Manifestaciones clínicas y complicaciones de la enfermedad por coronavirus 2019 (COVID-19): revisión de la literatura

Herberth G. Maldonado Briones, Mario Melgar Toledo, Nancy Sandoval Paiz, Hugo Pezzarossi

Resumen


La Enfermedad por Coronavirus 2019 (COVID-19) supone un reto sin precedentes para la salud pública. Los médicos deben fortalecer sus habilidades clínicas para combatir esta nueva enfermedad. El objetivo de esta revisión fue describir los signos, síntomas y complicaciones de pacientes con COVID-19. Se realizó una búsqueda en la literatura en la base de datos PubMed incluyendo publicaciones entre 1 de diciembre 2019 y 15 de agosto 2020, sin restricciones de lenguaje, utilizando las palabras clave ‘COVID-19’ cruzada con ‘manifestaciones clínicas’, ‘signos y síntomas’ y ‘complicaciones’. Se incluyeron revisiones sistemáticas y meta-análisis, estudios epidemiológicos y series de casos. Se identificaron 1,066 artículos, de los cuales se seleccionaron 71 de acuerdo a los contenidos previamente definidos por los autores. La COVID-19 presenta un curso de leve a moderado y severo-crítico, específicamente en mayores de 65 años con o sin comorbilidades. Los signos y síntomas no son específicos y usualmente se superponen de acuerdo a la edad y a la fase de la enfermedad. Los síntomas más comunes son fiebre, tos y fatiga. Síntomas menos comunes incluyen escalofríos, dolor de garganta, cefalea, mialgias/artralgias, pérdida del gusto y del olfato, diarrea, nausea, vómitos, congestión nasal, palpitaciones, opresión precordial y dolor pleurítico. La sintomatología en niños difiere de la de los adultos y el curso es usualmente benigno y de baja mortalidad.  La evaluación clínica de COVID-19 supone un reto hoy en día. Sin embargo, el conocimiento de la historia natural de la enfermedad permite situar los síntomas comunes e inespecíficos en el contexto clínico correcto


Texto completo:

PDF

Referencias


Andrikopoulou, M., Madden, N., Wen, T., Aubey, J. J., Aziz, A., Baptiste, C. D., . . . Friedman, A. M. (2020). Symptoms and critical illness among obstetric patients with coronavirus disease 2019 (COVID-19) infection. Obstetrics & Gynecology, 136(2), 291-299. https://doi.org/10.1097/AOG.0000000000003996

Annweiler, C., Sacco, G., Salles, N., Aquino, J. P., Gautier, J., Berrut, G., . . . Gavazzi, G. (2020). National French survey of COVID-19 symptoms in people aged 70 and over. Clinical Infectious Diseases, ciaa792 http://doi.org/10.1093/cid/ciaa792

Asgharpour, M., Zare, E., Mubarak, M., & Alirezaei, A. (2020). COVID-19 and kidney disease: Update on epidemiology, clinical manifestations, pathophysiology and management. Journal of the College of Physicians and Surgeons Pakistan, 30(6), 19-25. https://doi.org/10.29271/jcpsp.2020.Supp1.S19

Ashcroft, J., Hudson, V. E., & Davies, R. J. (2020). COVID-19 gastrointestinal symptoms mimicking surgical presentations. Annals of Medicine and Surgery, 56, 108-109. https://doi.org/10.1016/j.amsu.2020.06.025

Assaker, R., Colas, A. E., Julien-Marsollier, F., Bruneau, B., Marsac, L., Greff, B., . . . Dahmani, S. (2020). Presenting symptoms of COVID-19 in children: A meta-analysis of published studies. British Journal of Anaesthesia, 125(3), Article e330-e332. https://doi.org/10.1016/j.bja.2020.05.026

Batisse, D., Benech, N., Botelho-Nevers, E., Bouiller, K., Collarino, R., Conrad, A., . . . Wyplosz, B. (2020). Clinical recurrences of COVID-19 symptoms after recovery: viral relapse, reinfection or inflammatory rebound? Journal of Infection, 81(5), 816-846. https://doi.org/10.1016/j.jinf.2020.06.073

Bikdeli, B., Madhavan, M. V., Jimenez, D., Chuich, T., Dreyfus, I., Driggin, E., . . . Right Ventricular, F. (2020). COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. Journal of the American College of Cardiology, 75(23), 2950-2973. https://doi.org/10.1016/j.jacc.2020.04.031

