Introduction: Pulmonary Arterial Hypertension (PAH) is a clinical condition characterized by dysfunction of the pulmonary arterial endothelium that manifests with increased flow restriction in the pulmonary circulation. Numerous advances have been made in understanding the pathophysiology, risk stratification, treatment, and follow-up of patients with this disease. Among these advances is the update in the hemodynamic definition of the event, which largely determines the therapeutic actions to be followed. Due to the above, it was considered necessary to establish recommendations for managing patients with PAH, based on an approach that considers access, use, and provision of health services in Colombia. Methodology: The final document was developed in six stages: 1. Definition of the research questions and content. 2. Search, screening, selection, and evaluation of the evidence. 3. Preparation of a narrative summary of the evidence-based on the guiding questions. 4. Discussion of findings in formal panels. 5. Formulation of recommendations. 6. Writing and consolidation of the final consensus document. Results: The 34 participants reached a consensus and formulated 26 recommendations based on four thematic segments: i) definitions and diagnostic segment, ii) risk stratification segment, iii) treatment segment and iv) follow-up segment. Conclusion: The formulated recommendations will guide primary care physicians in identifying clinical suspicion of the disease and for specialists and subspecialists in confirming the diagnosis, defining the therapeutic approach, and managing patient follow-up. As new evidence emerges, these recommendations should be carefully reviewed and updated.

ABSTRACT Introduction Pulmonary hypertension (PH) is a chronic disease characterized by a progressive rise in pulmonary artery blood pressure. The objective was to describe the treatment patterns among ambulatory patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) in a real‐world setting. Methods This is a longitudinal cohort follow‐up study characterizing the treatment patterns of patients diagnosed with PAH or CTEPH, with secondary data from a population‐based drug‐dispensing database between 2022 and 2023, which includes sociodemographic, diagnosis, prescribing specialty, and treatment (drugs, persistence of use, and concomitant medications). Results In total, 1045 patients with a diagnosis of PH were identified, with mean age of 62.9 ± 18.2 years, and 72.3% of females; of which 947 (90.6%) received monotherapy, and 98 (9.4%) received combination therapy at the beginning of follow‐up. The most frequently used drugs for the treatment of PH were calcium channel blockers (58.1%), followed by phosphodiesterase 5 inhibitors (41.1%), endothelin receptor antagonist (32.5%), and guanylate cyclase stimulants (9.7%). The schemes used most frequently were monotherapy with amlodipine (31.0%), sildenafil (19.2%), or nifedipine (10.0%), but the main combination were sildenafil with nifedipine (2.5%). The mean of persistence of use was 161 ± 123 days during 1 year of follow‐up. Conclusions This group of patients with PH from Colombia were treated predominantly with monotherapy of calcium channel blockers and phosphodiesterase 5 inhibitors. However, current clinical practice guidelines recommend the use of combined therapy. The average persistence of the use of drugs for treatment for less than 6 months may be associated with difficulties in follow‐up, adherence, effectiveness, tolerability, and access.

Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) constituye un importante desafío tanto en el ámbito económico como en el de la salud pública, tanto a nivel mundial como en el contexto colombiano. Esta condición no solo repercute en los pacientes que la padecen, sino que también afecta a sus cuidadores y al sistema de salud en su conjunto. Se ha observado un incremento en el ausentismo laboral tanto por parte de los pacientes como de sus familiares, lo que resulta en pérdidas económicas y oportunidades laborales, agravando aún más el impacto adverso en el individuo y su entorno familiar. El propósito de esta guía clínica es establecer pautas basadas en la evidencia científica disponible para mejorar la atención médica y la gestión de recursos en el tratamiento de la EPOC en la población colombiana. Objetivo: Esta guía de práctica clínica (GPC) informada en evidencia de la Asociación Colombiana de Neumología y Cirugía de Tórax (Asoneumocito), Asociación Colombiana de Medicina Interna (ACMI) y Asociación colombiana de medicina familiar (SOCMEF) y Asociación Colombiana de Fisioterapia (ASCOFI), pretende apoyar a los pacientes, profesionales de la salud, y otros actores en la toma de decisiones sobre el diagnostico, enfoque, pronóstico y manejo de adultos con la EPOC en el contexto colombiano. Materiales y métodos: El Comité de la EPOC de Asoneumocito por delegación de la presidencia de esta, conformó un panel de expertos multidisciplinario para balancear y minimizar el potencial sesgo proveniente de los conflictos de intereses e invitó a las demás asociaciones que hicieron parte de esta guía. La Universidad de los Andes coordinó y desarrolló la actualización o realización de novo de revisiones sistemáticas de la literatura acorde a la metodología GRADE (Grading of Recommendations Assessment, Development and Evaluation). El comité de EPOC planteó una serie de preguntas que el panel de expertos priorizó, así como los desenlaces según su importancia para los profesionales de la salud y los pacientes. Se utilizaron los marcos de la Evidencia a la Decisión (EtD) desarrollados por el grupo de trabajo GRADE, los cuales estuvieron sujetos a comentarios públicos. Resultados: El panel elaboró 10 recomendaciones basadas en evidencia para el manejo de pacientes con la EPOC que recibieron alguna de las siguientes intervenciones: oxigenoterapia a largo plazo, vacunación contra virus de influenza, rehabilitación pulmonar, inhaloterapia con anticolinérgicos de acción prolongada, inhaloterapia con terapia triple, suplementos nutricionales, terapia complementaria con azitromicina, cesación tabáquica con vareniclina y reemplazo de alfa-1 antitripsina. Conclusiones: Las recomendaciones incluidas en esta guía se desarrollaron para el contexto colombiano. El panel consideró que hacen falta por desarrollar estudios de evaluaciones económicas, así como el impacto de las intervenciones evaluadas en áreas como la equidad, aceptabilidad y factibilidad de implementación en Colombia.

This post-hoc analysis of the SABINA III study evaluated the association of short-acting beta(2)-agonist (SABA) prescriptions and self-reported over-the-counter (OTC) SABA purchase in the previous 12 months with asthma-related outcomes using multivariable regression models in 4556 patients (mean age, 48.9 years). Of the 2810 patients prescribed >= 3 SABA canisters, 776 (27.6%) also purchased >= 1 SABA OTC. This subset of 776 patients reported the highest disease burden; 73.2% had >= 1 severe exacerbation and 55.7% had uncontrolled asthma. Asthma-related outcomes worsened with any SABA OTC purchase, regardless of SABA prescriptions; disease burden was the highest in patients with >= 3 SABA prescriptions and >= 1 SABA OTC purchase vs 1-2 SABA prescriptions only (86% lower odds of having at least partly controlled asthma and 124% increased incidence of severe asthma (both P < 0.001). These findings emphasize the need to implement policy changes to restrict SABA purchase without prescriptions and ensure access to affordable asthma care.

"The Evidence of Electronic Cigarettes for Harm Reduction Is Not There." American Journal of Respiratory and Critical Care Medicine, 0(ja), pp.

