Lesión pulmonar apical por SARS-COV-2 y manifestación de cuadro clínico leve. Reporte de un caso. Apical pulmonary injury by SARS-COV-2 and mild clinical profile manifestation. A case report

Abstract

The coronavirus is a viral agent, responsible for the current pandemic, declared a public health emergency by the WHO, which began in Wuhan, China. COVID-19 is causing severe lung involvement in some patients. Computerized axial tomography has proven to be a sufficiently sensitive diagnostic method to complement the diagnosis of coronavirus pneumonia, supporting the RT-CPR test. The compromise of the ventilation / perfusion ratio in some cases can help to guide the severity of the lung compromise, and in others, it can serve as a prognosis. The ventilation / perfusion relationship can be calculated through the formula of the Alveolar-arterial Oxygen Difference (DA-a02), together with this, the Kirby index is an indirect measure that allows evaluating the degree of respiratory failure as a product of a pulmonary inflammatory process, intrapulmonary shunt. The results of both calculations, added to the CT imaging findings and the semiological elements, can be indicative of the pulmonary functional status and the risk of having an unfavorable evolution. Applying these principles of lung physiology in the pathophysiological context of COVID-19 lung infection may be useful in medical practice. In our case, the distribution of the injuries observed in the CT scan by COVID-19 could be related to the areas of affectation in the lung parenchyma observed and the commitment that the pulmonary inflammatory process has in unbalancing the gas exchange zones, the ventilation ratio / perfusion (V / Q).