Santo Domingo.- La doctora Elsa Camilo de Amarante, pediatra neumólogo del Hospital Robert Reid Cabral ha impartido durante el desayuno virtual de la Sociedad Dominicana de Pediatría una conferencia sobre el manejo de pacientes pediátricos con enfermedades crónicas y COVID19.
La doctora comenzó describiendo qué son las enfermedades crónicas de la infancia, resaltando que entre ellas se encuentran el asma, las enfermedades metabólicas como diabetes y obesidad, las cardiopatías, dolencias cardiológicas, hemoglobinopatías, tuberculosis y malnutrición.
A continuación, disertó sobre la pandemia de COVID19 en la población infantil, indicando que en un estudio realizado en China se estableció que los niveles de gravedad de acuerdo con los síntomas presentados podían clasificarse de la siguiente forma:
• Infección asintomática, sin signos clínicos y con imágenes de tórax normales, pero con prueba positiva.
• Infección leve, que incluye síntomas como fiebre, fatiga, mialgia, tos, dolor de garganta, secreción nasal, estornudos. Algunos casos pueden no tener fiebre o solo tener síntomas digestivos.
• Infección moderada a severa, que añade a los anteriores síntomas la neumonía, fiebre recurrente y tos seca o tos acompañada de secreciones.
Igualmente, la doctora comentó que el estudio Kids Corona, realizado en Barcelona, España, realizó un seguimiento a 724 niños que habían convivido en el hogar de un progenitor positivo por coronavirus, observándose lo siguiente:
• Los niños se infectaron igual que los adultos cuando están expuestos a una fuente de infección.
• La enfermedad se manifestó de forma mucho más leve en los niños.
• Los niños pueden tener carga viral baja incluso pasado un mes de que el progenitor o cuidador esté positivo.
Para terminar, la doctora aportó diversos datos de interés sobre el impacto de la COVID19 en las enfermedades crónicas preexistentes de los infantes, y propuso una serie de recomendaciones a familiares y sanitarios:
• Mantener a los pacientes bajo control, reduciendo al mínimo las visitas a los centros de salud de estos pacientes.
• Habilitar áreas específicas en los hospitales para los pacientes pediátricos con enfermedades crónicas.
• Garantizar las medidas de bioseguridad para pacientes, familiares y personal sanitario durante las estancias y visitas hospitalarias.
• Mantener el contacto con el pediatra por vía telefónica o videoconferencia (telemedicina).
• Mantener las terapias de las enfermedades crónicas durante la pandemia.
• Educar a los pacientes y cuidadores sobre las medidas preventivas y de atención en casa. Refuerzo de las medidas de higienización, lavado de manos incluido.
• Solicitar la prueba PCR ante cualquier manifestación clínica compatible con la COVID19.
• Aislar al enfermo y a las personas que hayan tenido contacto con un enfermo diagnosticado.
• Aplicar los protocolos de manejo de la COVID19
• Informar a los pacientes y allegados sobre los riesgos de atención a distancia y atención presencial.
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