Introduction The EXAcerbations of Chronic obstructive lung disease (COPD) and their OutcomeS (EXACOS) International Study aimed to quantify the rate of severe exacerbations and examine healthcare resource utilisation (HCRU) and clinical outcomes in patients with COPD from low-income and middle-income countries.Methods EXACOS International was an observational, cross-sectional study with retrospective data collection from medical records for a period of up to 5 years. Data were collected from 12 countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Guatemala, Hong Kong, Mexico, Panama, Russia and Taiwan. The study population comprised patients ≥40 years of age with COPD. Outcomes/variables included the prevalence of severe exacerbations, the annual rate of severe exacerbations and time between severe exacerbations; change in lung function over time (measured by the forced expiratory volume in 1 s (FEV1)); peripheral blood eosinophil counts (BECs) and the prevalence of comorbidities; treatment patterns; and HCRU.Results In total, 1702 patients were included in the study. The study population had a mean age of 69.7 years, with 69.4% males, and a mean body mass index of 26.4 kg/m2. The mean annual prevalence of severe exacerbations was 20.1%, and 48.4% of patients experienced ≥1 severe exacerbation during the 5-year study period. As the number of severe exacerbations increased, the interval between successive exacerbations decreased. A statistically significant decrease in mean (SD) FEV1 from baseline to post-baseline was observed in patients with ≥1 severe exacerbation (1.23 (0.51) to 1.13 (0.52) L; p=0.0000). Mean BEC was 0.198 x109 cells/L, with 64.7% of patients having a BEC ≥0.1 x109 cells/L and 21.3% having a BEC ≥0.3 x109 cells/L. The most common comorbidity was hypertension (58.3%). An increasing number of severe exacerbations per year was associated with greater HCRU.Discussion The findings presented here indicate that effective treatment strategies to prevent severe exacerbations in patients with COPD remain a significant unmet need in low-income and middle-income countries.

Objetivo. El objetivo del estudio fue explorar variables predictivas de mortalidad en pacientes con EPOC de Colombia. Materiales y métodos. Estudio de casos y controles, en pacientes mayores de edad, con diagnóstico de EPOC, atendidos en la clínica “Comfamiliar”, Risaralda, del 1 de enero de 2015 a 31 de diciembre de 2018. Se denominó caso a pacientes fallecidos y el grupo control fueron los supervivientes. Se utilizó un instrumento de recolección de datos validado por juicio de expertos. Se realizó un análisis multivariado de tipo regresión logística y posteriormente análisis post modelamiento para su validación. Los análisis fueron realizados en Stata 14, versión oficial. Se considero significativo con p valor <0,05. El proyecto fue aprobado por el comité de bioética de la clínica Comfamiliar. Resultados. Se incluyeron 230 pacientes con diagnóstico de EPOC. La tasa de mortalidad fue de 10%, por lo que se contó con 23 casos. En el análisis multivariado, los factores predictores de mortalidad fueron la Enfermedad Renal Crónica (ERC) (OR: 8,2, IC: 2,3-29,2, p = 0,001), presencia de exacerbación severa el último año (OR: 7,4, IC: 2,6-20,8, p < 0,001), y la hemoglobina en rangos adecuados (Hb>12 in mujeres/hb>13 in hombres) (OR: 0,82, IC: 0,68-0,99, p = 0,047). Conclusiones. Se observó que la ERC, exacerbaciones severas el último año y valores bajos de hemoglobina predicen la mortalidad en el paciente con EPOC en Colombia.

Objective Short-acting beta(2)-agonist (SABA) over-reliance is associated with poor asthma outcomes. As part of the SABA Use IN Asthma (SABINA) III study, we assessed SABA prescriptions and clinical outcomes in patients from six Latin American countries. Methods In this cross-sectional study, data on disease characteristics/asthma treatments were collected using electronic case report forms. Patients (aged >= 12 years) were classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma) and practice type (primary/specialist care). Multivariable regression models analyzed the associations between SABA prescriptions and clinical outcomes. Results Data from 1096 patients (mean age, 52.0 years) were analyzed. Most patients were female (70%), had moderate-to-severe asthma (79.4%), and were treated by specialists (87.6%). Asthma was partly controlled/uncontrolled in 61.5% of patients; 47.4% experienced >= 1 severe exacerbation in the previous 12 months. Overall, 39.8% of patients were prescribed >= 3 SABA canisters in the preceding 12 months (considered over-prescription). SABA canisters were purchased over the counter (OTC) by 17.2% of patients, of whom 38.8% purchased >= 3 canisters in the 12 months prior. Of patients who purchased SABA OTC, 73.5% were prescribed >= 3 SABA canisters. Higher SABA prescriptions (vs. 1 - 2 canisters) were associated with an increased incidence rate of severe exacerbations (ranging from 1.31 to 3.08) and lower odds ratios of having at least partly controlled asthma (ranging from 0.63 to 0.15). Conclusions SABA over-prescription was common in Latin America, highlighting the need for urgent collaboration between healthcare providers and policymakers to align clinical practices with the latest evidence-based recommendations to address this public health concern.

