembre del 2020 al 31 de octubre de ese mismo año, a través de una encuesta aplicada. La intervención se diseñó en tres etapas: diagnóstica,= de intervención propiamente dicha y evaluativa. Resultados: Se observ= ó un aumento significativo del nivel de conocimiento adecuado después de la intervención educativa sobre generalidades de la Covid-19 (84.8%), los si= gnos y síntomas de enfermedad (95.7%), las complicaciones (82.6%), medidas de prevención (100%) y susceptibilidad a la Covid-19 (93.5%). Discusión:<= /b> la intervención educativa permite incrementar la percepción del riesgo en quienes la reciben, garantizando un mejor actuar en los mismos. Conclu= siones: la intervención educativa incrementó los conocimientos sobre la Covid-19 = y se demostró la efectividad de la misma.

 

 

Keywords:<= span lang=3DEN-US style=3D'font-size:12.0pt;line-height:115%;font-family:"Time= s New Roman",serif; mso-fareast-font-family:"Times New Roman";mso-ansi-language:EN-US;mso-far= east-language: EN-US'> Covid-19; Lung Cancer; Educational intervention; Prevention.=

 

 

Abstract

Introduction: COVID 19 is a pandem= ic disease caused by the SARS-CoV-2 virus, with several groups vulnerable to complications of infection such as patients with lung cancer, associated = with immunosuppression due to the oncospecific treatment imposed. Objective= : to determine the effectiveness of an educational intervention on Covid-19= in patients with lung cancer and their families. Methodology: A quasi-experimental, before-after study was carried out through an educati= onal intervention during the period from the first of September 2020 to Octobe= r 31 of that same year, through an applied survey. The intervention was design= ed in three stages: diagnostic, intervention itself and evaluative. Results: A significant increase in the level of adequ= ate knowledge was observed after the educational intervention on generalities= of Covid-19 (84.8%), signs and symptoms of disease (95.7%), complications (82.6%), prevention measures (100%) and susceptibility to Covid-19 (93.5%= ). Discussion: the educational intervention allows to increase the perception of the ris= k in those who receive it, guaranteeing a better act in them. Conclusions:<= /b> the educational intervention increased knowledge about Covid-19 and its effectiveness was demonstrated.

 

 

 

 

Introducción

El 30 de enero del 2020 la Organización Mundial de la Salud (OMS) (1-3) <= /sup>declara emergencia sanitaria de compromiso internacional a la enfermedad producida = por el virus Sars-CoV-2, y luego bajo la rápida expansión y el grado de letalid= ad, se implanta el término de pandemia, el 11 de marzo del mismo año. El comportamiento desmedido sobre casi todo el territorio internacional provocó una parábola de casos que se batían entre cifras de muertes y casos confirmados. En el mundo hasta el 11 de octubre se reportaban 185 países con casos de COVID19, 37 287 938 los casos confirmados y 1 073 675 fallecidos, = para una letalidad de 2,87 %. La región de las Américas, a su vez, reporta 17 971 691 casos confirmados, el 48,19 % del total de casos reportados en el mundo, con 592 222 fallecidos para una letalidad de 3,29 %. Para el 12 de octubre = del 2020 Cuba reporta un total de 699 646 muestras realizadas y de ellas 6 000 positivas y 123 fallecidos para una letalidad de 2,1 %. <= /p>

Los coronavirus constituyen virus envueltos, de mediano a gran tamaño (80-220 n= m) y con el genoma de ARN monocatenario de sentido positivo más extenso que se ha conocido. Pertenecen a la categoría betaCoVs y codifican la proteína nsp14 exón. Reciben el nombre al presentar proyecciones proteicas superficiales características en forma de espiga, que dan aspecto de corona en microscopía electrónica de tinción negativa; es sensible a los rayos ultravioleta y al calor y puede ser inactivado por solventes lipídicos que incluyen éter (75%= ), etanol, desinfectante que contiene cloro, ácido peroxiacético y cloroformo, excepto la clorhexidina. Chan (4-6) demostraron que el genoma del SARS-CoV-2 tenía un 89% de identidad de nucleótidos con CoVZXC21 similar al SARS de murciélago y un 82% con el del SARSCoV humano. Su genoma de ARN monocatenario contiene 29,891 nucleótidos que codifican 9,860 aminoácidos. =

