When the epidemic broke out Covid-19 In our lives, so did a group of doubts of all kinds. We did not know, for example, whether the virus causing the disease, SARS-CoV-2, would disappear after a while or remain, or how serious the disease would be in the medium or long term. Pulmonology is the medical specialty that has done, and still does, the greatest amount of work to fight disease on the one hand, and reveal all the unknowns on the other hand.
This is how pulmonology services have adapted to Covid-19
the doctor Sarah Healyin charge of the Intermediate Respiratory Care Unit (ICUR) inJiménez Díaz Foundation University Hospital From Madrid, it states that the management of COVID-19 patients is now clear and agreed upon. It is intended for drug treatments, as well as for mechanical respiratory support, in cases where this is necessary.
Dr. Healy is one of the authors of the paper The role of intensive care units in Spainpublished in October 2020, in contextAdapting pulmonology services in the face of COVID-19. These units, not as complex as the ICU, but providing cardiac and respiratory monitoring and non-invasive respiratory support, were very useful in the most difficult phase of the epidemic.
The study collected data that found this “The number of intensive care units present in the Spanish public health system has increased from 16 to 41”. The number of beds in this type of unit increased from 112 to 525. Pulmonary services had to be restructured, and an important reason was that “the most common serious clinical manifestations that appeared in patients with Covid-19 were severe acute respiratory failure.” Which requires the respiratory system.” Supports.
More than half of the study participants felt that after the COVID-19 pandemic, their center would retain the position UCIEven if it was with a lower stop. More than three years later, Dr. Sarah Healy has become clear These units are essential To reduce mortality and improve patient experience. Therefore, they are still necessary.
Following up on patients after they pass COVID-19
On the website of the Spanish Society of Pulmonary and Thoracic Surgery (SEPAR), you can consult Consensus document on post-COVID-19 follow-up, which was also published in late 2020 in the journal Open Respiratory Archives. It contains recommendations, as a result of experience and consensus Clinical monitoring of patients After passing the acute stage of this disease.
The document compiles a classification of the different clinical forms in which the disease manifests itself, and defines the follow-up that should be performed for each of them. And also how to act in front of different types of sequences.
Identify serious causes and consequences
During research into COVID-19 and the virus that causes it, it has been investigated why some patients develop much worse than others, without knowing the cause with certainty. New symptoms or problems caused by the SARS-CoV-2 virus have also been discovered.
For example, looking for reasons that justify Different progression of the disease In some patients monitored by internal medicine and pulmonology services, an explanation was sought in the patients’ genome. Blood samples were collected from more than 11,000 patients from many countriesGenOMICC genome-wide association study (GWAS) .
the doctor José María Echafe-SustaitaHead of the Pulmonary Service Quirónsalud MadridOne of the study participants explains, “The study discovered genes that predispose to disease severity and that Covid-19 can share with other viruses,” and this study was published by the journal Nature in May 2023.
In addition to fever, chills and sore throat. According to the World Health OrganizationCovid-19 showed a wide range of symptoms that varied from one virus wave to another, and also from one patient to another. the difficulty breathing It was one of the signs that advises seeking urgent medical care. Among the patients who required hospitalization, one of the serious consequences of the disease was respiratory failure.
But it soon turned out to be this type of coronavirus Not only did he develop respiratory symptoms. Some of its more striking side effects, such as changes in taste and smell, have been widely discussed in the press. But it also affects the skin, eyes, nervous system, and heart.
Other possible consequences of overcoming or overcoming the disease are constantly being studied. For example, a doctor David BlassieObstetrics and Gynecology Specialist Quirónsalud Digest Medical Centerexplains howImpact of COVID-19 on men’s fertility .
What is persistent Covid and how does it appear?
Not only has the virus that causes Covid-19, the SARS-CoV-2 coronavirus, stayed with us causing new infections, but there are also people who have developed post-Covid sequelae and in some cases also caused Ongoing Covid Or “long Covid,” a syndrome that appears weeks or even months after the disease has been overcome.
As the doctor explains Juan Ruiz ManzanoHead of the Pulmonology Department Technoon Medical Centerthe Covid is ongoing It is “a syndrome characterized by the persistence of Covid-19 symptoms from the third or fourth week after the initial infection, or due to the appearance of symptoms after a period of time without them.”
Between 10 and 30% of Covid cases can later be affected by this syndrome, although it is more common in middle-aged women. the disease It seriously affects the patient’s quality of lifeIt can also last for weeks or months. General symptoms appear, such as fatigue, fever, changes in rest, dizziness or muscle pain, but also more specific symptoms, not only the respiratory system.
You have to remember that this is what a doctor does Jose Angel CabreraHead of the Department of Cardiology atQuirónsalud University Hospital Madridwhich Covid-19 also entails Cardiovascular problems. It does that as it progresses, but it also leaves post-COVID sequelae in the heart or with various cardiovascular symptoms associated with ongoing COVID.
Learn from the mistakes you make
Although many positive aspects can be drawn from the global response to the pandemic, there are also many things that could have been done better. In September 2022, Lancet Commission on COVID-19 issued a report describing pandemic management as ““A profound tragedy and a colossal failure.”.
On the positive side of the scale, they place public-private cooperation, which has enabled the development of several vaccines in record time. Unfortunately, they believe that Global and widespread failures It has caused millions of avoidable deaths.
They also point to a serious problem of our time: many people have protested against common-sense public health measures, influenced by misinformation. Another downside they point out is Global health inequalities“This is an issue that should be addressed.”Protecting the world from future pandemics “.
Latest WHO guidelines on treatments
Today, we continue to learn. As a result of this learning, the World Health Organization (WHO) recently presented the thirteenth update of its report Guidance on treatments against coronavirus (COVID-19)..
It is clear that the situation has also evolved, and the current variants of the virus are generally more responsible Less serious forms of the disease . In addition, thanks to vaccination, immunity levels are high, and this significantly reduces the risk of serious illness and death.
All new recommendations focus on patients who, in principle, do not present a severe picture of Covid-19. They have updated Hospital admission risk estimates For this group: People who are immunocompromised are still at risk of hospitalization. They have also updated the Treatments of choice Depending on whether the risk of hospitalization is high, medium or low.
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