Pulmonary artery catheterization and echocardiographic are essential tests in the diagnostic process of patients with Pulmonary Hypertension (PH). The first one, as the gold standard defined (invasive procedure); the other, as usual non-invasive heart analysis. Aim: To evaluate the potencial concordance between invasisve hemodynamic and echocardiographic, in PAH and CTEPH patients from the Colombian Network of Pulmonary Hypertension. Methods: Cross-sectional study of data from 571 subjects in 7 national hospital centers, consolidated in a central database. We selected adults with a PAH and CTEPH diagnosis. Lin9s and Pearson9s correlation coefficients and Bland-Altman agreement limits were estimated. Results: Mean difference in sPAP by catheterization vs. echocardiography was 10±28 mmHg (+67 to -47), with Lin coefficient of 0.32 and Pearson coefficient 0.349 (Graphs 1). In men, the difference was 6±25 mmHg, while in women it was 12±30 (Lin=0.27; Pearson=0.3, p<0.001) (Graph 2). Dispersion of values was evident. Conclusions: There are relevant differences between PAP values obtained from hemodynamic variables vs. echocardiographic pressures in a range between +67 and -47 mmHg. These differences are greater among women. The impact of this low concordance on risk stratification and clinical behaviors deserves to be evaluated.

Functional class (FC) is a useful tool for decisions in hypertension pulmonary management. Regulatory bodies in Colombia require a high FC to authorize prescriptions. However, the usefulness of FC should be verified in the Colombian Andean zone. Objective: To analyze the functional class (NYHA CF) from referenced centers in Colombian Pulmonary Hypertension Network. Methods: A cross-sectional study in 7 health centers. We included patients with PVR>3Wu and used Kruskal Wallis and Pearson’s Chi2 and Spearman’s correlation tests for evaluating differences and correlations between FC, PVR and pulmonary pressures. Results: 245 subjects (45%) show a weak correlation between FC and PVR (Rho= 0.1865) and about 45% of FC-I present PVR ≥10Wu. Despite of significant differences between CF and sPAP (p=0.0265), the correlation is moderate (Rho= 0.1544) (Table 2). On heat map, we founded discordance in 7% of patients with a FC-I and high PVR/pulmonary pressures (Figure 1a-1b). Conclusions: Correlation between FC, PAP, and PVR is weak, generating a proportion of patients with FC does not agree with diagnosis parameters, thus limiting the treatment.

Introduction: with regards to tobacco dependence management, there are certain barriers to successful smoking cessation for patients, such as untreated anxiety and depression. Complicating the impact of mental health morbidities on tobacco dependence may be the significant portion of patients whose mental health issues and limited social connections are undiagnosed and unaddressed. We hypothesize that patients with no prior mental health diagnoses who are treated for tobacco dependence have high rates of undiagnosed mental health morbidities. Methods: patients were recruited from a tobacco treatment clinic in 2021. Every patient who came for an inaugural visit without a prior diagnosis of mental health disease was screened for depression, anxiety, social isolation and loneliness. Sociodemographic variables were collected. Results: over a 12-month period, 114 patients were seen at the tobacco treatment clinic. Of these 114 patients, 77 (67.5%) did not have a prior diagnosis of a mental health disease. The mean age was 54.3 ± 11.2 years, 52 (67.5%) were females, and 64 (83.1%) were Black/African American. The mean age of starting smoking was 19.3 ± 5.2 years, and 43 (55.8%) had never attempted to quit smoking in the past. With regards to mental health screening, 32 (41.6%) patients had a score of 9 or greater on the Patient Health Questionnaire (PHQ) 9, 59 (76.6%) had a score of 7 or greater on the Generalized Anxiety Disorder (GAD) 7, 67 (87.0%) were identified with social isolation and 70 (90.1%) for loneliness on screening. Conclusion: there was a high prevalence of undiagnosed mental health morbidities and social disconnection in patients who were actively smoking and were struggling to achieve smoking cessation. While a larger scale study is necessary to reaffirm these results, screening for mental health morbidities and social disconnection may be warranted in order to provide effective tobacco dependence management.

