Terapia
respiratoria en pacientes adultos mayores con COVID-19. Revisión
de literatura
Respiratory therapy in eld=
erly
patients with COVID-19. =
Literature
review
1
Merwin Alejandro
Valencia Robalino
https://orcid.org/=
0009-0002-6684-6976
Maestría en Geront=
ología
Social -
Especialización en
Cuidados Paliativos, Universidad Nacional de Chimborazo, Riobamba, Ecuado=
r.
2
Lenin Sebastián Ar=
ias Á lvarez
https://orcid.org/0009-0009-16=
45-6364
Máster en Salud Pú=
blica
- Especialización en Salud Ocupacional, Investigador Independiente, Rioba=
mba,
Ecuador.
Lenin.arias.sso@gmail.com
3
Verónica del Rocío
Ramos Avalos
https://orcid.org/0009-0005-61=
83-189X
Magister en Gestió=
n de
los Servicios Hospitalarios Investigador Independiente, Riobamba, Ecuador=
.
VeronicaRamosfisioterapia@gmail.com
4
Ximena del Rocío
Robalino Flores
https://orcid.org/0000-0002-47=
12-6466
Magister en Cienci=
as
de la Educación mención Biología, Universidad Nacional de Chimborazo,
Riobamba, Ecuador.
xrobalino @unach.edu.ec
Artícu=
lo
de Investigación Científica y Tecnológica
Enviado: 2 9 /10/20=
23
Revisado: 2 6 /11/20=
23
Aceptado: 15/12/2023
Publicado:28/12/2023
<=
/p>
DOI:
https://do=
i.org/10.33262/anatomiadigital.v6i4.3.2822
Cítese:
Valencia Robalino, M. A., Arias Álvarez, L. S., Ramos Avalos, V. del =
R.,
& Robalino Flores, X. del R. (2023). Terapia respiratoria en pacientes
adultos mayores con COVID-19. Revisión de literatura. Anatomía Digital,
6(4.3), 559-576. https:=
//doi.org/10.33262/anatomiadigital.v6i4.3.2822 <=
/o:p>
&=
nbsp;
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oner
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 prestigio registrada en la Cámara
Ecuatoriana de Libro con No de Afiliación 663) www.celibro.org.=
ec
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nbsp;
Esta
revista está protegida bajo una licencia Creative Commons
Atribución-NoComercial-CompartirIgual 4.0 International. Copia de la
licencia: https://creative=
commons.org/licenses/by-nc-sa/4.0/deed.es
Palabras claves:
Terapia
Respiratoria, Adulto,
COVID-19,=
Fisioterapia y=
Post COVID-19<=
/span>
Resumen
La terapia respiratoria en los últimos a=
ños
ha tomado gran relevancia y con la llegada de la pandemia se convirtió en=
uno
de los pilares centrales del tratamiento de los pacientes infectados por
SARS-CoV-2 mejorando el pronóstico en su recuperación Objetivo. Ef=
ectuar
una revisión sistemática de literatura acerca de la terapia
respiratoria en el adulto mayor contaminado por el virus SARS-CoV-2. M=
etodología.
Se realizó una revisión sistemática de literatura recolectada de base=
de
datos como Medline (a través de PubMed), Scielo y Google Academic y bibliotecas virtuales de repositorios universitarios. Sobre la terapia respiratoria aplicad=
a en
el tratamiento en pacientes infectados por COVID-19 siendo las palabras
claves utilizadas: terapia respiratoria, adulto, COVID-19, fisioterapia y
post COVID-19. Resultados. Se realizó una revisión bibliográfica y
documentada de los artículos científicos publicados dando como resultado =
que
la población más afectada por la pandemia fueron las personas de género
masculino y el promedio de recuperación de los pacientes sometidos a tera=
pia
respiratoria es de 13 días. Conclusión. Se pudo evidenciar que los
pacientes de género masculino son los más afectados por el virus de
SARS-CoV-2 además l as enfermedades como la
hipertensión arterial, la diabetes y la obesidad son predictores de un
aumento del porcentaje de fallecimientos de los pacientes contaminados por
SARS-CoV-2. Área=
de
estudio general: Fisi=
oterapia.
