| Abstract | SARS-CoV-2 virus novootkriveni je koronavirus koji uzrokuje bolest COVID-19. Virus ima visoku stopu transmisije te je vrlo infektivan pa se infekcija nakon pojave prvih slučajeva u Kini veoma brzo proširila na druge države, a ubrzo zahvatila i čitav svijet pokrenuvši jednu od najvećih pandemija u povijesti čovječanstva. Klinički znakovi COVID-19 mogu varirati od umjerenih do teških, a u određenog broja zaražnih javlja se asimptomatski oblik bolesti. Najčešći su simptomi vrućica, umor, suhi kašalj, kratak dah, dispneja, a rjeđe se javljaju i glavobolja, grlobolja, rinoreja te gastrointestinalni simptomi (povraćanje, proljev). Prema težini simptoma COVID-19 može se podijeliti na blagi oblik, srednje teški oblik s blažom pneumonijom, teški oblik s teškom pneumonijom i kritični oblik bolesti. U većine zaraženih nastupi blagi oblik bolesti, ali stariji bolesnici i oni s predstojećim bolestima i komorbiditetima češće razvijaju teški ili kritični oblik bolesti koji zahtijeva liječničku pomoć. Teški oblik COVID-19 udružen je s atipičnom pneumonijom nastalom oštećenjem plućnog parenhima uslijed prejake imunološke reakcije domaćina na SARS-CoV-2 virus i pojačanog otpuštanja proupalnih citokina (citokinska oluja). COVID-19 pneumonija je intersticijska upala pluća koja se u teškom obliku prezentira teškom hipoksijom, a može progredirati do ARDS-a, septičkog šoka i respiratornog zatajenja. Pokazalo se da je klinička slika i tijek pneumonije uzrokovane SARS-CoV-2 virusom teži u starijih te u bolesnika s kroničnim bolestima poput arterijske hipertenzije, dijabetesa, srčanih bolesti. Od komplikacija uslijed infekcije SARS-CoV-2 virusom i COVID-19 pneumonije najčešće se pojavljuju ARDS, plućna fibroza, plućna embolija, pneumotoraks i bakterijska superinfekcija. Za postavljanje dijagnoze pneumonije uzrokovane SARS-CoV-2 virusom potrebno je potvrditi infekciju SARS-CoV-2 virusom pomoću RT-PCR-a. U laboratorijskom nalazu značajan je nalaz limfopenije, a slikovnim se pretragama prikazuju tipične promjene: na RTG-u pluća višestruka mrljasta zamućenja, a na CT-u subsegmentalna ili segmentalna zamućenja poput zrnatog stakla (engl. ground glass). Trenutno je za liječenje bolesnika s COVID-19 u Hrvatskoj dostupna peta verzija Smjernica za liječenje oboljelih od COVID-19 prema kojoj se liječenje provodi antivirusnim i imunomodulacijskim lijekovima, a simptomatska se terapija provodi u obliku nadomjesne terapije kisikom, antitrombotske terapije i antipireze. |
| Abstract (english) | SARS-CoV-2 virus is a newly discovered coronavirus that causes disease called COVID-19. The virus has a high transmission rate and is highly contagious. Thus, after the first cases in China, the infection quickly spread to other countries and continents and started one of the largest pandemics in human history. Clinical signs of COVID-19 can vary from moderate to severe, in some cases, an asymptomatic form of the disease occurs. The most common symptoms are fever, fatigue, dry cough, shortness of breath, dyspnea, and less common are headache, sore throat, rhinorrhea, and gastrointestinal symptoms (vomiting, diarrhea). According to the severity of symptoms, COVID-19 can be divided into mild form, moderate form with mild pneumonia, severe form with severe pneumonia and critical form of the disease. Most infected people develop a mild form of the disease, but older patients and those with previous chronic illnesses and comorbidities are more likely to develop a severe or critical form of COVID-19 which requires medical treatment. Severe form of COVID-19 is associated with atypical pneumonia caused by the damage of the lung parenchyma due to a strong immune response of the host to the SARS-CoV-2 virus and increased release of proinflammatory cytokines (cytokine storm). COVID-19 pneumonia is an interstitial pneumonia that presents with severe hypoxia in the severe form of COVID-19 and can progress to ARDS, septic shock, and respiratory failure. It has been shown that the clinical presentation and course of pneumonia caused by SARS-CoV-2 virus is more severe in the elderly and in patients with chronic diseases such as arterial hypertension, diabetes, heart disease. The most common complications that occur during SARS-CoV-2 virus infection and COVID-19 pneumonia are ARDS, pulmonary fibrosis, pulmonary embolism, pneumothorax, and bacterial superinfection. To diagnose pneumonia caused by SARS-CoV-2 virus, it is necessary to confirm SARS-CoV-2 virus infection by RT-PCR. Lymphopenia is significant in the laboratory test results and imaging shows typical changes: multiple blurred opacities on pulmonary X-ray, and subsegmental or segmental ground glass opacities on CT scan. Currently, the fifth version of the COVID-19 Guidelines for the Treatment of Patients with COVID-19 is available for the treatment of patients with COVID-19 in Croatia. |