La principal vía de transmisión es mediante el contacto directo o indirecto de= las mucosas con gotitas o fómites contagiosos, donde las células ciliadas representan la diana de ataque principal, que, asociado al proceso de infección, pérdidas de células individuales y respuesta inmunitaria dan pas= o a la expresión clínica de la enfermedad. La infección se vincula a la síntesi= s de citoquinas, dígase interleucina 6, 8 (IL-6 u 8) y el interferón g (IFN-g), donde se muestra una relación directa entre la tormenta de citoquinas y est= ado de severidad (7).

La sintomatología propia de esta patología (8) consiste en tos, dol= or faríngeo, cefalea y malestar general. La fiebre es uno de los principales síntomas de alerta, presente en el 60% de los casos e incluso asociado a la aparición de infecciones de vías respiratorias bajas: bronquiolitis, neumon= ías en adultos y niños inmuno-competentes e inmunodeprimidos. Los niños desarro= llan en mayor medida otitis media y trastornos del tracto digestivo. La complica= ción más severa es el distrés respiratorio agudo que surge a evolución de una neumonía bacteriana secundaria.

Los pacientes con cúmulo de comorbilidades aumentan el grado de complicación y letalidad, representando 10.5 % enfermedades cardiovasculares, 7.3 % en diabéticos, 6.3 % en pacientes con enfermedades respiratorias crónicas, 6.0= % en hipertensos y el 5.6 % en individuos con cáncer, esta última entidad representa la segunda causa de muerte en Cuba y en el mundo y entre ellos, = el de pulmón alcanza el primer puesto de defunciones asociadas, esta entidad se  detecta en su mayoría de forma<= span style=3D'mso-spacerun:yes'>  tardía, se diagnostica en etapas avanza= das y hasta un 80% evoluciona a la enfermedad metastásica, por lo que se asocia un pronóstico desfavorable y solo el 3 a 7% alcanzan una larga supervivencia. = El tratamiento de elección para las etapas iniciales se basa en cirugía, por lo que se sumerge el paciente a la manipulación continua y el uso del ventilad= or; sin embargo los candidatos a radioterapia y quimioterapia comprometen el sistema inmunológico humano, pero se ha de destacar que en el paciente oncológico no posee un umbral menor que un individuo aparentemente sano, en cuanto a transmisión del virus se refiere, sin embargo los tratamientos impuestos disminuyen su capacidad de defensa inmunológica,  estos datos la mayoría de la población = los desconocen por lo que todo el personal de salud se envuelve en la responsabilidad de promover información para después recibir resultados emp= rendedores (9). El objetivo de este trabajo es determinar la efectividad de= una intervención educativa sobre la COVID-19 en pacientes con cáncer de pulmón.=

Metodología

Se realizó un estudio cuasi-experimental, tipo antes-después sin grupo control mediante una intervención educativa en pacientes con diagnóstico de cáncer = de pulmón y sus familiares durante el período comprendido entre el 1ero de septiembre del 2020 al 31 de octubre de ese mismo año. El universo lo constituyó 46 personas (pacientes con diagnóstico de cáncer de pulmón y familiares de estos pacientes) que asistieron a la consulta de oncología en= el transcurso de esos dos meses y aceptaron participar en la investigación. La intervención se diseñó en tres etapas: diagnóstica, de intervención educati= va y evaluativa (medidor del impacto), las fases fueron desarrolladas entre mart= es y miércoles de cada semana. 