Braun, F., Lutgehetmann, M., Pfefferle, S., Wong, M. N., Carsten, A., Lindenmeyer, M. T., . . . Huber, T. B. (2020). SARS-CoV-2 renal tropism associates with acute kidney injury. Lancet, 396(10251), 597-598. https://doi.org/10.1016/S0140-6736(20)31759-1

Byrd, K. M., Beckwith, C. G., Garland, J. M., Johnson, J. E., Aung, S., Cu-Uvin, S., . . . Kantor, R. (2020). SARS-CoV-2 and HIV coinfection: clinical experience from Rhode Island, United States. Journal of the International AIDS Society, 23(7), Article e25573. https://doi.org/10.1002/jia2.25573

Center of Disease Control and Prevention. (2020). Infection control guidance for healthcare orofessionals about coronavirus (COVID-19). Recuperado de https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html

Chen, X., Laurent, S., Onur, O. A., Kleineberg, N. N., Fink, G. R., Schweitzer, F., & Warnke, C. (2020). A systematic review of neurological symptoms and complications of COVID-19. Journal of Neurology. https://doi.org/10.1007/s00415-020-10067-3

Cheng, Y., Luo, R., Wang, K., Zhang, M., Wang, Z., Dong, L., . . . Xu, G. (2020). Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney International, 97(5), 829-838. https://doi.org/10.1016/j.kint.2020.03.005

Chow, C. B. (2004). Post-SARS infection control in the hospital and clinic. Paediatric Respiratory Reviews, 5(4), 289-295. https://doi.org/10.1016/j.prrv.2004.07.006

Connors, J. M., & Levy, J. H. (2020). Thromboinflammation and the hypercoagulability of COVID-19. Journal of Thrombosis and Haemostasis, 18(7), 1559-1561. https://doi.org/10.1111/jth.14849

Cruz, J., Hernández, P., Dueñas, N., & Salvato, A. (2012). Importancia del método clínico. Revista Cubana de Salud Pública, 38(3), 422-437.

Cucinotta, D., & Vanelli, M. (2020). WHO declares COVID-19 a pandemic. Acta Biomedica, 91(1), 157-160. https://doi.org/10.23750/abm.v91i1.9397

https://doi.org/10.1080/0142159x.2020.1798368

de Souza, T. H., Nadal, J. A., Nogueira, R. J. N., Pereira, R. M., & Brandao, M. B. (2020). Clinical manifestations of children with COVID-19: A systematic review. Pediatric Pulmonology, 55(8), 1892-1899. https://doi.org/10.1002/ppul.24885

Dhakal, B. P., Sweitzer, N. K., Indik, J. H., Acharya, D., & William, P. (2020). SARS-CoV-2 infection and cardiovascular disease: COVID-19 heart. Heart Lung and Circulation, 29(7), 973-987. https://doi.org/10.1016/j.hlc.2020.05.101

Falkenhain-López, D., Agud-Dios, M., Ortiz-Romero, P. L., & Sánchez-Velázquez, A. (2020). COVID-19-related acute genital ulcers. Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.16740

Galván, C., Catala, A., Carretero, G., Rodríguez-Jimenez, P., Fernández-Nieto, D., Rodríguez-Villa, A., . . . García-Doval, I. (2020). Classification of the cutaneous manifestations of COVID-19: A rapid prospective nationwide consensus study in Spain with 375 cases. British Journal of Dermatology, 183(1), 71-77. https://doi.org/10.1111/bjd.19163

Gao, Z., Xu, Y., Sun, C., Wang, X., Guo, Y., Qiu, S., & Ma, K. (2020). A systematic review of asymptomatic infections with COVID-19. Journal of Microbiology, Immunology, and Infection. https://doi.org/10.1016/j.jmii.2020.05.001

Garrigues, E., Janvier, P., Kherabi, Y., Bot, A. L., Hamon, A., Gouze, H., . . . Nguyen, Y. (2020). Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. Journal of Infection. https://doi.org/10.1016/j.jinf.2020.08.029

Goren, A., Vano-Galvan, S., Wambier, C. G., McCoy, J., Gomez-Zubiaur, A., Moreno-Arrones, O. M., . . . Washenik, K. (2020). A preliminary observation: Male pattern hair loss among hospitalized COVID-19 patients in Spain - A potential clue to the role of androgens in COVID-19 severity. Journal of Cosmetic Dermatology, 19(7), 1545-1547. https://doi.org/10.1111/jocd.13443