Área de estudio específica: Terapia Respiratoria. Tipo de estud=
io: Revisión Bibliográfica.
Keywords:
Respiratory Therapy,
Adult,
COVID-19,
Physiotherapy and
Post COVID-19
Abstract
Introduction.
Respiratory therapy has gained significant relevance in recent yea=
rs,
and with the onset of the pandemic, it has become one of the central pill=
ars
in the treatment of Elderly Patients infected with SARS-CoV-2, improving
their prognosis in recovery. Objective. To conduct a systematic
literature review on respiratory therapy in adults infected with the
SARS-CoV-2 virus. Methodology. A
systematic literature review was conducted, collecting data from databases
such as PubMed, Scielo, Google Academic and virtual libraries of universi=
ty
repositories. The focus was on respiratory therapy applied in the treatme=
nt
of COVID-19-infected patients, with the keywords used including respirato=
ry
therapy, adult, COVID-19, physiotherapy, and post-COVID-19. Results. <=
/b> A documented literature review of scie=
ntific
articles was performed, revealing that the most affected population by the
pandemic was males and the average recovery time for patients undergoing
respiratory therapy is 13 days. Conclusion. It was evident that male patients =
are
the most affected by the SARS-CoV-2 virus. Additionally, conditions such =
as
arterial hypertension, diabetes, and obesity are predictors of an increas=
ed
percentage of fatalities in patients infected with SARS-CoV-2. General
Study Area: Physiotherapy. Specific area of study:
Respiratory Therapy. Type of study: Literature Review.
Introducción <=
/b>
La Organización Mundial =
de
la Salud declaró como pandemia el 11 de marzo del
2020, a la presente fecha en China existieron 81.181 casos con 3.277 fallec=
idos
con una tasa de mortalidad de 4,04%. Al
momento Italia y España son los países de Europa que colapsaron sus sistema=
s de
salud, incluso Italia superó a China en el número de fallecidos (1).
El COVID-19, causado por=
el
virus SARS-CoV-2, ha desencadenado una pandemia global sin precedentes que =
ha
afectado a millones de personas en todo el mundo. La comprensión de la
inmunología e inmunopatología de esta enfermedad ha sido esencial para abor=
dar
su prevención, diagnóstico y tratamiento, así como para investigar sus efec=
tos
a largo plazo en la salud humana (2).
La investigación científ=
ica
sobre COVID-19 se ha diversificado para abordar no solo la epidemiología, s=
ino
también los aspectos bioquímicos de la infección. Los cambios bioquímicos en
los pacientes con COVID-19 se han convertido en un campo de estudio crucial
para comprender los mecanismos subyacentes de la enfermedad, identificar
biomarcadores pronósticos y orientar el desarrollo de terapias efectivas (2=
).
El presente trabajo busca
contribuir al entendimiento integral de esta enfermedad, efectuando
una revisión sistemática de bibliografía acerca de la terapia
respiratoria en el adulto mayor contaminado por el virus SARS-CoV-2 proporcionando una visión general la información
generada será fundamental para orientar futuras investigaciones y estrategi=
as
de atención médica en la lucha continua contra el COVID-19, hasta el moment=
o no
existe un tratamiento específico para el COVID-19. (3)
La recopilación de datos=
se
realizó en base a nueve artículos, los mismos brindaron información según l=
os
parámetros investigados sobre porcentajes y cantidades de hombres y mujeres=
que
se infectaron por COVID-19, los síntomas que se presentaron, las enfermedad=
es,
edad de los pacientes, el total de personas en UCI y el porcentaje de
fallecidos (4).
Es por ello por lo que, =
el
presente trabajo investigativo tiene como objetivo efectuar una revisión
sistemática de literatura acerca de la terapia respiratoria en el adulto ma=
yor
contaminado por el virus SARS-CoV-2. Razón por la cual, se basó en la sigui=
ente
pregunta investigativa: ¿Qué importancia tiene la terapia respiratoria en el
adulto mayor contaminado por el virus SARS-CoV-2?
Metodología
Para
la presente investigación se optó la investigación documental, a través de =
una
revisión de literatura, con el fin de obtener información sobre la terapia
respiratoria en el adulto mayor contaminado por el virus COVID-19 hospitali=
zado
en el área de cuidados intensivos (UCI).
