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COVID-19.UN.LIBRO.DE.TEXTO.Pdf 1 COVID-19 un libro de texto Hugo Villarroel-Ábrego, MD Task Force COVID-19 El Salvador Producido y editado en El Salvador como una publicación independiente del Task Force COVID-19 El Salvador San Salvador, El Salvador, 30 de diciembre 2020. 2 Autor, compilador y editor: Dr. Hugo Villarroel-Ábrego, médico internista, cardiólogo y ecocardiografista. Corrección de texto y estilo: Lic. Silvia Yanira Martínez de Villarroel. Diseño y diagramación: Dr. Hugo Villarroel-Ábrego. Primera Edición: 2020. © Del autor, Hugo Villarroel Abrego, 2020 Todos los derechos reservados. Hecho el depósito que marca la ley. Portada: “Asclepius Lament… Give Them A Break”, Eduardo Alonso Villarroel Martínez (a.k.a QUALIA). Contraportada: Fotografía cortesía del Dr. Edwin Noé Escalante. 3 PREFACIO Este libro es el resultado de un trabajo constante e intenso que data de abril del 2020. Comenzó a gestarse a partir de las Boletines del Task Force COVID-19 El Salvador, un grupo de chat multidisciplinario constituido por más de 150 miembros de diferentes áreas de la Salud, que se ha mantenido activo hasta la fecha, presente en redes sociales, orientándose a labores educativas destinadas al gremio de trabajadores de salud y la población general. Con 29 boletines distribuidos a miles de personas en El Salvador y en el extranjero, webinars y presencia en redes como Twitter y Facebook, nuestro Task Force se erige como un tanque de pensamiento legítimo, apegado a nuestro manifiesto, publicado en el Boletín Número 1, de fecha 25 de abril, y que se transcribe literal, a continuación: 1. Los profesionales miembros del grupo de trabajo conjunto COVID- 19 en El Salvador (COVID-19 Task Force SV) nos definimos como un “tanque de pensamiento” que trabaja con el objetivo de crear una base de datos científicos de la mejor calidad posible durante la pandemia causada por el virus SARS-CoV-2. 2. Nuestra misión no tiene fines de lucro ni está vinculada a corriente política o religiosa de ningún tipo, porque estamos comprometidos con la educación libre de sesgos, disponible para todos, que pueda difundirse en todas las plataformas posibles. 3. Estamos constituidos por profesionales de ambos sexos, formados en medicina, enfermería, psicología y nutrición y otras disciplinas aliadas a las Ciencias de la Salud. 4. Nuestra organización es horizontal e igualitaria, con espacios para amplia participación. 5. Estos esfuerzos cristalizarán en boletines periódicos, que resuman de modo práctico las evidencias que vayan emergiendo respecto a la pandemia COVID-19, basándose en fuentes de reconocido prestigio, tanto de periodismo médico como de publicaciones especializadas en Ciencias de la Salud. La difusión de estos boletines será libre y gratuita. Pronto resultó evidente que la avalancha de datos merecía ser compilada, clasificada, revisada, discutida y resumida, para fines de difusión en una plataforma sencilla, para el uso cotidiano. Muchos médicos salvadoreños y extranjeros han expresado que este cuerpo de información, esperado y codiciado, ha servido de apoyo para los retos 4 que COVID-19 impone, de tantas y tan sorprendentes maneras, desafiando nuestra capacidad de tolerancia y resistencia. Muchos miembros del Task Force han aportado artículos, fotografías, casos clínicos, resúmenes y críticas, siempre bien intencionadas. Muchos, sufriendo en carne propia o en sus familiares y amigos los embates de la enfermedad han compartido generosamente sus historiales clínicos, experiencias y temores, muchas veces entre lágrimas. A pesar de la terrible carga emocional hemos catequizado en cada uno la objetividad de hombres y mujeres de ciencia y por ello debate ha habido, y mucho, a veces intenso. Todos hemos salido ganando de estas discusiones, de las que nace el presente libro texto. Como editor de los Boletines y autor de este libro, doy fe que sin el apoyo de las administradoras del grupo y los aportes desinteresados de todos no habría sido posible esta faena, demoledora y siempre a la espera de cambios de último minuto, dada la naturaleza de la enfermedad que nos ocupa. Muchos conceptos podrán cambiar, quizá en días o semanas, pero la esencia de lo aquí escrito se apoya en las mejores fuentes disponibles, sin que podamos tomar actitudes dogmáticas: pronto toda la ciencia alrededor de esta pandemia se verá confrontada por más y más información que validará o descalificará lo que ahora creemos probable o, al menos, posible. Dios ilumine nuestro entendimiento, fortalezca nuestra Fe y guíe nuestros pasos en la senda del Conocimiento bueno, útil y verdadero, impulsados por la fuerza del Amor al prójimo, en especial a los más desvalidos, necesitados y menesterosos. Solo así valdrá la pena nuestra breve residencia en esta Tierra azotada por calamidades, pero que sigue siendo nuestro Hogar. San Salvador, El Salvador, 21 de diciembre 2020 (Año 1 de Pandemia). Dr. Hugo Villarroel-Ábrego Fellow SIAC, Fellow SISIAC Médico internista, cardiólogo y ecocardiografista. Profesor de Medicina Universidad Salvadoreña “Alberto Masferrer” Editor de los Boletines del Task Force COVID-19 El Salvador. 