COVID-19 i pneumonija

Bolest uzrokovana novim koronavirusom 2019 (COVID-19) postala je prijetnja cijeloj svjetskoj populaciji. Njena česta komplikacija je upala pluća. Najčešći simptomi bolesti su povišena tjelesna temperatura, suhi kašalj, umor, iskašljavanje, zaduha. Rjeđi simptomi su glavobolja, suho grlo, probavne tegobe, simptomi gornjega dišnog puta, promjene u osjetu njuha i okusa. Starija dob i komorbiditeti kao što je visoki krvni tlak, šećerna bolest, kronične plućne bolesti, kardiovaskularne bolesti, srčane bolesti, pretilost predstavljaju značajni rizični faktor za bolesnike inficirane koronavirusom SARS-CoV-2. Uobičajeni laboratorijski nalazi uključuju limfopeniju, povišenu razinu C-reaktivnog proteina, feritina, aminotransferaza, laktat dehidrogenaze. Bolesnici koji razviju tešku kliničku sliku obično imaju brojne laboratorijske poremećaje što sugerira da SARS-CoV-2 infekcija može uzrokovati ozljedu stanične imunosti, aktivaciju koagulacije, oštećenje miokarda, jetre i bubrega. Najčešće komplikacije su akutni respiratorni distres sindrom, šok, aritmije, akutna ozljeda miokarda, akutno oštećenje bubrežne funkcije. Kompjuterizirana tomografija (CT) može biti korisna kao komplementarna metoda polimeraznoj lančanoj reakciji u realnom vremenu za dijagnozu COVID-19 pneumonije. Njezine glavne CT karakteristike su infiltrati tipa mliječnog stakla periferne i subpleuralne distribucije. Ova područja uzorka mliječnog stakla mogu se miješati s područjima žarišne konsolidacije i/ili se na njih superponiraju zadebljale intralobularne septe, što daje uzorak ludog popločenja.
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a clinical threat to the general population worldwide. Pneumonia is a common complication of COVID-19. Most common symptoms include fever, dry cough, fatigue, sputum production, dyspnea. Less common symptoms include headaches, sore throat, gastrointestinal symptoms, upper airway symptoms, alterations in smell or taste. Higher age and comorbidities, such as hypertension, diabetes mellitus, chronic lung disease, cardiovascular disease, cerebrovascular disease and obesity, pose significant risk for patients infected with SARS-CoV-2. Common laboratory findings include lymphopenia, elevated C-reactive protein, ferritin, aminotransferase levels and lactate dehydrogenase levels. Patients who develop severe disease typically have numerous laboratory abnormalities, which suggests that SARS-CoV-2 infection may be associated with cellular immune deficiency, coagulation activation, myocardial, hepatic and kidney injury. The most frequent complications include acute respiratory distress syndrome, shock, arrhythmias, acute cardiac injury and acute renal failure. Computed tomography (CT) may prove useful as a complementary method to real-time polymerase chain reaction for diagnosing COVID-19 pneumonia. The main CT feature of COVID-19 pneumonia is the presence of ground-glass opacities (GGO), typically with peripheral and subpleural distribution. These areas of GGO may be admixed with areas of focal consolidation and/or associated with superimposed intralobular reticulations, resulting in a crazy-paving pattern.