La pandemia de COVID-19 ha presentado una serie de desafíos sin
precedentes para la comunidad médica y científica en todo el mundo. A medida
que se acumula una cantidad significativa de datos y experiencias clínicas,=
la
necesidad de comprender las variables y factores que influyen en la graveda=
d y
el pronóstico de los pacientes con COVID-19 se ha vuelto imperativa. <=
/o:p>
Una de las variables más estudiadas en relación con la COVID-19 es la
edad. Se ha observado consistentemente que la edad juega un papel fundament=
al
en la gravedad de la enfermedad, con un mayor riesgo de complicaciones y
mortalidad en pacientes de edad avanzada. En este sentido, examinaremos de
manera detallada la asociación entre la edad y la gravedad en pacientes con
COVID-19, analizando datos clínicos y epidemiológicos disponibles (4).=
Asimismo, se abordarán las alteraciones bioquímicas que se han
identificado en pacientes con COVID-19. Estos hallazgos son esenciales para
comprender la fisiopatología de la enfermedad y desarrollar estrategias de
tratamiento adecuadas. Se revisarán los marcadores bioquímicos más relevant=
es y
su relación con la progresión de la enfermedad (3).
Por último, se explorarán índices de oxigenación, el índice de choque
diastólico y el tiempo en presión de soporte como posibles predictores de é=
xito
en el retiro de la ventilación mecánica invasiva en pacientes críticamente
enfermos con COVID-19. Estos aspectos son fundamentales en la gestión de
pacientes en estado crítico y pueden influir en el resultado final (5).
En conjunto, esta revisión busca arrojar luz sobre diversas dimension=
es
de la COVID-19, desde la influencia de la edad hasta las alteraciones
bioquímicas, factores de riesgo específicos, y la gestión de pacientes
críticamente enfermos. El conocimiento generado contribuirá al continuo
esfuerzo por comprender y combatir esta pandemia global (2).
Las complicaciones tempranas y tardías secundarias a COVID 19 son un =
tema
de vital importancia dentro del ámbito hospitalario y del manejo en general=
de
este tipo de pacientes. Una adecuada valoración y oportuna intervención en =
los
pacientes con afectación severa secundaria a esta patología es fundamental =
para
reducir la morbimortalidad por el virus (15).
Estrategia de búsqueda
En
este estudio se realizó la recolección de datos de diferentes buscadores de
información como Medline (a través de PubMed), Scielo y Google Académico, la
búsqueda fue desde diciembre del 2019 hasta septiembre del 2023 en los idio=
mas
español e inglés. Basado en la pregunta investigativa ¿Es eficaz la terapia
respiratoria en el adulto mayor contaminado con COVID-19? Además, se implem=
entaron
los siguientes Operadores Booleanos, AND y OR con el objetivo de alcanzar u=
na
búsqueda más específica.
Tabla
1:
Estrategia de Búsqueda
Estrategi=
a de
Búsqueda
Bases de
datos
Árbol de
búsqueda
Google Academic
Búsqueda: Terapia Respiratoria, COVID-19, UCI=
y
Adulto Mayor. Filtros Aplicados: (Años de publicación 2020 hasta el 2023).
Idiomas: español e inglés.
Medline (=
PubMed)
Búsqueda: (Terapia Respiratoria) y (COVID-19).
Filtros Aplicados: artículos científicos de libre acceso y publicados des=
de
el año 2020. Idiomas: inglés y español.
Scielo
Búsqueda: (Terapia Respiratoria), (COVID-19) y
(Adulto Mayor). Filtros Aplicados: Publicaciones desde el año 2020. Idiom=
as:
inglés y español. Últimos 3 años
Para la selección de
estudios de interés, se basó en los siguientes criterios de inclusión y
exclusión:
Criterios de
Inclusión
Los
criterios determinados fueron: publicaciones de los últimos 3 años (2020-20=
23)
de pacientes hospitalizados en el área de UCI que recibieron terapia
respiratoria siendo estos artículos científicos, revisiones sistemáticas,
revisiones bibliográficas, estudios de casos en los idiomas de español e
inglés.