Etapa diagnóstica: Los participantes recibieron explicaciones detalladas acerca de los objetivos y beneficios de esta investigación, así como también se les solicitó su consentimiento informado. Se elaboró un listado con los nombres= y apellidos de todos los pacientes y se aplicó una encuesta para determinar c= uál era el conocimiento base sobre la Covid-19 y su relación con el cáncer de pulmón; se identificaron las principales necesidades de aprendizaje. La encuesta aplicada constó de cinco interrogantes, evaluándose el nivel de conocimiento como adecuados o inadecuados. La evaluación por preguntas incl= uyó: generalidades de la Covid-19 (interrogante 1), signos y síntomas de la Covid-19: tos seca, fiebre, dificultad respiratoria, congestión nasal, dolo= r de garganta, cefalea y malestar general (interrogante 2), las complicaciones d= e la Covid-19: síndrome de distrés respiratorio, arritmias cardíacas, choque sép= tico y muerte (interrogante 3), medidas para la prevención de la Covid-19 (interrogante 4), susceptibilidad de los mismos a la Covid-19 (interrogante= 5); y se obtuvo una evaluación global del conocimiento.

Etapa de intervención: Al culminar el análisis de los resultados obtenidos median= te la encuesta, se realizó una intervención educativa cuyo programa se diseñó = en base a las necesidades del aprendizaje detectadas. Se crearon dos grupos de= 23 pacientes separados en dos sesiones. Se trabajó con los pacientes durante d= os meses, a razón de dos sesiones semanales (martes y miércoles), de 45 minutos cada una. Se utilizaron técnicas participativas como lluvia de ideas, charl= as educativas, discusión grupal y se les entregó un folleto diseñado por los autores con el objetivo de promover salud y motivarlos. 

Etapa de evaluación.

Se realizó la aplicación de la encuesta inicial, que permitió medir el impacto= del nivel de conocimiento alcanzado, la cual fue aplicada antes y después de la intervención educativa. Dicha encuesta se evaluó con anterioridad en una población de 10 pacientes para determinar posibles errores o ajustes, se ob= tuvo una correcta aceptación de las interrogantes, catalogadas como comprensible= s, directos, adecuada extensión y aplicable tiempo dispuesto, sin negación o resistencia a las preguntas.

Para el procesamiento de la información, se diseñó una base de datos en el progr= ama Microsoft Excel 2013 y se reflejaron las variables correspondientes. Se rea= lizó el análisis descriptivo de los datos a través de frecuencias absolutas y porcentajes. Se utilizaron medidas de resumen para variables cualitativas y cuantitativas, los resultados se presentaron en tablas estadísticas para su mejor comprensión. Para el análisis comparativo que contempla el estudio (a= ntes y después) se aplicó el test de McNemar, para analizar si la tasa de respue= sta inicial es igual a la tasa de respuesta final. Para ello se clasificó el co= nocimiento de los pacientes de las cuatro variables en estudio, es decir adecuado (1) e inadecuado (0), esto llevó a dos hipótesis: no hubo cambio en el conocimien= to con la intervención(H0) o sí hubo cambio en el conocimiento(H1). Con la utilización del SPSS versión 23 se pudo aplicar adecuadamente esta prueba p= ara cada una de las variables estudiadas obteniendo como resultado una probabil= idad p ≤ 0.05.

Los aspectos éticos se ajustaron a los principios fundamentales y emanados de la Asociación Médica Mundial y el Ministerio de Salud Pública de Cuba. Se les explicó a pacientes y familiares en qué consistía el estudio y se les entre= gó un consentimiento informado, el cual firmaron antes de la inclusión. <= /o:p>

Resultado= s

Tabla1. <= /span>Interrogante 1, generalidades sobre la covid-19. N=3D46

Valoración

Antes.

Después.

 

Fa

Fr(%)

Fa

Fr(%)

Adecuado

18

39.1

39

84.8

Inadecuado

28

60.9

7

15.2

Total

46

100

46

100

Fuente: Encuesta.