La evidencia sugiere que los síntomas pulmonares a largo plazo y el deterioro funcional ocurren en una proporción de individuos después de la infección por SARS-CoV-2. Aunque aún no se ha determinado la proporción de pacientes afectados, los médicos se enfrentan cada vez más a pacientes que informan síntomas respiratorios y deterioro más allá de la fase aguda de COVID-19. Ante la necesidad de protocolizar las conductas de tratamiento, la Asociación Colombiana de Neumología y Cirugía de Tórax (Asoneumocito) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en la evidencia, por consenso de expertos, para el manejo de las complicaciones respiratorias en el paciente pos-COVID-19. Recomendaciones realizadas por profesionales de distintas áreas de Asoneumocito con el propósito de ayudar al profesional clínico en atención primaria en el manejo de las posibles complicaciones respiratorias que pueden aparecer durante los meses posteriores al cuadro agudo de la enfermedad causada por el coronavirus (COVID-19) y estandarizar su seguimiento. Métodos. La construcción del documento se desarrolló en 6 etapas: 1. Definición de las preguntas objeto de investigación y contenido, 2. Búsqueda, tamización, evaluación y selección de la evidencia, 3. Elaboración de resumen de evidencia dando respuesta a las preguntas objeto, 4. Discusión en paneles formales, 5. Generación de recomendaciones y 6. Redacción y construcción del documento de consenso. Resultados. Los 85 participantes llegaron a un consenso y formularon 71 recomendaciones en relación con los siguientes enfoques: 1. Definición síndrome Post-covid, 2. Rehabilitación pulmonar y neuromuscular, 3. Función pulmonar, 4. Radiología e imágenes diagnósticas en síndrome pos-COVID-19, 5. Manejo anticoagulante y tromboembolismo pos-COVID-19, 6. Secuelas en vía aérea – broncoscopia, 7. Fibrosis pulmonar y neumonía de organización secundaria y 8. Consideraciones oxigenoterapia. Conclusión. Las recomendaciones formuladas deben servir como una guía provisional para facilitar el tratamiento de los pacientes con síndrome pos-COVID-19 pulmonar. A medida que surja nueva evidencia, es posible que sea necesario reconsiderar y revisar cuidadosamente estas recomendaciones.

Body weight may be increased or decreased in subjects diagnosed with pulmonary arterial hypertension (PAH) or chronic thromboembolic hypertension (CTEPH). This alteration is related to the prognosis of the disease. Objective: To identify the prevalence of low or high weight syndrome in subjects with pulmonary hypertension (HP) from 7 hospital centers of the Colombian Pulmonary Hypertension Network. Methods: Sociodemographic and clinical patient study with diagnosis of PAH or CTEPH. Weight and height were included for body mass index calculation (BMI, kg/m2) at diagnosis. Values were categorized according to WHO criteria[1]. Potential association with demographic, functional and outcome variables was evaluated. Results: Weight and height data were available in 371 subjects (47.4%). Weight was affected in 49.1% of patients. Underweight prevalence at diagnosis was 6.5%, obesity 10.8% and overweight 31.8% (Table 1). Underweight subjects were younger (median, 26.3 vs. 41.4-51.1-51.6 years in the other groups), but showed higher PVR (24 uW vs. 11.5 Wood in the others) (Table 2). Conclusion: 49% of HP patients show abnormal weight at the point of diagnosis. Underweight is 2.9 times more frequent than in general population (7% of the total), in association with younger age and greater severity (PVR) of the disease. [1] Underweight (BMI>18.5), Normal Weight (BMI 18.5-24.99), Overweight (BMI 25-29.9) or Obesity (BMI>30).