Criterios de
Exclusión
Se
eliminaron investigaciones que no tengan gran relevancia científica de las =
que
se descartaron tesis de pregrado y postgrado, tesinas, conferencias,
seminarios, documentos editoriales de la salud que los autores presenten
conflicto de interés dentro de su estudio y artículos sin libre acceso.
Selección de d=
atos
y cribaje
Mediante una selección exhaus=
tiva
se obtuvo un total de 15.900 textos. Luego de ello se implementaron los fil=
tros
de los últimos 3 años de publicación, idiomas inglés y español y los tipos =
de
estudios ya mencionados, quedando con 28 documentos. Finalmente, con la ayu=
da
del cribaje se eliminaron 19 artículos, Es por ello que=
,
para este estudio se consideraron 9 documentos. Los mismos que están
distribuidos de la siguiente manera, estudios clínicos aleatorizados 3,
revisión bibliográfica 1 y estudios de caso 5.
Figura 1. Tipo de
Estudios Recopilados
En la figura 1, se
recopiló información de artículos con diferentes tipos de estudios, donde l=
os
estudios de caso son el 56%, revisiones bibliográficas el 11%, y estudios
clínicos aleatorizados el 33%.
Flujograma describe el proceso=
de
búsqueda de las bases de datos digitales mediante la aplicación de criterio=
s de
inclusión, exclusión, cribaje y selección.
Las enfermedades respiratorias
producidas por agentes patógenos generan un mal funcionamiento en la
difusión alveolocapilar; un
ejemplo de estas
afecciones es producida
por el síndrome
respiratorio agudo grave tipo II (SARS-CoV-2) el cual infecta las
células epiteliales de las vías respiratorias
desencadenando una respuesta
proinflamatoria desregulada con manifestaciones clínicas como
signos de dificultad
respiratoria tales como
taquipnea, taquicardia, tirajes
intercostales, aleteo nasal; estados de conciencia alterados, hipoxemia
y acidosis, esto
permite tomar medidas
complementarias que ayuden
al paciente mantener el intercambio de gases y una de las medidas
terapéuticas es la ventilación mecánica ya que permite mejorar la oxigenaci=
ón,
disminuir el trabajo
respiratorio y gasto
energético (17).
Existen cambios fisiológicos e=
n el
sistema respiratorio debido a la interacción presente entre el paciente que
está sometido a ventilación mecánica, entre ellos se encuentra la inversión=
de
las presiones, pues fisiológicamente la inspiración presenta una presión
negativa, y en la ventilación mecánica esta se convierte en positiva,
haciéndose más positiva durante la espiración.
Además de este efecto sobre las presiones, es válido resaltar también
que la función muscular se ve afectada, pues los músculos respiratorios deb=
ido
a la sedación o la inhibición muscular disminuyen o cesan su función, gener=
ando
de esta forma desacondicionamiento en ellos.
Sumado a todo esto, otros problemas a resaltar son las infecciones,
derrames, atelectasias y delirios, los cuales deben ser manejados y control=
ados
de manera oportuna para disminuir la mortalidad (18).
A continuación, en la tabla 2 =
se exhibe
un comprendido con los datos de los artículos científicos seleccionados par=
a la
investigación en donde podemos visualizar el título de los artículos
científicos, el año de publicación, autores, población y muestra con los
resultados de los diferentes tratamientos efectuados en los pacientes
infectados por SARS-CoV-2.
T=
abla
2. Resultados de terapia respiratoria en COVID-19
Título
Año
Autor
Población y Muestra
Resultados
Adaptación de u=
na
UCI a Unidad de Adultos Críticos durante la pandemia COVID-19 (6) <=
span
lang=3DES-MX style=3D'font-family:"Times New Roman",serif;mso-fareast-fon=
t-family:
"Times New Roman";color:black;mso-ansi-language:ES-MX;mso-fareast-languag=
e:
ES-MX'>
2020
Vázquez y García
19
pacientes SARS-CoV-2 (mortalidad 15,6%) y ante la creciente necesidad de
camas para pacientes críticos no COVID
Se
ha dado atención hasta la fecha a un total de 182 pacientes posquirúrgico=
s de
muy diversas patologías y edades. La experiencia adquirida como Unidad CO=
VID
sin duda ha facilitado esta nueva reorientación asistencial.
