Índices de inflamación como predictores de daño pulmonar en pacientes recuperados de COVID-19

Lisania Reyes Espinosa, Agustín Lage Dávila, Consuelo Macías Abraham

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Resumen

Introducción. La pandemia del nuevo coronavirus 2019 (COVID-19), ha afectado a más de 40 millones de personas en todo el mundo. La fase aguda de la enfermedad ha sido ampliamente descrita, sin embargo, existen pocos estudios en la fase de recuperación. La tercera parte de los pacientes recuperados quedan con lesiones inflamatorias pulmonares que pueden llevar a una fibrosis irreversible. El presente estudio evalúa tres marcadores de inflamación en pacientes recuperados de COVID-19 con y sin daño pulmonar, así como el efecto del tratamiento en dichos marcadores. Métodos. Se realizó un estudio piloto longitudinal prospectivo en 49 pacientes recuperados de COVID-19, 20 de ellos con daño pulmonar y 29 sin daño. Se les realizó hemograma completo, obteniéndose el conteo absoluto de neutrófilos (N), linfocitos (L) y plaquetas (P), para el análisis de la razón neutrófilos/linfocitos (NLR), la razón plaquetas/linfocitos (PLR) y el índice de inflamación inmune sistémica (SII). Resultados. El PLR y el SII estuvieron aumentados en los pacientes con daño pulmonar. El PLR fue el mejor índice para predecir el daño, niveles superiores o igual a 112.07, se asociaron con un incremento de 7 veces el riesgo. El tratamiento con prednisona disminuyó el PLR en los pacientes recuperados al mes de tratados. Conclusiones. El PLR y el SII son marcadores predictivos del daño pulmonar, siendo el PLR el que mejor discrimina a los pacientes con daño. Estos resultados sugieren que pudiera emplearse el tratamiento con prednisona en los pacientes recuperados con daño pulmonar y PLR superior o igual a 112.07.

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