Goyal, P., Choi, J. J., Pinheiro, L. C., Schenck, E. J., Chen, R., Jabri, A., . . . Satlin, M. J. (2020). Clinical characteristics of Covid-19 in New York City. New England Journal of Medicine, 382(24), 2372-2374. https://doi.org/10.1056/NEJMc2010419

Gravell, R. J., Theodoreson, M. D., Buonsenso, D., & Curtis, J. (2020). Radiological manifestations of COVID-19: key points for the physician. British Journal of Hospital Medicine, 81(6), 1-11. https://doi.org/10.12968/hmed.2020.0231

Guan, W., Ni, Z., Hu, Y., Liang, W., Ou, C., He, J., . . . Zhong, N. (2020). Clinical characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine, 382(18), 1708-1720. https://doi.org/10.1056/NEJMoa2002032

He, X., Lau, E. H. Y., Wu, P., Deng, X., Wang, J., Hao, X., . . . Leung, G. M. (2020). Temporal dynamics in viral shedding and transmissibility of COVID-19. Nature Medicine, 26(5), 672-675. https://doi.org/10.1038/s41591-020-0869-5

Hu, L., & Wang, C. (2020). Radiological role in the detection, diagnosis and monitoring for the coronavirus disease 2019 (COVID-19). European Review for Medical and Pharmacological Sciences, 24(8), 4523–4528. https://doi.org/10.26355/eurrev_202004_21035

Huarcaya-Victoria, J., Meneses-Saco, A., & Luna-Cuadros, M. A. (2020). Psychotic symptoms in COVID-19 infection: A case series from Lima, Peru. Psychiatry Research, 293, 113378. https://doi.org/10.1016/j.psychres.2020.113378

Jacobi, A., Chung, M., Bernheim, A., & Eber, C. (2020). Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review. Clinical Imaging, 64, 35-42. https://doi.org/10.1016/j.clinimag.2020.04.001

Karadas, O., Ozturk, B., & Sonkaya, A. R. (2020). A prospective clinical study of detailed neurological manifestations in patients with COVID-19. Neurological Sciences, 41(8), 1991-1995. https://doi.org/10.1007/s10072-020-04547-7

Klompas, M., Baker, M. A., & Rhee, C. (2020). Airborne transmission of SARS-CoV-2: Theoretical considerations and available evidence. Journal of the American Medical Association, 324(5), 441-442. https://doi.org/10.1001/jama.2020.12458

Kopel, J., Perisetti, A., Gajendran, M., Boregowda, U., & Goyal, H. (2020). Clinical insights into the gastrointestinal manifestations of COVID-19. Digestive Diseases and Sciences, 65(7), 1932-1939. https://doi.org/10.1007/s10620-020-06362-8

Lansbury, L., Lim, B., Baskaran, V., & Lim, W. S. (2020). Co-infections in people with COVID-19: A systematic review and meta-analysis. Journal of Infection, 81(2), 266-275. https://doi.org/10.1016/j.jinf.2020.05.046

Lauer, S. A., Grantz, K. H., Bi, Q., Jones, F. K., Zheng, Q., Meredith, H. R., . . . Lessler, J. (2020). The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Annals of Internal Medicine, 172(9), 577-582. https://doi.org/10.7326/M20-0504

Li, N., Han, L., Peng, M., Lv, Y., Ouyang, Y., Liu, K., . . . Yang, L. (2020). Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: A case-control study. Clinical Infectious Diseases, 71(16), 2035-2041. https://doi.org/10.1093/cid/ciaa352

Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., . . . Feng, Z. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. New England Journal of Medicine, 382(13), 1199-1207. https://doi.org/10.1056/NEJMoa2001316

Liu, J., Cui, M., Yang, T., & Yao, P. (2020). Correlation between gastrointestinal symptoms and disease severity in patients with COVID-19: A systematic review and meta-analysis. British Medical Journal Open Gastroenterology, 7(1), Article e000437. https://doi.org/10.1136/bmjgast-2020-000437

Lovato, A., & de Filippis, C. (2020). Clinical presentation of COVID-19: A systematic review focusing on upper airway symptoms. Ear, Nose & Throat Journal, 99(9), 569-576.https://doi.org/10.1177/0145561320920762

