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Última revisão: 21 Oct 2024
Última atualização: 27 Nov 2020

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • febre
  • tosse
  • dispneia
  • olfato/paladar alterados

Outros fatores diagnósticos

  • fadiga
  • mialgia ou artralgia
  • produção de escarro/expectoração
  • constrição torácica
  • sintomas gastrointestinais
  • faringite
  • cefaleia
  • tontura
  • sintomas neurológicos
  • sintomas oculares
  • rinorreia/congestão nasal
  • dor torácica
  • sintomas cutâneos
  • hemoptise
  • murmúrios brônquicos
  • taquipneia
  • taquicardia
  • cianose
  • estertores na ausculta

Fatores de risco

  • residência/trabalho/viagem para local com alto risco de transmissão
  • contato com um caso provável ou confirmado
  • idade avançada
  • residência em unidade de cuidados de longa permanência
  • sexo masculino
  • etnia
  • presença de comorbidades
  • doença cardiovascular
  • hipertensão
  • obesidade
  • diabetes
  • doença respiratória crônica
  • doença renal crônica
  • neoplasia maligna
  • doença falciforme
  • transplante de órgão sólido
  • tabagismo
  • doença cerebrovascular
  • demência
  • doença hepática crônica
  • doença hepática gordurosa associada a disfunção metabólica
  • cirurgia
  • gestação
  • imunossupressão
  • doença autoimune
  • deficiência de vitamina D
  • poluição do ar
  • clima e latitude
  • residência em áreas urbanas ou carentes
  • Uso de inibidor da enzima conversora da angiotensina (IECA)/antagonista do receptor de angiotensina II
  • dislipidemia
  • uso de estatina
  • uso de inibidor da bomba de prótons
  • Infecção pelo vírus da imunodeficiência humana (HIV)
  • talassemia
  • Síndrome de Down
  • crianças com certas condições subjacentes
  • grupo sanguíneo A
  • disbiose intestinal

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • reação em cadeia da polimerase via transcriptase reversa (RT-PCR) em tempo real
  • oximetria de pulso
  • gasometria arterial
  • Hemograma completo
  • perfil metabólico completo
  • nível glicêmico
  • coagulograma
  • biomarcadores cardíacos
  • proteína C-reativa sérica
  • velocidade de hemossedimentação sérica
  • concentração sérica de lactato desidrogenase
  • nível sérico de interleucina-6
  • 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
  • sorologia
  • teste de antígenos

Novos exames

  • amplificação isotérmica mediada por ciclo de transcrição reversa (RT-LAMP)
  • ultrassonografia do pulmão

Algoritmo de tratamento

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

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 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

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 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

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.

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