Resumo
Definição
História e exame físico
Outros fatores diagnósticos
- fadiga
- mialgia ou artralgia
- faringite
- cefaleia
- rinorreia ou congestão nasal
- espirros
- expectoração
- dor/constrição torácica
- mal-estar
- tontura
- confusão ou delirium
- sintomas gastrointestinais
- sintomas cutâneos
- sintomas oculares
- sinais de pneumonia ou desconforto respiratório agudo
- hemoptise
- sintomas audiovestibulares
- lesões na mucosa oral
Fatores de risco
- contato com um caso provável ou confirmado
- residência/trabalho em local com alto risco de transmissão
- idade avançada
- sexo masculino
- etnia
- residência em unidade de cuidados de longa permanência
- presença de comorbidades
- obesidade
- doença cardiovascular
- diabetes
- doença respiratória crônica
- doença renal crônica
- doença hepática crônica
- gestação
- tabagismo
- neoplasia maligna
- doença cerebrovascular
- transtornos de saúde mental
- transplante de órgão sólido ou de células-tronco hematopoiéticas
- deficiências
- demência
- imunossupressão
- Infecção pelo vírus da imunodeficiência humana (HIV)
- sedentarismo
- distúrbios da hemoglobina
- hipertensão
- transtornos relacionados ao uso de substâncias
- crianças com certas condições subjacentes
- deficiência de vitamina D
- uso de inibidor da bomba de prótons
- doença autoimune
- doença tireoidiana
- Doença de Parkinson
- gota
- dislipidemia
- cirurgia
- grupos sanguíneos A e B
- disbiose intestinal
- fatores ambientais
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- reação em cadeia da polimerase via transcriptase reversa (RT-PCR) em tempo real
- testes rápido de antígeno
- oximetria de pulso
- gasometria arterial
- Hemograma completo
- perfil metabólico completo
- testes da função tireoidiana
- nível glicêmico
- coagulograma
- biomarcadores cardíacos
- proteína C-reativa sérica
- velocidade de hemossedimentação sérica
- concentração sérica de lactato desidrogenase
- nível sérico de interleucina (IL)
- procalcitonina sérica
- nível de ferritina sérica
- nível de amiloide A sérica
- creatinoquinase e mioglobina séricas
- hemoculturas e culturas de escarro
- radiografia torácica
Investigações a serem consideradas
- tomografia computadorizada (TC) torácica
- ultrassonografia do pulmão
- sorologia
Algoritmo de tratamento
Colaboradores
Consultores especialistas
Nicholas J. Beeching, MA, BM BCh, FRCP, FRACP, FFTM RCPS (Glasg), FESCMID, DCH, DTM&H
Consultant and Emeritus Professor of Tropical and Infectious Diseases
Royal Liverpool University Hospital and Liverpool School of Tropical Medicine
Liverpool
UK
Declarações
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 the UK Health Security Agency (UKHSA; formerly Public Health England), 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 UKHSA.
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
Declarações
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 the UK Health Security Agency (UKHSA; formerly Public Health England), 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 UKHSA.
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
Declarações
RF declares that he has no competing interests.
Revisores
William A. Petri, Jr., MD, PhD
Professor
Division of Infectious Diseases and International Health
University of Virginia
Charlottesville
VA
Declarações
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
Declarações
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
Declarações
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.
Editores
Adam Mitchell
Section Editor (Infectious Diseases)/Drug Editor, BMJ Best Practice
Declarações
AM declares that he has no competing interests.
Irene Chiwele
Lead Section Editor, BMJ Best Practice
Declarações
IC declares that she has no competing interests.
Julie Costello
Comorbidities Editor, BMJ Best Practice
Declarações
JC declares that she has no competing interests.
Consultores especialistas: comorbidades
Martyn Patel, BMBcH, FRCP, MA
Consultant, Older People's Medicine
Norfolk and Norwich University Hospitals
NHS Foundation Trust
Norwich
UK
Declarações
MP is a contributor to the Oxford Textbook of Otolaryngology, Oxford University Press, 2021, having written a chapter about mental capacity law, for which he received no fee. MP is the NHS representative on the board for Norwich Institute for Healthy Ageing (unpaid role). MP has spoken at the International Forum on Quality and Safety in Healthcare, virtual conference in November 2020 for which he received no fee.
Paul Cockwell, PhD, FRCP
Consultant Nephrologist
Queen Elizabeth Hospital Birmingham
Professor of Nephrology (honorary)
University of Birmingham
Birmingham
UK
Declarações
PC is president of UK Kidney Association (UKKA), which is the professional organisation that supports healthcare professionals involved in care for, and research, innovation and education in, kidney disease. UKKA has a broad remit with relationships with multiple partners and includes responsibility for UK Kidney Week, the major educational meeting for UK kidney professionals. PC holds grant funding from Kidney Research UK in areas related to chronic kidney disease, and has recently (within the last 3 years) held grants from the EU, NIHR, and MRC in research in areas related to chronic kidney disease. PC has a non-remunerated research partnership with Boehringer Ingelheim into the epidemiology of chronic kidney disease. PC is author of the BMJ Learning module on chronic kidney disease.