Lu, W., Zhang, S., Chen, B., Chen, J., Xian, J., Lin, Y., . . . Su, Z. Z. (2020). A clinical study of noninvasive assessment of lung lesions in patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound. Ultraschall Med, 41(3), 300-307. https://doi.org/10.1055/a-1154-8795

Ma, N., Li, P., Wang, X., Yu, Y., Tan, X., Chen, P., . . . Jiang, F. (2020). Ocular manifestations and clinical characteristics of children with laboratory-confirmed COVID-19 in Wuhan, China. Journal of the American Medical Association Ophthalmology, 138(10), 1079-1086. https://doi.org/10.1001/jamaophthalmol.2020.3690

Mendez-Flores, S., Zaladonis, A., & Valdes-Rodriguez, R. (2020). COVID-19 and nail manifestation: Be on the lookout for the red half-moon nail sign. International Journal of Dermatology, 59(11), 1414. https://doi.org/10.1111/ijd.15167

Montoya, J., Ugaz, C., Alarcon, S., Maradiegue, E., Garcia, J., Diaz, R., . . . Vasquez, L. (2020). COVID-19 in pediatric cancer patients in a resource-limited setting: National data from Peru. Pediatric Blood Cancer, Article e28610. https://doi.org/10.1002/pbc.28610

Moosavi, S. A., Mashhadiagha, A., Motazedian, N., Hashemazar, A., Hoveidaei, A. H., & Bolignano, D. (2020). COVID-19 clinical manifestations and treatment strategies among solid-organ recipients: a systematic review of cases. Transplant Infectious Diseases, Article e13427. https://doi.org/10.1111/tid.13427

Ministerio de Salud Pública y Asistencia Social. (2020). Casos COVID-19. Recuperado de https://tablerocovid.mspas.gob.gt

Ministerio de Salud Pública y Asistencia Social. (2020). Vigilancia Epidemiológica COVID-19, Guatemala, actualización al 12 de octubre de 2020. Presentación del Departamento de Epidemiología. No disponible en línea.

Nanda, A., Vura, N., & Gravenstein, S. (2020). COVID-19 in older adults. Aging Clinical and Experimental Research, 32(7), 1199-1202. https://doi.org/10.1007/s40520-020-01581-5

Nouri-Vaskeh, M., & Alizadeh, L. (2020). Fecal transmission in COVID-19: A potential shedding route. Journal of Medical Virology, 92(10). https://doi.org/10.1002/jmv.25816

Organización Mundial de la Salud. (2020). Orientaciones técnicas sobre el nuevo coronavirus (2019-nCoV). https://www.who.int/es/emergencies/diseases/novel-coronavirus-2019/technical-guidance

Organización Panamericana de la Salud. (2019). Indicadores básicos 2019: Tendencias de salud en las Américas. Washington, D.C. https://iris.paho.org/bitstream/handle/10665.2/51543/9789275321287_spa.pdf?sequence=7&isAllowed=y

Parra, A., Juanes, A., Losada, C. P., Alvarez-Sesmero, S., Santana, V. D., Marti, I., . . . Rentero, D. (2020). Psychotic symptoms in COVID-19 patients. A retrospective descriptive study. Psychiatry Research, 291, 113254. https://doi.org/10.1016/j.psychres.2020.113254

Pinato, D. J., Lee, A. J. X., Biello, F., Segui, E., Aguilar-Company, J., Carbo, A., . . . Gennari, A. (2020). Presenting features and early mortality from SARS-CoV-2 infection in cancer patients during the initial stage of the COVID-19 pandemic in Europe. Cancers, 12(7). https://doi.org/10.3390/cancers12071841

Raba, A. A., Abobaker, A., Elgenaidi, I. S., & Daoud, A. (2020). Novel coronavirus infection (COVID-19) in children younger than one year: A systematic review of symptoms, management and outcomes. Acta Paediatrica, 109(10), 1948-1955. https://doi.org/10.1111/apa.15422

Ribas, R. M., Campos, P. A., Brito, C. S., & Gontijo-Filho, P. P. (2020). Coronavirus Disease 2019 (COVID-19) and healthcare-associated infections: Emerging and future challenges for public health in Brazil. Travel Medicine and Infectious Disease, 37.https://doi.org/10.1016/j.tmaid.2020.101675

