ABSTRACT
Background There is evidence that the adaptive or acquired immune system is one of the crucial variables in differentiating the course of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This work aimed to analyze the immunopathological aspects of adaptive immunity that are involved in the progression of this disease. Methods This is a systematic review based on articles that included experimental evidence from in vitro assays, cohort studies, reviews, cross-sectional and case-control studies from PubMed, SciELO, MEDLINE, and Lilacs databases in English, Portuguese, or Spanish between January 2020 and July 2022. Results Fifty-six articles were finalized for this review. CD4+ T cells were the most resolutive in the health-disease process compared with B cells and CD8+ T lymphocytes. The predominant subpopulations of T helper lymphocytes (Th) in critically ill patients are Th1, Th2, Th17 (without their main characteristics) and regulatory T cells (Treg), while in mild cases there is an influx of Th1, Th2, Th17 and follicular T helper cells (Tfh). These cells are responsible for the secretion of cytokines, including interleukin (IL) - 6, IL-4, IL-10, IL-7, IL-22, IL-21, IL-15, IL-1α, IL-23, IL-5, IL-13, IL-2, IL-17, tumor necrosis factor alpha (TNF-α), CXC motivating ligand (CXCL) 8, CXCL9 and tumor growth factor beta (TGF-β), with the abovementioned first 8 inflammatory mediators related to clinical benefits, while the others to a poor prognosis. Some CD8+ T lymphocyte markers are associated with the severity of the disease, such as human leukocyte antigen (HLA-DR) and programmed cell death protein 1 (PD-1). Among the antibodies produced by SARS-CoV-2, Immunoglobulin (Ig) A stood out due to its potent release associated with a more severe clinical form. Conclusions It is concluded that through this study it is possible to have a brief overview of the main immunological biomarkers and their function during SARS-CoV-2 infection in particular cell types. In critically ill individuals, adaptive immunity is varied, aberrantly compromised, and late. In particular, the T-cell response is also an essential and necessary component in immunological memory and therefore should be addressed in vaccine formulation strategies.
ABSTRACT
Objetivo: descrever as implicações da COVID-19 no sistema cardiovascular: prognósticos e intercorrências. Método: trata-se de uma revisão integrativa da literatura, realizada nas bases de dados, Science Direct, National Library of Medicine National Institutes of Health dos EUA (PUBMED), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cochrane Collaboration e Medical Literature Analysis and Retrieval System Online (MEDLINE) com os descritores, Cardiovascular System;Cardiovascular Diseases;Coronary Disease, e a palavra-chave Covid-19. Incluíram-se estudos originais, relatos de casos, revisões sistemáticas na série temporal 2019-2020. Resultados: a busca resultou em 13 artigos, todos na língua inglesa, emergindo os pontos-chave: potencialização das complicações cardiovasculares pela infecção por COVID-19;aumento da mortalidade de origens cardiovasculares influenciadas pela infecção por COVID-19. Conclusão: o envolvimento do sistema cardiovascular no COVID-19 pode determinar a gravidade da doença, potencializado na presença de fatores de riscos cardiovasculares, repercutindo em complicações que necessitam de tratamento intensivo e morte. De maneira geral, todos os pacientes com COVID-19 são passíveis de ter comprometimento cardiológico, fato que pode depender de antecedentes mórbidos pessoais, resposta inflamatória e liberadores bioquímicos. Objective: to describe the implications of COVID-19 in the cardiovascular system: prognosis and intercurrences. Method: This is an Integrative Literature Review, performed in the databases, Science direct, National Library of Medicine National Institutes of Health (PUBMED), Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Collaboration and Medical Literature Analysis and Retrieval System Online (MEDLINE) with the descriptors, Cardiovascular system;Cardiovascular Diseases;Coronary Disease, and the keyword Covid-19. It included original studies, case reports, systematic reviews in the time series 2019-2020. Results: The search resulted in 13 articles, all in English language, emerging the key points, Potentiation of cardiovascular complications by COVID-19 infection;Increased mortality of cardiovascular origin influenced by COVID-19 infection. Conclusion: The involvement of the cardiovascular system in COVID-19 may determine the severity of the disease, potentiated in the presence of cardiovascular risk factors, resulting in complications that require intensive treatment and death. In general, all patients with COVID-19 are likely to have cardiological impairment, which may depend on personal morbid antecedents, inflammatory response and biochemical liberators.