ABSTRACT
Neuroinflammation is closely related to the development of depression, since the latter is caused, among other factors, by inflammatory processes, mainly related to the activation of microglia and expression of specific genes, which occurs during the neuroinflammatory process. Thus, COVID-19 is an important risk factor for the development of depression, since in addition to generating the feeling of stress, which also increases the activity of the immune system, it is also the cause of pathological processes and physiological ones that lead to the development of neuroinflammation, microglial activation, gene expression dysfunction and decreased concentration of available serotonin. That said, drugs are being used to combat COVID-19 to reduce the oxidative stress presented in the disease. Thus, tramadol and fluoxetine are highlighted as drugs used, however, although they present some positive results, such as the reduction of pro-inflammatory cytokines, they are also associated with negative effects such as dependence, pulmonary, cardiac and brain impairment. From this, the purinergic system is highlighted in the literature as a possible therapeutic target. This is because its mechanisms are related to the regulation of microglia, astrocytes and the physiology of important neurotransmitters and hormones. Added to this, there is a modulation of inflammatory activity, especially with regard to the P2X7 receptors of this system. The latter is an important target for the treatment of depression and COVID-19, since positive results were obtained through the genetic exclusion of this receptor and the use of selective antagonists.
ABSTRACT
Objetivo: a finalidade desse trabalho é, através de uma revisão de literatura recente, apresentar características clínicas da doença pelo Coronavírus (COVID-19), as vias de transmissão conhecidas, abordar como o Cirurgião-Dentista (CD) pode identificar casos suspeitos e, principalmente, apresentar medidas preventivas para controlar e minimizar a infecção no serviço odontológico. Material e Métodos: foi realizada uma pesquisa de busca bibliográfica na base de dados MEDLINE (National Library of Medicine, USA - NLM), com as palavras-chave COVID-19 and dental practice, de 12 a 16 de março de 2020, e três artigos publicados no ano corrente foram disponibilizados. Foram critérios de inclusão artigos em suas versões completas e gratuitas, na língua inglesa. Resultados: a COVID-19 apresenta como principais sintomas clínicos febre, tosse, espirros e catarro, em casos considerados leves. As principais vias de transmissão são a direta e por contato. A fim de identificar casos suspeitos o CD deve medir a temperatura corporal do paciente e aplicar um breve questionário. O profissional deve realizar com frequência a lavagem das mãos antes e após o atendimento e usar equipamentos de proteção individual. São recomendados com bochechos com Peróxido de Hidrogênio 1% e Lodopovidona a 0,2% ao tratamento, Clorexidina 0,12% não é eficaz. Conclusão: em momentos de surtos de doenças, surgem novos desafios aos quais os profissionais devem responder com cuidado ainda maior com a biossegurança, ética, zelo e treinamento atualizado e periódico Objective: the aim of this study is to, through a recent literature review, present the clinical characteristics of COVID 19, the known transmission routes, to address how dentists can identify suspected cases and, mainly, provide preventive measures to control and minimize infection in dental practice. Material and Methods: a bibliographical research was carried out in the MEDLINE (National Library of Medicine, USA - NLM) database, with the keywords COVID 19 and dental practice, from March 12nd to 16th of 2020, and three articles published in the current year were available. The selection criteria were articles in their full and free versions, written in the english language. Results: COVID-19 has fever, cough, sneezing and phlegm as the main clinical symptoms in mild considered cases. The main transmission routes are direct and through contact. In order to identify suspected cases, dentists should measure the patient's body temperature and apply a brief questionnaire. Professionals should frequently perform hand washing before and after the service and use personal protective equipments. Mouthwash with 1.0% Hydrogen Peroxide and 0.2% povidone-iodine to treatment is recommended. 0.12% Chlorhexidine is not effective. Conclusion: in times of disease outbreaks, new challenges arise, to which professionals must respond with even greater care with biosafety, ethics, zeal and preparation.