Se observa en = la tabla1, un predominio del conocimiento inadecuado de los pacientes acerca de las generalidades de la Covid-19, que representa el 60.9% al inicio de la investigación y luego de la intervención educativa y reevaluación. Se obtuvo un ascenso a la categoría de aprendizaje adecuado de 84.8% para un diferencial de 45.7%.

Tabla 2. Interrogante 2, signos y síntomas de la Covid-19. N=3D46

Valoración

Antes.

Después.

 

Fa

Fr(%)

Fa

Fr(%)

Adecuado

21

45.7

44

95.7

Inadecuado

25

54.3

2

4.3

Total

46

100

46

100

Fuente: Encuesta.

Se evidencia e= n la tabla 2 un predominio del conocimiento inadecuado con 54.3%, pero se ha de resaltar que con solo un diferencial de 8.6% de los que si poseían una evaluación base adecuada al inicio del estudio, que representó un 45.7%, y = al establecerse la intervención educativa se obtiene un ascenso al 95.7% de pacientes con un aprendizaje aceptable.

Tabla 3. Interrogante 3, complicaciones de la Covid-19. N= =3D46

Valoración

Antes.

Después.

 

Fa

Fr(%)

Fa

Fr(%)

Adecuado

12

26.1

38

82.6

Inadecuado

34

73.9

8

17.4

Total

46

100

46

100

Fuente: Encuesta.

La tabla 3 mue= stra en principio, un predominio del conocimiento inadecuado de los pacientes ac= erca de las complicaciones de la Covid-19, representando un 73.9%, y solo el 26.= 1% obtuvo una categoría de adecuado, entonces tras la intervención educativa y reevaluación se obtiene un ascenso de la cifra de pacientes que logran obte= ner una categoría de adecuado representando un 82.6%, con un diferencial de 56.= 5%, evidencia notable del aprendizaje adquirido y consigo haciendo muestra del impacto de la intervención.

Tabla 4. Interrogante 4, medidas para la prevención de la Covid-19. N=3D46

Valoración

Antes.

Después.

 

Fa

Fr(%)

Fa

Fr(%)

Adecuado

38

82.6

46

100

Inadecuado

8

17.4

0

0

Total

46

100

46

100

Fuente: Encuesta.

Se muestra en = la tabla 4, un predominio del conocimiento adecuado sobre las medidas de prevención de la Covid-19 al inicio del estudio, representando el 82.6%, y luego de la intervención educativa se consolidaron y ascendieron las cifras hasta alcanzar la totalidad de pacientes con un conocimiento aceptable.

 

 

Tabla 5. Interrogante 5, susceptibilidad de los mismos a la Covid-19. N=3D46

Valoración

Antes.

Después.

 

Fa

Fr(%)

Fa

Fr(%)

Adecuado

17

37

43

93.5

Inadecuado

29

63

3

6.5

Total

46

100

46

100

Fuente: Encuesta.

Al comienzo se evidencia, en la tabla 5, cifras muy elevadas de conocimiento inadecuado de= los pacientes con cáncer de pulmón sobre la susceptibilidad de los mismos a la Covid-19, representando un 63%, casi la totalidad de los participantes planteaban que la enfermedad oncológica aumentaba su predisposición a la enfermedad, que en realidad es incierto, pues son los tratamientos oncoespecíficos los que ocasionan un estado de inmunodepresión relativa que puede aumentar el estado de severidad del cuadro clínico, pero no existe una intervención directa en la susceptibilidad a la transmisión. Luego de la intervención educativa las cifras de aprendizaje eficiente aumentaron, lo q= ue representó el 93.5%.