Sacco, G., Briere, O., Asfar, M., Guerin, O., Berrut, G., & Annweiler, C. (2020). Symptoms of COVID-19 among older adults: systematic review of biomedical literature. Geriatrie Psychologie Neuropsychiatrie Vieillissement, 18(2), 135-140. https://doi.org/10.1684/pnv.2020.0863

Salameh, J.-P., Leeflang, M. M., Hooft, L., Islam, N., McGrath, T. A., van der Pol, C. B.,... McInnes, M. D. (2020). Thoracic imaging tests for the diagnosis of COVID-19. Cochrane Database of Systematic Reviews, (9), Article CD013639. https://doi.org/10.1002/14651858.CD013639.pub2

Sattar, Y., Ullah, W., Rauf, H., Virk, H. U. H., Yadav, S., Chowdhury, M., . . . Chadi Alraies, M. (2020). COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management. International Journal of Cardiology Heart & Vasculature, 29, 100589. https://doi.org/10.1016/j.ijcha.2020.100589

Schiffrin, E. L., Flack, J. M., Ito, S., Muntner, P., & Webb, R. C. (2020). Hypertension and COVID-19. American Journal of Hypertension, 33(5), 373-374. https://doi.org/10.1093/ajh/hpaa057

Seah, I., & Agrawal, R. (2020). Can the coronavirus disease 2019 (COVID-19) affect the eyes? A review of coronaviruses and ocular implications in humans and animals. Ocular Immunology and Inflammation, 28(3), 391-395. https://doi.org/10.1080/09273948.2020.1738501

SeyedAlinaghi, S., Ghadimi, M., Hajiabdolbaghi, M., Rasoolinejad, M., Abbasian, L., Nezhad, M. H., . . . Ahmadinejad, Z. (2020). Prevalence of COVID-19-like symptoms among people living with HIV, and using antiretroviral therapy for prevention and treatment. Current HIV Research, 18(5), 373-380. https://doi.org/10.2174/1570162X18666200712175535

Shen, K. L., Yang, Y. H., Jiang, R. M., Wang, T. Y., Zhao, D. C., Jiang, Y., . . . Wang, X. F. (2020). Updated diagnosis, treatment and prevention of COVID-19 in children: experts' consensus statement (condensed version of the second edition). World Journal of Pediatrics, 16(3), 232-239. https://doi.org/10.1007/s12519-020-00362-4

Siddiqi, H. K., & Mehra, M. R. (2020). COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. Journal of Heart and Lung Transplantation, 39(5), 405-407. https://doi.org/10.1016/j.healun.2020.03.012

Soy, M., Keser, G., Atagunduz, P., Tabak, F., Atagunduz, I., & Kayhan, S. (2020). Cytokine storm in COVID-19: Pathogenesis and overview of anti-inflammatory agents used in treatment. Clinical Rheumatology, 39(7), 2085-2094. https://doi.org/10.1007/s10067-020-05190-5

Steardo, L., Steardo, L., Jr., Zorec, R., & Verkhratsky, A. (2020). Neuroinfection may contribute to pathophysiology and clinical manifestations of COVID-19. Acta Physiologica, 229(3), Article e13473. https://doi.org/10.1111/apha.13473

Sungnak, W., Huang, N., Becavin, C., Berg, M., Queen, R., Litvinukova, M., . . . Network, H. C. A. L. B. (2020). SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nature Medicine, 26(5), 681-687. https://doi.org/10.1038/s41591-020-0868-6

Tanasa, I. A., Manciuc, C., Carauleanu, A., Navolan, D. B., Bohiltea, R. E., & Nemescu, D. (2020). Anosmia and ageusia associated with coronavirus infection (COVID-19) - what is known? Experimental and Therapeutic Medicine, 20(3), 2344-2347. https://doi.org/10.3892/etm.2020.8808

van Dam, M., Ramani, S., & Ten, O. (2020). Breathing life into bedside teaching in the era of COVID-19. Medical Teacher, 42(11), 1310-1312. https://doi.org/10.1080/0142159x.2020.1798368

Wambier, C. G., Vano-Galvan, S., McCoy, J., Gomez-Zubiaur, A., Herrera, S., Hermosa-Gelbard, A., . . . Goren, A. (2020). Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The "Gabrin sign". Journal of the American Academy of Dermatology, 83(2), 680-682. https://doi.org/10.1016/j.jaad.2020.05.079

Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., . . . Peng, Z. (2020). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Journal of the American Medical Association, 323(11), 1061-1069. https://doi.org/10.1001/jama.2020.1585

