Infección por SARS-CoV2 en pacientes con trasplante de órgano sólido: Cinco preguntas importantes.
DOI:
https://doi.org/10.30944/20117582.623Palabras clave:
COVID-19, virus del SRAS, coronavirus, infecciones por coronavirus, pandemias, cirugía general, trasplanteResumen
Es grande la expectativa que genera en todos los servicios de salud del mundo la rápida expansión del SARS-CoV2 (Coronavirus 2 del Síndrome Respiratorio Agudo y Grave), agente etiológico de la Enfermedad Infecciosa por Coronavirus del año 2019, COVID-19. Por tratarse de una enfermedad emergente es poco lo que se conoce sobre su comportamiento en los humanos, lo que lleva a múltiples interrogantes al momento de tomar decisiones en la práctica clínica. Hasta el momento, las estrategias para enfrentar esta pandemia se basan en la experiencia de los países que han sido epicentro del brote infeccioso y en la evidencia recopilada durante el manejo de otros coronavirus en años anteriores (SARS-CoV en el año 2002 y MERS-CoV en 2012).
La falta de información contundente y unificada ha dado lugar a especulaciones y a suposiciones, especialmente relacionadas con la atención del COVID-19 en poblaciones consideradas de alto riesgo, como son los pacientes crónicamente inmunosuprimidos postrasplante. A través de esta revisión narrativa de la literatura, más allá de dar la opinión de los autores, se pretende organizar de manera juiciosa los documentos hasta el momento publicados, y responder, basados en datos reales, cinco de las preguntas más importantes que surgen en el día a día durante el manejo de los pacientes trasplantados.
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Referencias bibliográficas
Chan JF-W, Kok K-H, Zhu Z, Chu H, To KK-W, Yuan S, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect. 2020;9:221–36.
Johns Hopkins coronavirus resource center. COVID-19 map [cited 2020 Apr 6]. Disponible en: https://coronavirus.jhu.edu/map.html
TrackCorona. [cited 2020 Apr 6]. Disponible en: https://www.trackcorona.live/
World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19. [cited 2020 Apr 6]. Disponible en: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Ministerio de Salud Colombia. CORONAVIRUS (COVID-19) [cited 2020 Apr 6]. Disponible en: https://www.minsalud.gov.co/salud/publica/PET/Paginas/Covid-19_copia.aspx
Russell TW, Hellewell J, Jarvis CI, van-Zandvoort K, Abbott S, Ratnayake R, et al. Estimating the infection and case fatality ratio for COVID-19 using age-adjusted data from the outbreak on the Diamond Princess cruise ship. medRxiv. 2020 Mar 9;2020.03.05.20031773. doi: https://doi.org/10.1101/2020.03.05.20031773
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet Lond Engl. 2020 28;395:1054–62.
Instituto Nacional de Salud. Red nacional de donación y trasplante de órganos y tejidos marco legal, documentos técnicos y estadísticas. [cited 2020 Apr 6]. Disponible en: https://www.ins.gov.co/Direcciones/RedesSaludPublica/DonacionOrganosYTejidos/Paginas/Marco-Legal,-Documentos-Tecnicos-y-Estadisticas.aspx
World Health Organization. Novel coronavirus situation report 2 [cited 2020 Apr 6]. Disponible en: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200122-sitrep-2-2019-ncov.pdf?sfvrsn=4d5bcbca_2
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020 Mar 17;0(0):null. https://doi.org/10.1056/NEJMc2004973
World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations [Internet]. [cited 2020 Apr 6]. Disponible en: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020 Mar 26;382:1199–207.
Chan JF-W, Yuan S, Kok K-H, To KK-W, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet. 2020 Feb 15;395:514–23.
Kakimoto K. Initial investigation of transmission of COVID-19 among crew members during quarantine of a cruise ship — Yokohama, Japan, February 2020. MMWR Morb Mortal Wkly Rep [cited 2020 Apr 6];69. Disponible en: https://www.cdc.gov/mmwr/volumes/69/wr/mm6911e2.htm
Liu M, He P, Liu HG, Wang XJ, Li FJ, Chen S, et al. Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za Zhi Zhonghua Jiehe He Huxi Zazhi Chin J Tuberc Respir Dis. 2020 Feb 17;43(0):E016.
Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Critical Care Medicine. JAMA Network. [cited 2020 Apr 6]. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2761044
Clinical characteristics of coronavirus disease 2019 in China. NEJM. [cited 2020 Apr 6]. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa2002032
Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19). [cited 2020 Apr 6]. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html
Gauret P, Lagier JC, Parola P, Meddeb L, Mailhe M, Doudier B, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a sex day follow up: an observational study. [cited 2020 Apr 6]. Int J Antimicrob Agents. 2020 Mar 20:105949. https://doi.org/10.1016/j.ijantimicag.2020.105949
XIaoling Xu, Mingfeng H, Tiantian L, Wei S, Dongsheng W, Binqing F, et al. Effective Treatment of severe COVID-19 patients with Tocilizumab. [cited 2020 Apr 6]. Disponible en: http://www.chinaxiv.org/abs/202003.00026v1
Stockman LJ, Massoudi MS, Helfand R, Erdman D, Siwek AM, Anderson LJ, et al. Severe acute respiratory syndrome in children. Pediatr Infect Dis J. 2007 Jan;26:68–74.
World Health Organization. Consensus document on the epidemiology of severe acute respiratory syndrome (SARS). [cited 2020 Apr 6]. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/70863/WHO_CDS_CSR_GAR_2003.11_eng.pdf
Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission - The Lancet Infectious Diseases. [cited 2020 Apr 6]. Disponible en: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30127-0/fulltext
Song W, Gui M, Wang X, Xiang Y. Cryo-EM structure of the SARS coronavirus spike glycoprotein in complex with its host cell receptor ACE2. PLoS Pathog. 2018;14(8):e1007236.
Jin X, Lian J-S, Hu J-H, Gao J, Zheng L, Zhang Y-M, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020 Mar 24. http://dx.doi.org/10.1136/gutjnl-2020-320926
Muthiah Vaduganathan, Orly Vardeny, Pharm D, Thomas Michel, John J.V. McMurray, Marc A. Pfeffer, Scott D. Solomon. Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19. NEJM. 30 mar 2020. [cited 2020 Apr 6]. https://doi.org/10.1056/NEJMsr2005760
Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004 Jun;203:631–7.
Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X, et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ. 2020 Mar 23;1–4.
Campbell DJ, Zeitz CJ, Esler MD, Horowitz JD. Evidence against a major role for angiotensin converting enzyme-related carboxypeptidase (ACE2) in angiotensin peptide metabolism in the human coronary circulation. J Hypertens. 2004;22:1971–6.
University Liverpool UK. Liverpool Drug Interactions Group. Interactions with experiemental COVID-19 therapies. Liverpool, UK. University Liverpool; 2020. Disponible en: https://www.covid19-druginteractions.org
Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020 Mar 18;0(0):null. https://doi.org/10.1056/NEJMoa2001282
Gautret P, Lagier J-C, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020 Mar 20;105949.
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