Discusión

Los coronavirus son virus de ARN de cadena positiva, sencilla, no segmentados. Pertenecen al orden Nidovirales, la fam= ilia Coronaviridae y la subfamilia Orthocoronavirinae, que se dividen en géneros según sus características serotípicas y genómicas. Posee una estructura con protuberancias en forma de corona, que cierra el genoma ARN, viriones redon= dos u ovalados, que estos datos le conceden su denominación. El diámetro del coronavirus se extiende desde 60 a 140nm. La proteína espiga se encuentra e= n la superficie del virus y forma una estructura en forma de barra. Como una de = las principales proteínas antigénicas del virus, es utilizada para la tipificac= ión, encapsula el genoma viral y puede usarse como antígeno de diagnóstico = (1,4).

En 2019 se aísla el nuevo coronavirus del tracto respiratorio inferior de pacientes que padecieron de neumonía debido= a causas desconocidas, la Organización Mundial de la Salud (OMS) (7) lo denominó 2019-nCoV .Tras estudios genómicos se determina que existe homolog= ía genética con el Sars-CoV, y la confirmación de transmisión entre las person= as, sin embargo su estructura vino acompañado de varias mutaciones antigénicas = lo que ocasiona que el sistema inmunológico humano lo reconozca como un nuevo virus, todo esto propició que en un tiempo muy reducido, esta nueva cepa se volviera epidémica. Sin embargo, continuaba la duda del origen de la infecc= ión, donde un sinnúmero de investigaciones reveló que fue a través de vectores zoonóticos como las serpientes y los murciélagos, estos últimos se consider= an los anfitriones naturales con más del 85% de homología genómica. =

En el estudio realizado (10) se obtuvo que el 60.9% de los participantes no poseían un conocimiento básico adecuado acerca de las generalidades de la Covid-19, los autores de este trabajo lo relacionan con el justificante de que existe muy poca información acerca de esta etiología, y aunque los medios de difusión actual brindan contenido exclusivo de la enfermedad, no siempre se captan de una forma apr= opiada por la población en general. El impacto de la intervención educativa se evidencia en el incremento del porcentaje de los pacientes que tras la reevaluación obtuvieron una valoración satisfactoria o aceptable, con un 84= .8%. Estos resultados discrepan a los obtenidos en un estudio en la provincia de= Las Tunas, en un grupo de estudiantes de medicina, incorporados a la pesquisa activa en función de la Covid-19, que obtuvieron una categoría de bien en un 80% con una apropiada clasificación etiológica de la enfermedad desde el comienzo de la encuesta, esto se relaciona de forma directa al campo estudiantil vinculante y la exposición constante como promotores de salud j= unto al equipo básico de salud.

Lo antes planteado se evidencia con el est= udio realizado por Gómez (11), donde evaluó el impacto de la aplicaci= ón de una intervención educativa sobre el nivel de conocimiento de la Covid-19, sobre las generalidades del nuevo coronavirus, donde solo 23,4 % presentó al inicio un adecuado nivel de conocimientos, y luego de realizada la interven= ción se evidenció en el 95,4 %, coincidiendo con el presente estudio.

La enfermedad por Covid-19, encierra un cu= adro clínico que involucra signos y síntomas (8) como: fiebre, tos, d= olor de cabeza, dolor muscular y otros síntomas de infección respiratoria relacionados a neumonía o síndrome de dificultad respiratoria aguda que pue= den llevar al paciente a fallecer. Los síntomas pueden diferenciarse de los desatados por virus respiratorios en general, se extienden desde un resfria= do común hasta enfermedades más graves como laringo-traqueítis, exacerbaciones= de asma, bronquiolitis y neumonías. Además, pueden causar cuadros infecciosos digestivos como: enteritis o colitis ulcerosa en recién nacidos y lactantes= .

