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Última revisión: 21 Oct 2024
Última actualización: 06 Nov 2020

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • fiebre
  • tos
  • disnea
  • sentido del olfato/gusto alterado

Otros factores de diagnóstico

  • fatiga
  • mialgia o artralgia
  • producción de esputo/expectoración
  • opresión en el pecho
  • síntomas gastrointestinales
  • dolor de garganta
  • cefalea
  • mareos
  • síntomas neurológicos
  • síntomas oculares
  • rinorrea/congestión nasal
  • dolor torácico
  • síntomas cutáneos
  • hemoptisis
  • sonidos de respiración bronquial
  • taquipnea
  • taquicardia
  • cianosis
  • crepitaciones/estertores durante la auscultación

Factores de riesgo

  • residencia/trabajo/viajes en lugares con alto riesgo de transmisión
  • contacto con el caso probable o confirmado
  • edad avanzada
  • residencia en un centro de cuidados a largo plazo
  • sexo masculino
  • grupo étnico
  • presencia de comorbilidades
  • enfermedad cardiovascular
  • hipertensión
  • obesidad
  • diabetes
  • enfermedad respiratoria crónica
  • enfermedad renal crónica
  • neoplasia maligna
  • anemia falciforme
  • trasplante de órganos sólidos
  • tabaquismo
  • enfermedad cerebrovascular
  • demencia
  • hepatopatía crónica.
  • enfermedad de hígado graso asociada a la disfunción metabólica
  • cirugía
  • embarazo
  • inmunosupresión
  • enfermedad autoinmune
  • deficiencia de vitamina D
  • la contaminación atmosférica
  • el clima y la latitud
  • residencia en zonas urbanas o desfavorecidas
  • Uso de inhibidores de la IECA y antagonistas de los receptores de angiotensina II
  • dislipidemia
  • uso de estatinas
  • uso de inhibidores de la bomba de protones
  • Infección por VIH
  • talasemia
  • síndrome de Down
  • niños con ciertas afecciones subyacentes
  • grupo sanguíneo A
  • Disbiosis intestinal

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • Reacción en cadena de la polimerasa de transcripción inversa en tiempo real (RT-PCR)
  • oximetría de pulso
  • GSA
  • hemograma completo (HC)
  • perfil metabólico completo (PMC)
  • nivel de glucemia
  • cribado de coagulación
  • biomarcadores cardíacos
  • proteína C-reactiva sérica
  • velocidad de sedimentación globular en suero
  • lactato deshidrogenasa en suero
  • nivel de interleucina-6 en suero
  • procalcitonina sérica
  • nivel de ferritina en suero
  • amiloide sérico nivel A
  • creatina-cinasa y mioglobina en suero
  • cultivos de esputo y hemocultivos
  • radiografía de tórax

Pruebas diagnósticas que deben considerarse

  • Tomografía computarizada (TC) de tórax
  • serología
  • prueba de antígenos

Pruebas emergentes

  • amplificación isotérmica mediada por bucles de la transcripción inversa (RT-LAMP)
  • ultrasonido de pulmón

Algoritmo de tratamiento

Colaboradores

Autores

Nicholas J. Beeching, MA, BM BCh, FRCP, FRACP, FFTM RCPS (Glasg), FESCMID, DCH, DTM&H

Consultant and Honorary Senior Lecturer in Infectious Diseases

Royal Liverpool University Hospital and Liverpool School of Tropical Medicine

Liverpool

UK

Divulgaciones

NJB is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or PHE.

Tom E. Fletcher, MBE, PhD, MBChB, MRCP, DTM&H

Senior Clinical Lecturer and Defence Consultant in Infectious Diseases

Royal Liverpool University Hospital and Liverpool School of Tropical Medicine

Liverpool

UK

Divulgaciones

TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General, the NHS, and Liverpool School of Tropical Medicine. TEF is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. He has received research grants from the Wellcome Trust, Medical Research Council, and the UK Public Health Rapid Support Team (UK-PHRST). The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or PHE.

Robert Fowler, MDCM, MS (Epi), FRCP(C)

H. Barrie Fairley Professor of Critical Care

University Health Network and Interdepartmental Division of Critical Care Medicine

Director

Clinical Epidemiology and Health Care Research

Institute of Health Policy, Management and Evaluation

Dalla Lana School of Public Health

University of Toronto

Chief

Tory Trauma Program

Sunnybrook Hospital

Toronto

Canada

Divulgaciones

RF declares that he has no competing interests.

Revisores por pares

William A. Petri, Jr., MD, PhD

Professor

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Divulgaciones

WAP declares that he has no competing interests.

Xin Zhang, MD, PhD

Attending Physician

The Fifth Medical Center of PLA General Hospital

Clinical Division and Research Center of Infectious Disease

Beijing

China 

Divulgaciones

XZ declares that he has no competing interests.

Ran Nir-Paz, MD

Associate Professor in Medicine

Department of Clinical Microbiology and Infectious Diseases

Hadassah Hebrew University Medical Center

Jerusalem

Israel

Divulgaciones

RNP has received research grants from US-Israel Binational Science Foundation, Hebrew University, Rosetrees Trust, and SpeeDx. He is chair of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma and Chlamydia Infections (ESGMAC). RNP is a consultant for and has stocks in eDAS Healthcare. He is also chairperson of the Israeli Society for Infectious Diseases guidelines committee.

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