RESUMO
SARS-CoV-2 is the virus responsible for the COVID-19 pandemic. This disease is beginning to be better understood in terms of its other, non-respiratory, clinical manifestations. Over the course of months caring for patients infected by the virus, clinical and laboratory changes have been identified that have prompted researchers to debate the potential that SARS-CoV-2 has to trigger an exacerbated immune response that is capable of changing endothelial homeostasis through both direct and indirect mechanisms. With the intention of contributing to this debate, a review was conducted of the possible mechanisms that could trigger these phenomena in patients with COVID-19. It is important to understand the pathophysiology of the immunological mechanisms related to this disease in order to understand the potential endothelial damage that COVID-19 can provoke.
RESUMO
Resumo O SARS-CoV-2 é o vírus responsável pela pandemia da COVID-19. Essa doença começou a ser melhor entendida devido a outras manifestações clínicas além das respiratórias. Ao longo dos meses de atendimento aos pacientes infectados pelo vírus, foram identificadas alterações clínicas e laboratoriais que incitaram os pesquisadores a discutir sobre o potencial do SARS-CoV-2 no desencadeamento de uma resposta imunológica exacerbada capaz de alterar a homeostase endotelial, através de mecanismos diretos e indiretos. Com esse intuito, foram revisados os possíveis mecanismos que desencadeiam este fenômeno em pacientes portadores de COVID-19. Dessa forma, torna-se importante o entendimento fisiopatológico dos mecanismos imunológicos relacionados à doença para a compreensão do potencial de dano endotelial que a COVID-19 pode promover.
Abstract SARS-CoV-2 is the virus responsible for the COVID-19 pandemic. This disease is beginning to be better understood in terms of its other, non-respiratory, clinical manifestations. Over the course of months caring for patients infected by the virus, clinical and laboratory changes have been identified that have prompted researchers to debate the potential that SARS-CoV-2 has to trigger an exacerbated immune response that is capable of changing endothelial homeostasis through both direct and indirect mechanisms. With the intention of contributing to this debate, a review was conducted of the possible mechanisms that could trigger these phenomena in patients with COVID-19. It is important to understand the pathophysiology of the immunological mechanisms related to this disease in order to understand the potential endothelial damage that COVID-19 can provoke.
Assuntos
Humanos , Coagulação Intravascular Disseminada/etiologia , COVID-19/complicações , Endotélio Vascular/lesões , COVID-19/fisiopatologia , COVID-19/sangue , Hemostasia , ImunidadeRESUMO
INTRODUÇÃO: A pandemia da doença causada pelo novo coronavírus 2019, COVID-19, tem impactado sobremaneira o cenário mundial, agravando as taxas de morbidade e mortalidade. Diante desse cenário, é urgente a necessidade de capacitar e qualificar profissionais da área de saúde no enfrentamento dessa doença. OBJETIVO: Este estudo se propôs a realizar uma revisão narrativa sobre a COVID-19, abordando os aspectos relacionados à origem, à etiologia, às manifestações clínicas, ao diagnóstico e ao tratamento. MÉTODO: Trata-se de uma revisão narrativa da literatura, realizada a partir de periódicos científicos indexados na base de dados PubMed/MEDLINE, durante o período de janeiro a abril de 2020. Os seguintes descritores foram utilizados na pesquisa: "COVID-19", "SARS-CoV-2" e "2019nCoV". RESULTADOS: Os artigos evidenciaram que a origem do SARS-CoV-2, agente causador da COVID-19, é incerta. A rápida propagação do vírus pode estar relacionada à forma de transmissão e capacidade de sobrevivência no ambiente externo. Os pacientes hospitalizados apresentam, em sua maioria, idade acima de 60 anos, presença de imunossupressão e comorbidades como hipertensão e diabetes. O diagnóstico é, basicamente, clínico e/ou associado ao exame molecular. Não há medicamento específico para o tratamento da COVID-19. No entanto, alguns parecem promissores e encontram-se em fase de ensaios clínicos. CONCLUSÕES: Os resultados apresentados podem orientar a prática de profissionais de saúde no contato direto com o cuidado às pessoas com a COVID-19. No entanto, mais estudos são necessários para melhor condução das estratégias de enfrentamento da pandemia
INTRODUCTION: The pandemic caused by the new coronavirus 2019, COVID-19 has severely impacted the global scenario, worsening the rates of morbidity and mortality. Given that scenario, there is an urgent need to train and qualify healthcare professionals in coping with this disease. OBJECTIVE: This study carried out a narrative review on COVID-19, analyzing aspects related to epidemiology, etiology, clinical manifestations, diagnosis and treatment. METHOD: It is a narrative review of the literature, developed from scientific research indexed in the PubMed/MEDLINE database, from January to April 2020. The following search terms were used for the search, "COVID-19", "SARS-CoV-2" and "2019nCoV". RESULTS: The articles showed that the origin of SARS-CoV-2, the causative agent of COVID-19, is uncertain. The rapid spread of the virus may be related to the form of transmission and its ability to survive in the external environment. Most hospitalized patients are over 60 years old, have immunosuppression and comorbidities such as hypertension and diabetes. The diagnosis is basically clinical and/or associated with molecular examination. There is no specific drug for the treatment of COVID-19. However, some drugs look promising and are in clinical trials phases. CONCLUSIONS: The results presented can guide strategy and practice of healthcare professionals in direct contact with the care of people with COVID-19. However, further studies are needed to better conduct pandemic coping strategies