En el estudio realizado se obtuvo un nivel adecuado de conocimiento en un 45.7% de los participantes, que ascendió a posteriori al 95.7%, cabe resaltar que desde la aplicación de la primera encuesta solo existió un diferencial bastante reducido (8.6%) en relación al personal que contaba con una idea general inadecuada. Lo establecido coinci= de con una investigación de Díaz y otros, en un estudio entre abril y mayo del 2020 en adultos mayores de un consultorio médico del municipio Habana del E= ste, donde se constató resultados similares a los obtenidos, pues el 48,8 % de la población mostró niveles inadecuados de conocimientos sobre signos y síntom= as de alerta de la Covid-19 y luego del desarrollo de la intervención ascendió= a 64,28 % en la categoría de adecuado (12). =

Las complicaciones desarrolladas por la enfermedad (9) son: el síndrome de distrés respiratorio, arritmi= as cardíacas, choque séptico y muerte, la mayoría de los pacientes evaluados no poseían un conocimiento adecuado al inicio del estudio, con un 26.1%, sin embargo el estado de severidad lo asociaban directamente a los antecedentes personales del individuo afectado, aun desconociendo las complicaciones a desarrollar en los peores pronósticos, luego de la intervención se obtuvo un aprendizaje efectivo en el 82.6% de los pacientes, lo que permitió valorar = como óptimo los resultados de la intervención educativa, respecto a esta sesión.=

Los cuadros más severos de la enfermedad c= omo se expuso con anterioridad se involucran a las comorbilidades que padecen, estos datos se refuerzan con estadísticas mundiales, pues la tasa de muerte= del brote en Wuhan, China, llega a 10.5 % en el caso de personas con enfermedad cardiovascular, un 7.3 % en pacientes con diabetes mellitus, un 6.3 % a cua= dros respiratorios anteriores, 6 % asociada a la hipertensión arterial y en un 5= .6 % en los pacientes oncológicos. Estos últimos constituyen la población elegida para la intervención pues en las consultas diarias se escucha con repetició= n la idea de existir una mayor susceptibilidad al contagio de la enfermedad por Covid-19 por parte de las personas afectadas por cáncer y en especial el de pulmón, y que se ha convertido en una información errónea compartida por pa= rte de la población no vinculada a la atención de salud en su mayoría, en el es= tudio realizado se encontró que solo el 37% poseía un conocimiento adecuado respe= cto a estos datos y tras la intervención se logró elevar estas cifras a 93.5% p= ara un diferencial de 56.5%. Existe la posibilidad de que los pacientes con un tratamiento oncológico inmunosupresor puedan tener un mayor número de complicaciones asociadas que la población general, tal y como ocurre con ot= ras infecciones virales respiratorias como la gripe, debido a la inmunodepresión asociada pero no hay evidencia de que el virus empeore la propia patología tumoral y en muchos casos tiene un curso clínico leve; lo que consolida la = idea de que el padecer cáncer de pulmón no aumenta el índice de contagio, pero en cambio sí representa un factor de riesgo para desarrollar cuadros más sever= os, al igual que el resto de las comorbilidades antes expuestas y la edad avanz= ada (1).

El tratamiento de elección para las etapas iniciales del cáncer de pulmón (13) se basa en cirugía, pero se sumerge el paciente a la manipulación continua y el uso del ventilador, por= lo que se prefiere el uso con radioterapia, quimioterapia e inmunoterapia en tiempos de pandemia.

