POSTKOVID STANJE- PLUĆNO ILI SISTEMSKO, REVERZIBILNO ILI IREVERZIBILNO?

Vesna Škodrić Trifunović

doi:10.5937/mp74-47379

vesna_skodric.trifunovic Univerzitet u Beogradu, Medicinski fakultet, Beograd, Srbija; Univerzitetski klinički centar Srbije, Klinika za pulmologiju, Beograd, Srbija

DOI: https://doi.org/10.5937/mp74-47379

Ključne reči: postkovid, oporavak, plućna funkcija, plućna fibroza

Sažetak

Pacijenti oboleli od kovida otpuštali su se iz kovid bolnica i sa kovid odeljenja bez precizne procene stepena oporavka. Najveći broj pacijenata potpuno se oporavio. Ipak, oko 30% imalo je prolongirane simptome, nezavisne od težine kliničke slike kovida. Nije postojala korelacija između težine bolesti i težine postkovid sindroma. U skladu sa NICE 2020 preporukama termin long covid uključuje simptomatski COVID- 19 ( period 4-12 nedelja nakon akutne bolesti) i postkovid 19 sindrom. Prema Svetskoj zdravstvenoj organizaciji postkovid 19 sindrom je stanje koje se razvija kod osobe koja je imala potvrđenu ili verovatnu kovid infekciju obično tri meseca nakon bolesti COVID -19, sa simptomima koji traju najmanje dva meseca i ne mogu se objasniti drugom dijagnozom. Prolongirani umor, otežano disanje i neuropsihijatrijske smetnje najčešće su postkovid tegobe. Najčešća respiratorna postkovid manifestacija je uporna dispneja, dok je perzistentna plućna fibroza bila izuzetno retka. Kod više od polovine pacijenata koji su imali tešku kovid pneumoniju nije bilo apsolutne korelacije između nalaza plućne funkcije i nalaza skenera grudnog koša, tj. poremećaj disajne funkcije perzistirao je i nakon potpune radiografske regresije. Dominantna manifestacija ovog poremećaja bila je snižena vrednost parametara difuzijskog kapaciteta pluća ( TLCOc i KCOc), dok su vrednosti spirometrije bile uredne kod većine postkovid pacijenata. Venski tromboembolizam, miokarditis, anksiozno-depresivni poremećaj, zaboravnost i opadanje kose u formi telogenog efluvijuma neke su od ozbiljnih postkovid komplikacija. Značajnom broju pacijenata bila je neophodna fizikalna rehabilitacija.

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