Características y especialización de la respuesta inmunitaria en la COVID-19

Abstract

Characteristics and Specialization of the Immune Response in COVID-19 Abstract The outbreak of coronavirus pneumonia in Wuhan, China, became a pandemic on March 11, 2020. It has caused almost 4 million confirmed cases worldwide, with more than 270,000 deaths. Coronavirus is an enveloped RNA virus of the β-coronavirus genus distributed in birds, humans, and other mammals. The World Health Organization has named the new disease COVID-19. The scientific community is look http://doi.org/10.22201/fm.24484865e.2020.63.4.02 8 8 Revista de la Facultad de Medicina de la UNAM | ing for evidence that can lead to a better understanding of the infection and the immune response (IR), prognostic and therapeutic predictors, effective treatments and vaccines. The objective of this review was to compile updated scientific evidence of the IR to COVID-19, in order to guide professionals with solutions that have a clinical impact. The most important elements involve innate immunity with failures in the interferon system in the early stages of the infection and a sustained increase in proinflammatory interleukins. This can end in a potentially fatal cytokine storm. The infiltration of neutrophils and macrophages at the alveolar level, accompanied by neutrophilia, is very characteristic. Lymphopenia is evident at the adaptive immunity level, that, depending on the degree, can indicate the severity of the disease. Understanding the temporal sequence of the IR is crucial for choosing the appropriate and effective therapies, especially when selecting which type of anti-inflammatory drugs can be used and the frequency of the dosage. Due to the fact that it is difficult to determine when they will be clearly beneficial, not harmful to the IR and not too late, due to the irreversibility of the process. Key words: COVID-19; coronavirus; immune response

Mortality and Survival Factors in Patients with Moderate and Severe Pneumonia Due to COVID-19

“…Accordingly, Grasselli et al, in a cohort study of 4209 patients in the intensive care unit (ICU), reported that patients with survival had evolution times and hospital stays greater than ten days [ 38 ]. This may be because severe forms of COVID-19 present the cytokine storm, a dysregulated inflammatory process that leads to multiple organ failure (MOF), producing death rapidly [ 38 , 39 , 40 , 41 , 42 ].…”

Características del SARS-CoV-2, COVID-19 y su diagnóstico en el laboratorio

“…NKG2A constituye otro punto de control nega-tivo de la respuesta inmune, junto con las moléculas CTLA-4, PD-1 y TIGIT. Esto sugiere que la alta expresión de NKG2A puede asociarse con el avance de la enfermedad y el agotamiento funcional de los linfocitos citotóxicos en la etapa temprana [45]. Un estudio realizado por Wang y colaboradores y publicado por The Journal of Infectious Diseases [46], encontró que el 72% de los pacientes con COVID-19 ingresados de gravedad, presentaron una disminución de linfocitos T CD4+, linfocitos T CD8+, linfocitos B y linfocitos NK.…”

What Do We Know Today about Long COVID? Nursing Care for a New Clinical Syndrome

“…The symptom map from a national study in Spain found up to 201 symptoms related to long COVID [ 8 ]. In any case, it is necessary to remember that the symptomatology appears in the form of outbreaks and not in continuity [ 10 ].…”