La quimioterapia es el principal tratamien= to oncológico asociado a inmunosupresión por lo que, en los pacientes en tratamiento activo deberán extremarse las precauciones para evitar el conta= gio(14,15). En la sala de quimioterapia de los hospitales es razonable también limitar = la presencia de acompañantes, con las excepciones que se consideren oportunas,= a criterio de médicos y enfermeras. La cantidad de exposición al virus también determina si se infecta o no.  Si e= stá expuesto a una gran cantidad de virus, puede enfermarse incluso si su funci= ón inmunológica es normal. El tratamiento con quimioterapia no debe ser prolon= gado pues traería consecuencias graves para el paciente con cáncer de pulmón, el miedo a enfermar no debe imponer una idea de dejación o prolongación de la quimioterapia, sino tomar las medidas necesarias para no enfermar pues el contagio de la infección por Covid-19 es el mismo para el paciente inmunodeprimido y el aparentemente sano. En cuanto a la radioterapia, un gr= upo de científicos investigadores publicaron un estudio donde se observó que en pacientes con COVID 19 se le podían administrar dosis bajas de radiaciones (menos de 100 centi grey) a esta neumonía viral y actuaba como antinflamato= rio y se observaba una disminución de la secreción de las citoquinas, inhibidor= es de la tirosina kinasa. (14) Sin embargo la inmunoterapia actúa a favor del sistema inmunológico, aumentando su capacidad de respuesta ante células anormales o cancerosas y consigo eleva las armas naturales del cuer= po para el ataque de enfermedades de carácter infeccioso como la enfermedad por Covid-19, esto se evidencia al emplearse el anticuerpo monoclonal Itolizuma= b en fases avanzadas de la enfermedad e implementados en los protocolos cubanos.=

La prevención de la enfermedad constituye = en la actualidad la base fundamental para combatir esta pandemia, por lo que se hace necesario continuar con la promoción de salud por el equipo básico de trabajo y fomento a través de los medios de difusión masiva, entre algunas = de las medidas aplicadas  están : lava= r las manos de manera frecuente, al toser y estornudar, cubrirse la boca y nariz = con la fosa cubital, uso del nasobuco, evitar el hacinamiento, uso constante de desinfectantes, adecuada ventilación, entre otras medidas, que de acuerdo a= los resultados de este estudio el conocimiento era adecuando en un 82.6% y lueg= o de la intervención se obtuvo un aprendizaje aceptable en la totalidad de los pacientes (8).

La intervención educativa les permitió a l= os pacientes conocer un poco más de la enfermedad por Covid-19, adquirir nuevas herramientas en la esfera del cuidado personal, en el ámbito laboral, hospitalario y social, además reconocer los signos clínicos de alarma e inc= luso incorporar la idea de que tanto los pacientes con cáncer de pulmón y los aparentemente sanos poseen el mismo riesgo de contagiosidad, sin embargo, destacar que las comorbilidades aumentan el riesgo de gravedad y aparición = de complicaciones, por lo que cuidar la salud individual y familiar mediante la prevención es el arma de ataque más potente y se encuentra en la mano de to= dos.

Conclusiones

·&nb= sp;        El cáncer de pulmón predispone a padecer COVID 19 y sus complicaciones.

·&nb= sp;        No existe una percepción de riesgo adecuada a padecer COV= ID 19 en los pacientes con cáncer de pulmón.

·&nb= sp;        Se obtuvo un ascenso a la categoría de aprendizaje= de los pacientes con los cuales se trabajó.

 

Referencias bibliográficas

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Conflicto de intereses

Los autores declaran que no existe conflicto de intereses en relación con el artículo presentado.

 

 

Declaración de contribución de los autores

Lisandry Alonso Lemus contribuyó con la recogida del dato primario, la confección de la base de datos, el procesamiento de los datos, la discusión= y la redacción del artículo.

Kirenia Camacho Sosa contr= ibuyó con la recogida del dato primario, la confección de la base de datos, el procesamiento de los datos.

Esteban Carlos Valenzuela Cordero contribuyó con la recogida del dato primario, la = confección de la base de datos.<= o:p>

Luís Enrique Curbelo Gutiérez contribuyó con la recogida del dato primario, la confección de la base de datos.

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El artíc= ulo que se publica es de exclusiva responsabilidad de los autores y no necesariamente reflejan el pensamiento de la Revista Anatomía Digital.

 


El artículo queda en propiedad de la revista y, por tanto, su publicación parcial y/o total en otro medio tiene = que ser autorizado por el director de la Revista Anatomía Digital.<= /o:p>

 

 


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Vol. 5 No. 2.1,  pp. 17 – 31 , abril 2022=

 

 

 

 

 

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