| Abstract | Koronavirusna bolest 2019 (COVID-19) je akutna zarazna bolest s pretežito respiratornim simptomima, a uzrokuje ju teški akutni respiratorni sindrom koronavirus 2 (SARS-CoV-2). Pored akutne bolesti opisuje se sve više slučajeva kroničnog oblika bolesti s dugotrajnim simptomima. Svjetska zdravstvena organizacija (SZO) je objavila definiciju post COVID-19 stanja, po kojoj post COVID-19 stanje nastaje kod osoba s poviješću vjerojatne ili potvrđene SARS-CoV-2 infekcije, obično 3 mjeseca od početka COVID-19 bolesti sa simptomima koji traju barem 2 mjeseca i ne mogu se objasniti niti jednom alternativnom dijagnozom.
Patofiziološki mehanizmi kojima bi se moglo objasniti post COVID-19 stanje uključuju direktno oštećenje tkiva virusom, disregulaciju imunološkog odgovora domaćina i kapilarno oštećenje. Neki od glavnih perzistentnih simptoma koji se javljaju nakon akutne COVID-19 bolesti su zaduha, kašalj, mijalgija, umor i poteškoće s pamćenjem. SARS-CoV-2 infekcija može dovesti do plućnih komplikacija, poput kroničnog kašlja, fibrotske bolesti pluća, bronhiektazija, plućne vaskularne bolesti i plućne hipertenzije. COVID-19 bolest može ostaviti dugoročne posljedice i na ostale organske sustave, primjerice kardiovaskularni, neurološki, gastrointestinalni, bubrežni, endokrini i hematološki sustav.
Prilikom dijagostike plućnih manifestacija post COVID-19 stanja važno mjesto zauzimaju testovi plućne funkcije i radiološke metode. Smanjenje difuzijskog kapaciteta pluća (DLCO) je najčešće zabilježeno fiziološko pogoršanje u post-akutnoj COVID-19 bolesti, dok radiološki nalazi uključuju infiltrate tipa zrnatog stakla, parenhimske trake, retikularne abnormalnosti, trakcijske bronhiektazije i mozaične atenuacije. Simptomatski možemo liječiti tegobe poput kašlja, boli i mijalgije. Rehabilitacija, koja uključuje neuromotornu i respiratornu rehabilitaciju, psihološku podršku te govornu i radnu terapiju, igra važnu ulogu u oporavku bolesnika nakon COVID-19 bolesti.
Post COVID-19 stanje je relativno nova pojava i potrebna su daljnja istraživanja i kliničko iskustvo za njeno bolje razumijevanje. Budući da post COVID-19 stanje može pogoditi razne organske sustave važna je suradnja stručnjaka iz različitih područja. |
| Abstract (english) | Coronavirus disease 2019 (COVID-19) is an acute infectious disease with predominantly respiratory symptoms. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition to acute disease, more and more cases of a chronic form of the disease with long-lasting symptoms have been described. The World Health Organization (WHO) has published a definition of post COVID-19 condition, according to which post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by any alternative diagnosis.
Pathophysiological mechanisms that could explain post COVID-19 condition include direct viral tissue damage, immune dysregulation and capillary damage. Some of the main persistent symptoms that occur after acute COVID-19 are dyspnea, cough, myalgia, fatigue, and memory impairment. SARS-CoV-2 infection can lead to pulmonary complications, such as chronic cough, fibrotic lung disease, bronchiectasis, pulmonary vascular disease, and pulmonary hypertension. COVID-19 can leave long-term consequences on other organ systems, for example cardiovascular, neurological, gastrointestinal, renal, endocrine, and hematological system.
When diagnosing pulmonary manifestation of post COVID-19 condition pulmonary function tests and radiological methods play an important role. A reduction in diffusion capacity (DLCO) is the most commonly reported physiologic impairment in post-acute COVID-19, while the most common radiological findings are ground-glass opacities, parenchymal bands, reticular abnormality, traction bronchiectasis and mosaic attenuation. Symptoms such as cough, pain and myalgia can be treated symptomatically. Rehabilitation, which includes neuromotor and respiratory rehabilitation, psychological support, speech, and occupational therapy, plays an important role in the recovery of patients after COVID-19.
Post COVID-19 condition is a relatively new phenomenon, so further research and clinical experience are needed for its better understanding. Since post COVID-19 condition can affect various organ systems, the cooperation of experts from different fields is important. |