5 COLABORADORES Y ASESORES Task Force COVID-19 El Salvador • Dra. Amanda Alonzo de Rodríguez, médica internista y neumóloga. • Dr. Ricardo Napoleón Arce, médico internista, cardiólogo y ecocardiografista. • Dr. Eduardo Arévalo, médico internista inmunólogo. • Dr. Javier Eduardo Arriaza Alcaine, médico anestesiólogo y algólogo. • Dra. Claudia Morena Artiga de Vivas, médica ginecóloga obstetra. • Dra. Myrna Elizabeth Artiga, médica ginecoobstetra, mastóloga y ultrasonografista. • Dr. Gabriel Alejandro Benítez Torres, médico en Año Social. • Dr. Nelson Ulises Bonilla Velásquez, médico cardiólogo intervencionista. • Dr. Milton Brizuela, médico cirujano, presidente del Colegio Médico de El Salvador. • Dra. Geraldina Castillejos, internista reumatóloga. • Dr. Ana Camila Flores Ventura, médica radióloga y especialista en cardiorresonancia. • Dra. Mirna Pérez Carvajal, médica pediatra intensivista. • Dr. Jorge Castaneda, médico internista, cardiólogo intervencionista. • Dr. Rafael Chávez-Díaz, médico internista y nefrólogo. • Dr. Ángel Díaz-Alvarenga, médico internista y nefrólogo. • Dra. Xenia Durán de Guevara, médica psiquiatra infantil y del adolescente. • Dr. Edwin Noé Escalante, médico epidemiólogo. • Dr. Mauricio Ernesto Flores Morales, médico alergólogo pediatra. • Dr. Carlos Enrique Franco, médico cardiólogo y ecocardiografista. • Dr. Rubén Ulises Franco Rivas, médico internista y oncólogo. • Dr. Luis Ernesto González Sánchez, médico internista y neurólogo. • Dr. Andrejulio Gregory Moreira, médico internista. • Dra. Mariela Grijalva De Zeledón, médica internista. • Dr. Héctor Guidos, médico alergólogo pediatra e inmunólogo clínico. • Lic. Sandra Hernández de Milla, laboratorista clínica. • Dr. Guillermo Karráa, médico anestesiólogo cardiovascular. • Dra. Verónica Raquel Lara de Granados, médica dermatóloga pediatra. • Dr. Ricardo Alberto Leal Vásquez, médico dermatólogo. 6 • Dra. Silvia Patricia Lemus, médica internista y cardióloga nuclear. • Dr. Manuel López Granados, médico internista y endocrinólogo. • Rosalía López Martínez, asistente médico. • Dra. Elena Maricela Majano Muñoz, internista, neuróloga. • Dr. Rafael Menéndez Montiel, médico neumólogo y cirujano cardiotorácico. • Dra. María Eugenia Menjívar de Ramos, internista, cardióloga y ecocardiografista. • Dr. Ernesto Navarro-Marín, médico internista e infectólogo. • Lic. Ana Patricia Marticorena, psicóloga clínica. • Dra. Norma Orantes, médica especialista en adicciones. • Dr. Rafael Orellana Cornejo, médico internista y neurólogo • Dr. Wilfredo Osorio Menocal, médico internista, especialista en Medicina del Trabajo. • Dr. Orlando Padilla, médico internista e infectólogo (Shreveport, Louisiana, USA). • Dr. Roberto Peña-Chang, médico ginecólogo. • Dra. Leana Quintanilla de Sánchez, médica dermatóloga. • Dr. Jorge Ramírez-Chávez, médico internista y neumólogo. • Dr. Francisco Reyes-Perdomo, médico anestesiólogo. • Dra. Erlinda Rivera de Castillo, médica oftalmóloga. • Dra. Antonieta Sandoval, médica psiquiatra. • Dra. Ana Mirella Schoenenberg de Wollants, médica nutrióloga y abogada. • Dr. Mario Tévez, médico radiólogo. • Dr. Roberto Ticas, médico internista y nefrólogo. • Dr. César Urquiza, médico internista inmunólogo. • Dra. Carolina Vásquez de Aparicio, médica otorrinolaringóloga. • Dra. Aurora Nohemy Velásquez Villatoro, médica ginecóloga oncóloga. • Dr. Adán Velásquez Lupi, médico internista e infectólogo. • Dr. Carlos Honorato Villacorta, médico internista y gastroenterólogo. • Dra. Mónica Alejandra Villarroel-Martínez, médica en Año Social. • Dra. Carolina Vásquez de Aparicio, médica otorrinolaringóloga. • Dra. Ana Jense Villatoro, médica internista y endocrinóloga • Dr. Edward Wollants, médico internista y nutriólogo, abogado de la República. 7 Autores y asesores extranjeros invitados: • Dra. Elizabeth Hirshhaut (médica internista y cardióloga) y Dra. Carmen Julia Delgado (internista, neumóloga e intensivista) del Grupo Venezolano de Ultrasonido Pulmonar, Grupo de Ecografia Pulmonar de la Sociedad Venezolana de Cardiología y Grupo de Ecografia Pulmonar SISIAC. • Lic. Massiel Villarroel Cerda, enfermera Jefe de Cuidados Intensivos, Clínica Las Condes, Santiago de Chile. • Dr. Juan Carlos González Suero, médico cardiólogo y ecocardiografista, Santiago de los Caballeros, RD. Para los demás miembros del Task Force COVID-19 El Salvador nuestra gratitud, por su apoyo irrestricto e incondicional para con este proyecto; aparte de los autores y asesores
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