Reporte de 4 casos COVID-19 hospitalizados en unidad de cuidados intensivos en una institución hospitalaria en Barranquilla, Colombia
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Fecha
2020
Autores
Iglesias Pertuz, Shirley
Aroca-Martinez, Gustavo
Velez-Verbel, María
Cadena Osorio, Andrés
Correa-Monterrosa, Mileidys
Cadena-Bonfanti, Andrés
Lemus Castro, Jorge
Brochado, Leonardo
Armesto, Wilfredo
Camargo Vasquez, Tomas
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Asociación Colombiana de Nefrología e Hipertensión Arterial
Resumen
Objetivo: Presentar una serie de casos de COVID-19 con requerimiento
de ingreso a Unidad de Cuidados Intensivos. Métodos: La información fue tomada
de las historias clínicas, y su evaluación y diagnóstico fue realizado mediante
estudios paraclínicos en sangre, orina, PCR e imágenes diagnósticas en 4 pacientes
con diferentes comorbilidades y nexo epidemiológico presente para desarrollo de la
enfermedad. El caso 1 desarrolló falla orgánica múltiple, incluyendo injuria renal
aguda con una estancia en UCI de 4 dias antes de su fallecimiento, mientras los
casos 2, 3 y 4 tuvieron una evolución favorable y fueron dados de alta de UCI. Los
cuatro casos fueron manejados con cloroquina 300 mg via oral cada 12 horas y
azitromicina 1 gr via oral cada 24 horas durante 5 dias sin complicaciones ni
toxicidad asociada. Conclusiones: Se requieren estudios multicéntricos rápidos
que orienten científicamente hacia un mejor abordaje diagnóstico y manejo, en el
contexto de una enfermedad con un comportamiento clínico-epidemiologico que
debe estudiarse en profundidad y que probablemente cobrará muchas vidas,
ademas, debido a la ausencia de pruebas diagnósticas rápidas, la utilización de una
clasificación basada en la severidad de lesiones radiológicas llamada CO-RADS
(Covid-19 Imaging Reporting and Data System), podría ser de gran importancia para
instalar de manera temprana los tratamientos farmacológicos disponibles y la
asistencia respiratoria mecánica precoz.
Objective: To present a COVID-19 case series with clinical admission criteria to Intensive Care Unit. Methods: Patients information was obtained from medical records, and daily clinical evaluation whereas diagnosis was carried out through paraclinical studies in blood, urine, PCR and diagnostic images in 4 patients with different comorbidities and epidemiological link for the development of COVID19. The case 1 developed multiple organ failure, including acute kidney injury with an ICU stay of 4 days before his death, while cases 2, 3 and 4 had a favorable evolution and were discharged from the ICU. All four cases were managed with chloroquine 300 mg orally every 12 hours and azithromycin orally every 24 hours for 5 days without complications or associated toxicity. Conclusions: rapid multicenter studies are required to scientifically guide a better diagnostic and management approach, in the context of a disease with a clinical-epidemiological behavior that must be studied in depth and will probably take many lives. In addition, due to the absence of sufficiently rapid tests, the use of a classification based on the severity of radiological lesions called CO-RADS (Covid-19 Imaging Reporting and Data System), could be of great importance to install ava
Objective: To present a COVID-19 case series with clinical admission criteria to Intensive Care Unit. Methods: Patients information was obtained from medical records, and daily clinical evaluation whereas diagnosis was carried out through paraclinical studies in blood, urine, PCR and diagnostic images in 4 patients with different comorbidities and epidemiological link for the development of COVID19. The case 1 developed multiple organ failure, including acute kidney injury with an ICU stay of 4 days before his death, while cases 2, 3 and 4 had a favorable evolution and were discharged from the ICU. All four cases were managed with chloroquine 300 mg orally every 12 hours and azithromycin orally every 24 hours for 5 days without complications or associated toxicity. Conclusions: rapid multicenter studies are required to scientifically guide a better diagnostic and management approach, in the context of a disease with a clinical-epidemiological behavior that must be studied in depth and will probably take many lives. In addition, due to the absence of sufficiently rapid tests, the use of a classification based on the severity of radiological lesions called CO-RADS (Covid-19 Imaging Reporting and Data System), could be of great importance to install ava
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Palabras clave
Coronavirus, COVID-19, Sars-CoV-2, Injuria renal aguda, Falla multisistémica, Cloroquina, Azitromicina, UCI, Acute kidney injury, Multi-system failure,, Chloroquine, Azithromycin, ICU, COVID-19, Sars-CoV-2, Coronavirus