T=
abla
2. Resultados de terapia respiratoria en COVID-19 (continuación)
Título
Año
Autor
Población y Muestra
Resultados
Características=
y
resultados de una serie de 59 pacientes con neumonía grave por COVID-19
ingresados en UCI (7)
2020
Serrano, et al.
De los pacientes incluidos, la mediana de edad fue de 63,0 años si=
endo
45 de ellos varones (76,3%) y presentando como comorbilidad más prevalent=
e la
hipertensión arterial
Del total de casos, 49 (83,1%) recibieron ventilación mecánica
invasiva (VM) en algún momento, 30 (61,2%) de manera exclusiva y 19 (38,8=
%)
tras fracaso de oxigenoterapia nasal de alto flujo. La mediana de días de=
VM
fue de 19 (RIQ 9,5 – 26), requiriendo el 61,2% de ventilación en decúbito
prono.
Relación entre
obesidad, diabetes e ingreso en UCI en pacientes COVID-19 (8)
2020
Fernández, Puentes & García
49
pacientes consecutivos ingresados en planta de hospitalizac=
ión
de Medicina Interna por infección COVID-19 del Complejo Hospitalario de
Toledo del 23 de marzo al 14 de abril de 2020. Se recogieron variables so=
bre
patología cardiovascular, necesidad de mascarilla reservorio y de ingreso=
en
UCI. Según el índice de masa corporal (IMC), se definió sobrepeso pa=
ra
valores de 25,0 a 29,9 kg/m 2 y obesidad para IMC > 30,0
kg/m 2.
En
este estudio no se ha podido definir la obesidad como factor que influye =
en
la infección por COVID-19, en términos de precisar ingreso en UCI y/o
necesidad de suplementación de oxigenoterapia en mascarilla con reservori=
o,
pero sí se ha demostrado asociación entre la diabetes y el ingreso en UCI=
.
T=
abla
2. Resultados de terapia respiratoria en COVID-19 (continuación) <=
/i>
Título
Año
Autor
Población y Muestra
Resultados
Pacientes críti=
cos
COVID-19. ¿Han variado el manejo y los resultados en la UCI tras un año de
pandemia? Estudio multicéntrico , prospectivo, observacional (9)
2021
Rama, et al.
Estudio
multicéntrico, prospectivo, en el que se incluyeron pacientes críticos
COVID-19 en 9 UCI del noroeste de España. Se compararán las
características clínicas, los tratamientos y la evolución de pacientes
ingresados en UCI durante los meses de marzo-abril de 2020
(periodo 1) con pacientes ingresados en enero-febrero =
de
2021 (periodo 2).
En
los pacientes ingresados en UCI se ha utilizado con mayor
frecuencia CNAF, VMNI, uso del decúbito prono y corticoides, disminuyendo=
los
pacientes en VMI, así como los tiempos de estancia en UCI y de estancia h=
ospitalaria. La
mortalidad ha sido similar en los dos periodos a estudio.
Pacientes críti=
cos
COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio
multicéntrico, prospectivo, observacional (10)
2021
Taboada et al.
Entre
el 21 de marzo y el 19 de abril de 2020, evaluamos a pacientes críticos c=
on
COVID-19 ingresados en la UCI de Anestesia de siete hospita=
les
de Galicia, noroeste de España. El resultado, las complicaciones y l=
os
tratamientos se controlaron hasta el 6 de mayo de 2020, fecha final del
seguimiento.
Un
alto porcentaje de pacientes críticos COVID-19 requirieron ventilación
mecánica, posición prona, medicaciones antivirales, corticoides y
anticoagulantes. Las complicaciones en UCI fueron frecuentes,
principalmente infecciones y eventos trombóticos.
T=
abla
2. Resultados de terapia respiratoria en COVID-19 (continuación) <=
/i>
Título
Año
Autor
Población y Muestra
Resultados
Insuficiencia
respiratoria COVID-19, soporte con ECMO para niños y adultos jóvenes (11)=
2020
Gimeno-Costa R, Barrios M, Heredi=
a T,
Garcia C, De Hevia L.
