Coma mixedematoso en el paciente con SARS-COV2. Revisión bibliográfica

Abstract

Introduction: Coma mixedematoso represents the extreme manifestation of uncontrolled hypothyroidism, which can occur in patients who are experiencing a systemic illness such as SARS-COV-2, leading to increased patient mortality due to the fatal interaction between these two conditions when they coexist. Objective: To provide an updated overview of the diagnosis and management of coma mixedematoso in patients with SARS-COV-2. Methodology: A conceptual literature review on coma mixedematoso in SARS-COV-2 patients was conducted, extracting information from various scientific databases such as PubMed, Scielo, Science Direct, among others, using the PRISMA strategy. Results: In patients with SARS-COV-2 and coma mixedematoso, notable vital signs include bradycardia, hypotension, eutermia, and low oxygen saturation. This may result from the interaction between both conditions. Coma mixedematoso can be directly or indirectly triggered by the infection, especially in intensive care patients with respiratory distress syndrome. Therefore, evaluating thyroid function in SARS-COV-2 patients, particularly in severe cases, is crucial. Conclusion: Thyroid profile assessment should be considered in SARS-COV-2-infected patients due to the possibility of developing coma mixedematoso. This diagnosis should be considered in cases of altered consciousness with normal or low body temperature, even during an infection. In these patients, the prevalence of coma mixedematoso is higher in women (90% in analyzed cases), and the relationship between respiratory rate and oxygen saturation is not always inversely proportional. Hypotension is common (72.73%) and is often associated with a decrease in pulse pressure due to negative inotropic and chronotropic effects and vasoconstriction.