Rajiv Sankaranarayanan, MBBS, FRCP (Lon), FESC, FHFA, PhD
Consultant Cardiologist and Heart Failure Lead
Liverpool University Hospitals NHS Foundation Trust
Liverpool Centre for Cardiovascular Science and NIHR Research Scholar and Honorary Senior Clinical Lecturer
University of Liverpool
Liverpool
UK
Declarações
RS has research grants from the British Heart Foundation, the NIHR, NHSX (Transformation Agency), AstraZeneca, Biotronik, and the University of Liverpool. RS has received speaker fees/honoraria and travel reimbursement for conferences from AstraZeneca, Novartis, Vifor, Medtronic, Biotronik, Pfizer, Daaichi Sankyo, and Boehringer. RS has been appointed to: NHS England PIFU Pathway Committee for Heart Failure (2021); British Society for Heart Failure Digital Pathway, Discharge and Virtual Ward Pathway panels; British Cardiac Society Digital and Communications Committee (2020); NIHR Research Scholar (Feb 2020); Clinical Advisory Board of UK’s patient-led charity Pumping Marvellous (2020); and NHS England HF Virtual Ward committee.
Rachael Evans, MBChB, FRCP (UK), PhD
Associate Professor (Clinical)
University of Leicester
Honorary Consultant Respiratory Physician
Glenfield Hospital
Leicester
UK
Declarações
RAE has given lectures for non-promotional industry-led sessions on long COVID and provided consultancy for GSK, AstraZeneca, Boehringer, and Chiesi, for individual payment and travel expenses totalling <£4000.
Gerry Rayman, MD, FRCP
Consultant Physician and Head of Service
Diabetes and Endocrine Centre and the Diabetes Research Unit
Ipswich Hospitals NHS Trust
Ipswich
UK
Declarações
GR received funding from Novo Nordisk in 2022 to attend the EASD conference. GR undertakes several research projects on behalf of East Suffolk and North Essex NHS Foundation Trust for pharmaceutical companies which are on the NIHR portfolio (he does not receive payment himself for these). GR has received lecture fees from Abbott Diabetes UK and Lilly UK.
Sotiris Posporelis, MD, MRCPsych
Consultant Liaison Neuropsychiatrist
King’s College Hospital
South London and Maudsley NHS Foundation Trust
Honorary Senior Clinical Lecturer
Institute of Psychiatry, Psychology & Neuroscience
King’s College London
London
UK
Declarações
SP declares that he has no competing interests.
Acknowledgement: Dr Matthew Jones
BMJ Best Practice would like to gratefully acknowledge Dr Matthew Jones for his advice on a section of the stroke comorbidity content.
Matthew Jones, MD, FRCP
Consultant Neurologist
Manchester Centre for Clinical Neurosciences
Northern Care Alliance
Honorary Senior Lecturer
University of Manchester
Manchester
UK
Declarações
MJ is the chair of the Association of British Neurologists Education Committee (unpaid position). MJ is a faculty member of an MRCP revision course.
Acknowledgement: Professor Sanjay Agrawal
BMJ Best Practice would like to gratefully acknowledge Professor Sanjay Agrawal, National Speciality Advisor for tobacco dependency at NHS England and Chair of Royal College of Physicians tobacco advisory group, for his advice on the comorbidity content for 'current smoker'.
Professor Sanjay Agrawal, MBChB, FRCP
Consultant in Respiratory and Intensive Care Medicine
University Hospitals of Leicester NHS Trust
Leicester
UK
Declarações
SA declares that he has no competing interests.
Revisores: comorbidades
Martyn Patel, BMBcH, FRCP, MA
Consultant, Older People's Medicine
Norfolk and Norwich University Hospitals
NHS Foundation Trust
Norwich
UK
Declarações
MP is a contributor to the Oxford Textbook of Otolaryngology, Oxford University Press, 2021, having written a chapter about mental capacity law, for which he received no fee. MP is the NHS representative on the board for Norwich Institute for Healthy Ageing (unpaid role). MP has spoken at the International Forum on Quality and Safety in Healthcare, virtual conference in November 2020 for which he received no fee.
Asangaedem Akpan, MPH, FRCP
Consultant Geriatrician
Bunbury Regional Hospital
Western Australia Country Health Service
Bunbury
Western Australia
Visiting Professor
University of Cumbria
Carlisle
Honorary Clinical Associate Professor
University of Liverpool
Liverpool
UK
Declarações
AA has a limited company that is seeking consultancy work offering reviews of healthcare services, facilitation of workshops, advice/review of publications. AA has received honorariums for giving lectures on behalf of Profile Pharma in 2021. AA was invited to be on a panel at the British Society for Heart Failure conference in 2022 with all expenses paid and has been invited to contribute to the European Union geriatric medicine conference (free conference registration) and British Society for Heart Failure conference (accommodation and travel expenses covered) in 2022. AA sat on the National Institute for Health and Care Excellence Quality Standards Committee on urinary tract infections in adults as an expert committee member in 2022 and is Deputy Chair of the British Geriatrics Society England Council and Ageing Specialty Research Lead CRN NWC. AA has received research funding from the Liverpool CCG and Applied Research Collaborative 2021-2022. AA contributed to developing a heart failure pathway tool for the British Society for Heart Failure in 2022. AA sits on advisory committees for the following research studies - VOICE2 (development and testing of communication skills training for hospital healthcare practitioners caring for people living with dementia), SWOP (social work in older people), and CFIN (cognitive frailty interdisciplinary network) 2022 -2023.
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