Búsqueda en bas=
es
de datos PubMed Central y otros
repositorios financiados con fondos públicos, como la base de datos COVID=
de
la OMS
Los pacientes
COVID-19 adultos necesitan entre 20 y 50 días de soporte extracorpóreo pa=
ra
recuperarse. En este caso, la ECMO durante 7 días fue suficiente para
mantener la oxigenación y permitió realizar una ventilación ultra protect=
ora
hasta que la respuesta inflamatoria disminuyó.
Calidad de vida=
y
síntomas persistentes tras hospitalización por COVID-19. Estudio
observacional prospectivo comparando pacientes con o sin ingreso en UCI (=
12)
2021
Taboada et al.
De
los 242 pacientes hospitalizados durante el período de estudio, 44
(18,2%) necesitaron ingreso en UCI. Cuarenta (16,5%)
pacientes fallecieron durante el ingreso hospitalario. Doscientos dos
(83,5%) pacientes fueron dados de alta del hospital. A los seis mese=
s,
183 (75,6%) pacientes completaron los cuestionarios (32 pacientes UCI y 1=
51
pacientes no UCI). Noventa y seis (52,4%) refirieron disminución de =
la
calidad de vida y 143 (78,1%) describieron síntomas persistentes.
Los
supervivientes de COVID-19 que necesitaron hospitalización presentaron
síntomas persistentes y un deterioro de su calidad de vida. Los
pacientes de UCI refirieron una mayor disminución de su calidad de vida, =
en
comparación con los pacientes que no precisaron UCI.
T=
abla
2. Resultados de terapia respiratoria en COVID-19 (continuación) <=
/i>
Título
Año
Autor
Población y Muestra
Resultados
Características
clínicas y factores pronósticos relacionados con la mortalidad en pacient=
es
adultos hospitalizados con COVID-19 en un hospital público de Lima, Perú =
(13)
2021
Mejía, et al.
De
los 369 pacientes incluidos en el análisis, 241 (65.31%) eran del sexo
masculino y la mediana de edad era 59 años (RIC: 49- 68). La mayoría de l=
os
pacientes (68.56%) presentaban al menos una comorbilidad, principalmente
obesidad (42.55%), diabetes mellitus (21.95%) e hipertensión arterial
(21.68%). Del total de pacientes, 278 (75.34%) cumplían la definición de =
caso
confirmado, 262 (71%) por PR positiva y 28 (7.59%) por RTPCR.
Entre
los pacientes con COVID-19 que fueron admitidos a un hospital público de
Perú, la mortalidad fue alta y se asoció independientemente a saturación =
de
oxígeno a la admisión y la edad mayor de 60 años.
Infecciones
asociadas a COVID-19 en la UCI: análisis retrospectivo en un hospital de
tercer nivel Sobreinfecciones en pacientes ingresados en UCI
con COVID-19: análisis retrospectivo en un hospital de tercer nivel (14)<=
/span>
2021
Ramos, et al.
Se
analizaron las variables clínicas, de laboratorio y relacionadas con
eventos. Registramos todos los medicamentos para la COVID-19 recibid=
os
de acuerdo con el protocolo de tratamiento
Las
sobreinfecciones en pacientes con COVID -19 ingresados =
;en
la UCI son frecuentes, pero aparecen tardíamente en el curso del
ingreso.
En este cuadro podemos evidenc=
iar
los resultados más relevantes siendo estos que la obesidad no está relacion=
ada
directamente con el agravamiento de la situación del paciente, pero la diab=
etes
si es un factor que puede empeorar el estado general de los pacientes
ingresados en las diferentes casas hospitalarias (8).
Discusión
El COVID-19, causado por el vi=
rus
SARS-CoV-2, es una enfermedad pulmonar que se manifiesta de manera variable=
en
función de la persona infectada y sus antecedentes médicos. Además de ser
altamente contagioso, afecta en su mayoría a adultos mayores, exacerbando s=
us
enfermedades crónicas preexistentes.