Purpose Overuse of short-acting β2-agonists (SABAs) for asthma is associated with a significant increase in exacerbations and healthcare resource use. However, limited data exist on the extent of SABA overuse outside of Europe and North America. As part of the multi-country SABA use IN Asthma (SABINA) III study, we characterized SABA prescription patterns in Colombia. Patients and Methods This observational, cross-sectional cohort study of SABINA III included patients (aged ≥12 years) with asthma recruited from seven sites in Colombia. Demographics, disease characteristics (including investigator-defined asthma severity guided by the 2017 Global Initiative for Asthma report), and asthma treatments prescribed (including SABAs and inhaled corticosteroids [ICS]) in the 12 months preceding the study were recorded using electronic case report forms during a single study visit. Results Of 250 patients analyzed, 50.4%, 33.2%, and 16.4% were enrolled by pulmonologists, general medicine practitioners, and allergists, respectively. Most patients were female (74.0%) and had moderate-to-severe asthma (67.6%). Asthma was partly controlled or uncontrolled in 57.6% of patients, with 15.6% experiencing ≥1 severe exacerbation 12 months before the study visit. In total, 4.0% of patients were prescribed SABA monotherapy and 55.6%, SABA in addition to maintenance therapy. Overall, 39.2% of patients were prescribed ≥3 SABA canisters in the 12 months before the study visit; 25.2% were prescribed ≥10 canisters. Additionally, 17.6% of patients purchased SABAs over the counter, of whom 43.2% purchased ≥3 canisters. Maintenance medication in the form of ICS or ICS/long-acting β2-agonist fixed-dose combination was prescribed to 36.0% and 66.8% of patients, respectively. Conclusion Our findings suggest that prescription/purchase of ≥3 SABA canisters were common in Colombia, highlighting a public health concern. There is a need to improve asthma care by aligning clinical practices with the latest evidence-based treatment recommendations to improve asthma management across Colombia.

Introduction: The SABA use IN Asthma (SABINA) International cross-sectional study reported that 38% of 8,351 patients were prescribed ≥3 SABA canisters/year (overprescription). Aim: This univariate post hoc analysis compares the sociodemographic and clinical characteristics of patients overprescribed SABA with those prescribed 1−2 canisters/year. Methods: In patients aged ≥12 years with asthma, ≥3 physician consultations, and medical records containing data for ≥12 months before the study visit, multiple characteristics were compared using Chi-square or Kruskal-Wallis tests. Results: Compared with patients prescribed 1−2 SABA canisters/year, a significantly higher percentage of those prescribed ≥3 SABA were obese (35.0% vs 29.2%) and ex-smokers (14.2% vs 10.9%), with a lower percentage receiving university or post-graduate education (30.7% vs 34.5%; Figure). A significantly higher percentage of patients prescribed ≥3 vs 1–2 SABA canisters/year were at Global Initiative for Asthma treatment Step 5 (18.9% vs 11.8%), classified with uncontrolled asthma (35.6% vs 21.2%) and reported 1 (24.6% vs 21.0%), 2 (14.2% vs 9.3%) or ≥3 severe asthma exacerbations (18.0% vs 11.0%). Conclusion: The characteristics of patients overprescribed SABA will aid physicians in identifying and targeting those at risk of SABA overuse, thereby improving asthma outcomes globally.

Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) have multiple prognostic indicators which allow classification of patients9 one-year morbimortality risk as low, medium, or high allowing therapeutic decisions to improve functional and vital patient outcomes. Objective: To perform a network analysis of frequencies of functional, progressive, hemodynamic and biomarker variables conventionally used in risk estimation scales, at the diagnosis time of subjects with PAH/CTEPH from the Colombian Pulmonary Hypertension Network. Methods: Multidisciplinary initiative that analyzes information of patients in 8 health institutions with a confirmed diagnosis of PH in Groups 1 and 4. This study was executed from available frequency records according to risk variables of ERS/ESC and REVEAL LITE 2 scales, included in patient characterization database. Results: Figure 1 presents a "network design" from pattern of coexisting variables, from the mentioned scales. Each node represents a variable of the scales, its size is proportional to the percentage of patients with available data. Nodes are linked if one or more subjects share the description of the variables. Conclusions: It is possible finding other registration sources with additional data to fulfill the characterization; However, an ICT-based application may improve the care supply and quality for HP patients.

AbstractTreatment for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension in Latin America differs between countries, with regard to disease etiology, health insurance coverage, and drug availability. A group of experts from Latin America, met to share regional experiences and propose possible lines of collaboration. The available evidence, regional clinical practice data, and the global context of the proceedings of the 6th World Symposium on Pulmonary Hypertension, held in Nice, France, in February 2018, were analyzed. Here, we discuss some priority concepts identified that could guide transnational interaction and research strategies in Latin America: (1) despite being evidence‐based, the 6th World Symposium on Pulmonary Hypertension proceedings may not be applicable in Latin American countries; (2) proactive identification and diagnosis of patients in Latin America is needed; (3) education of physicians and standardization of appropriate treatment for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension is vital; (4) our clinical experience for the treatment strategy for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension is based on drug availability in Argentina, Brazil, Colombia and México; (5) there are difficulties inherent to the consultation of patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension, and access to treatment; (6) the importance of data generation and research of Latin American‐specific issues related to pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension is highlighted.

La aparición del brote de coronavirus 2 (COVID-19) en China, a finales del 2019, se ha transformado en pandemia por un síndrome respiratorio agudo severo (denominado SARS-CoV-2). Este es un problema de salud pública (1). Hasta el momento se acepta que la transmisión es de persona a persona, por medio de gotitas producidas cuando hablamos o tosemos, o en contacto directo con las mucosas, como los ojos y la nariz, al llevarnos las manos contaminadas a dichos sitios (2). Se estima que la infección tiene un período de incubación promedio de 6,4 días, y un número de reproducción básico va desde 2,24 a 3,58 (3). Se han reportado 395 744 casos en el mundo, con mortalidad de 17 234 casos y 103 736 pacientes que se han recuperado (4). En Colombia, para el 24 de marzo, en total son 306 casos confirmados en el país según el último reporte, con 3 muertos para la fecha (5). Este artículo se diseñó para ofrecer recomendaciones a las unidades de sueño y laboratorios de función pulmonar en cuanto a la pandemia por coronavirus, con base en la evidencia que se ha publicado en los 3 últimos meses y en la opinión de expertos. Esto puede cambiar una vez se conozca más sobre la infección.

Desde la aparición del brote en China, se ha informado que la neumonía por coronavirus impacta más la mortalidad en pacientes adulto mayores y con comorbilidades, entre la cual está la enfermedad pulmonar obstructiva crónica (EPOC) y el tabaquismo. En Colombia, el primer caso apareció el 6 de marzo de 2020, y el riesgo de contraer la enfermedad en este país es alto. Se reconoce que las personas con EPOC se encuentran entre las más afectadas por COVID-19, y debe tratarse de minimizar el impacto de la infección (1). Aunque no fue tan alta la cantidad de pacientes con EPOC que se infectaron con coronavirus en Wuhan, la mayoría de estos requirió ingresar a unidad de cuidados intensivos (UCI) (2). Durante esta pandemia, la prevención de la nueva neumonía por COVID-19 en pacientes con EPOC se ha convertido en una prioridad para las diferentes asociaciones, concientizando al paciente con EPOC. Estos individuos tienen 6,4 veces más probabilidad de desarrollar una enfermedad grave, y 17,8 veces más probabilidades de necesitar manejo en la unidad de cuidado intensivo que la población general (3).