Whittaker, E., Bamford, A., Kenny, J., Kaforou, M., Jones, C. E., Shah, P., . . . Consortia, P. (2020). Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA, 323(11), 1061-1069 https://doi.org/10.1001/jama.2020.10369

Wolff, D., Nee, S., Hickey, N. S., & Marschollek, M. (2020). Risk factors for Covid-19 severity and fatality: a structured literature review. Infection. https://doi.org/10.1007/s15010-020-01509-1

Wollina, U., Karadag, A. S., Rowland-Payne, C., Chiriac, A., & Lotti, T. (2020). Cutaneous signs in COVID-19 patients: A review. Dermatologic Therapy, 33(5), Article e13549. https://doi.org/10.1111/dth.13549

Wong, H. Y. F., Lam, H. Y. S., Fong, A. H., Leung, S. T., Chin, T. W., Lo, C. S. Y., . . . Ng, M. Y. (2020). Frequency and distribution of chest radiographic findings in patients positive for COVID-19. Radiology, 296(2), Articel e72-e78. https://doi.org/10.1148/radiol.2020201160

Wu, P., Duan, F., Luo, C., Liu, Q., Qu, X., Liang, L., & Wu, K. (2020). Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China. JAMA ophthalmology.Ophthalmology, 138(5), 575-578. https://doi.org/10.1001/jamaophthalmol.2020.1291

Yang, C., Ma, Q. Y., Zheng, Y. H., & Yang, Y. X. (2020). Transmission routes of 2019-novel coronavirus (2019-nCoV). Zhonghua Yu Fang Yi Xue Za Zhi [Chinese Journal of Preventive Medicine], 54(4), 374-377. https://doi.org/10.3760/cma.j.cn112150-20200216-0016

Ye, Q., Wang, B., & Mao, J. (2020). The pathogenesis and treatment of the `Cytokine Storm' in COVID-19. Journal of Infection, 80(6), 607-613. https://doi.org/10.1016/j.jinf.2020.03.037

Ye, Z., Zhang, Y., Wang, Y., Huang, Z., & Song, B. (2020). Chest CT manifestations of new coronavirus disease 2019 (COVID-19): A pictorial review. European Radiology, 30(8), 4381-4389. https://doi.org/10.1007/s00330-020-06801-0

Youssef, K., & Abdelhak, K. (2020). Male genital damage in COVID-19 patients: Are available data relevant? Asian Journal of Urology. https://doi.org/10.1016/j.ajur.2020.06.005

Zhang, Y., Cao, W., Xiao, M., Li, Y. J., Yang, Y., Zhao, J., . . . Li, T. S. (2020). Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia. Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi, 41(04), Article e006. https://doi.org/10.3760/cma.j.issn.0253-2727.2020.0006

Zhao, D., Yao, F., Wang, L., Zheng, L., Gao, Y., Ye, J., . . . Gao, R. (2020). A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia with other pneumonias. Clinical Infectious Diseases, 71(15), 756-761. https://doi.org/10.1093/cid/ciaa247

Zhao, Y., Cao, Y., Wang, S., Cai, K., & Xu, K. (2020). COVID-19 and gastrointestinal symptoms. British Journal of Surgery, 107(10). https://doi.org/10.1002/bjs.11821

Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., . . . Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet, 395(10229), 1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3

Zou, L., Ruan, F., Huang, M., Liang, L., Huang, H., Hong, Z., . . . Wu, J. (2020). SARS-CoV-2 viral load in upper respiratory specimens of infected patients. New England Journal of Medicine, 382(12), 1177-1179. https://doi.org/10.1056/NEJMc2001737




DOI: http://dx.doi.org/10.36829/63CTS.v7i3.1005

Enlaces refback

  • No hay ningún enlace refback.

Comentarios sobre este artículo

Ver todos los comentarios
 |  Añadir comentario

Licencia Creative Commons
Este trabajo está licenciado bajo una Licencia Internacional Creative Commons 4.0 Atribución-NoComercial-CompartirIgual .

Dirección General de Investigación
Universidad de San Carlos de Guatemala
Ciudad Universitaria, edificio S-11 3er nivel, zona 12
Teléfono: (502) 24187950
http://digi.usac.edu.gt

Creative Commons License
Ciencia Tecnología y Salud by Universidad de San Carlos de Guatemala is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Based on a work at http://digi.usac.edu.gt/ojsrevistas/index.php/cytes/index.