Estudios realizados por (8), a=
sí
como (13), han revelado una mayor incidencia de COVID-19 en individuos de s=
exo
masculino. Esta población tiende a requerir intervenciones médicas avanzada=
s,
como el uso de mascarillas de alto flujo y ventilación mecánica en unidades=
de
cuidados intensivos (UCI).
Se ha observado que
aproximadamente del 14.2% al 30% de los pacientes ingresados por SARS-CoV-2
necesitan soporte respiratorio mediante ventilación mecánica y succión por
ciclo cerrado, según los estudios de (13) y (12).
Adicionalmente se ha indicado =
que
los adultos mayores que padecen obesidad e hipertensión y reciben atención
médica tardía tienen un mayor riesgo de fallecer debido al COVID-19 y el
período promedio de hospitalización se sitúa en alrededor de 13 días, según=
los
estudios de (13) y (14).
Las observaciones de (16), la
mayoría de los pacientes con COVID-19 presentan síntomas leves (aproximadam=
ente
el 80%), aunque un porcentaje significativo desarrolla formas más graves que
requieren oxigenoterapia suplementaria (alrededor del 15%) y, aproximadamen=
te,
un 5% de estos pacientes deben ser ingresados en UCI, donde la mayoría requ=
iere
soporte ventilatorio, incluyendo intubación y ventilación mecánica.
No obstante, aún persisten
numerosas incógnitas en torno al virus SARS-CoV-2, lo que motiva una contin=
ua
investigación, particularmente en lo que respecta a su incidencia en la
población adulta mayor y las posibles secuelas a largo plazo. Dada la noved=
ad
de la enfermedad y su variabilidad clínica en función de la genética del
paciente y las enfermedades crónicas preexistentes, se requiere un análisis
constante para comprender mejor sus efectos y abordar de manera más eficaz =
esta
pandemia global.
Conclusiones
·&nb=
sp;
Los pacientes con enfermed=
ades
crónicas como la hipertensión arterial, la diabetes y la obesidad son
predictores de un aumento del porcentaje de fallecimientos por SARS-CoV-2.<=
/span>
· =
No todos los pacientes se benefician d=
e la
ventilación mecánica invasiva por lo que otros sistemas de soporte como la
ventilación mecánica no invasiva, BIPAP y CPAP llegan a ser de gran utilida=
d.
La toma de decisiones en cuanto a su aplicación debe basarse en un estudio
personalizado de cada paciente.
· =
Los pacientes ingresados en UCI
experimentan una notable disminución en su calidad de vida como resultado de
las secuelas tanto del tratamiento como de la propia infección por el virus
COVID-19. Esta realidad subraya la importancia de la atención continua y el
seguimiento de los sobrevivientes de la enfermedad.
· =
Se ha observado claramente que la
población más vulnerable al virus COVID-19 son los pacientes de género
masculino. Esta tendencia, respaldada por estudios y datos epidemiológicos,
subraya la necesidad de abordar las razones subyacentes detrás de esta disp=
aridad
de género en la afectación por la enfermedad.
· =
Los tiempos de recuperación de los
pacientes con COVID-19 sometidos a terapia respiratoria es de 13 días.
Conflicto de intereses
No
existe conflicto de intereses ya que es una revisión bibliográfica sin
necesidad de consentimientos informados.
Declaración de contribución de los autores<=
o:p>
Autor 1: <=
/b>Realizó una exten=
sa
búsqueda bibliográfica en diversas bases de datos y recursos académicos
relevantes realizando una
extensa búsqueda bibliográfica, recopilando la información para ser analiza=
da
para la investigación.
Autor 2: <=
/b>Contribuyó con la
organización y estructuración del contenido de la revisión, participó en la
redacción y revisión crítica de la investigación. <=
/p>
Autor 3: <=
/b>Participó en la
creación de las conclusiones y recomendaciones del trabajo.
Autor 4: <=
/b>Participó en la
redacción y revisión crítica
=
Declaración Final: Todos los autores Merwin
Valencia, Lenin Arias, Verónica Ramos y Ximena Robalino han revisado y apro=
bado
la versión final del manuscrito, aceptando la responsabilidad de su conteni=
do.
Además, nos comprometemos a proporcionar cualquier aclaración o información
adicional requerida por los revisores o lectores interesados.
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39
El artículo 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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