Complications of Covid-19: developments for the Unified Health System

Abstract

Resumo Covid-19 is an infectious severe acute respiratory syndrome, caused by Coronavirus, which quickly reached pandemic levels. In July/2020, Brazil was the second country most affected by the disease, exceeding two million cases. Despite the increasing scientific literature on Covid-19, its containment is still compromised by the lack of understanding about its determinants and complications. This article presents a discussion on aspects related to Covid-19 complications and its effects on Unified Health System (SUS), aiming at planning new coping strategies. Additionally, it is pointed out that the overload of the health system does not result only from aspects associated with the assistance to Covid-19, but adds to the pre-existing health needs, whose care strategies were postponed and/or changed due to the actions transmission control. It is evident, then, the need to reinforce the action of Primary Health Care as the ordering of care in SUS, acting in the management of the reorganization of flows and in the improvement of the physical structures of the units. To this end, the end of measures to limit health resources is essential, since not only does the success of coping with Covid-19 depend on this, but also the future of SUS and Brazilian’s health.

Clinical characteristics and risk for severe COVID-19: a systematic review

“…However, about 80% of cases are considered mild and do not use specialized services, being assisted by primary services [39,40] . Therefore, this justifies the low number of studies retrieved in the search for SC, and the inclusion of only one, even when searching the grayliterature.…”

“…The literature has discussed that COVID-19 is not just a respiratory disease, but a systemic disease with an extensive spread in the human body, since the presence of pathogenic mechanisms and complications in vital organs has already been identified in studies [39,58,59] . As shown in our study, conditions such as kidney disease are preponderant in the death of patients.…”

“…COVID-19 complications, post-covid disease, may have an important impact on the population's quality of life, possibly increasing the demand for medium to high complexity care [60] . According to Avelar et al [39] , the effects of COVID-19 on the body affect several systems, such as respiratory, cardiovascular, urinary, central nervous system, sensory, digestive, male reproductive. Therefore, it is expected that in the post-COVID-19 phase there will be a demand for outpatient services, thus increasing the demand on health systems for diagnosis, treatment, and rehabilitation of recovered patients, but still with complications, specifically: due to respiratory complications, overload of cardiologists' care due to the accumulation of consultations postponed in the control protocol to avoid contamination and increase in the incidence of heart diseases from COVID-19, worsening of the drug therapy scenario, medical consultations and elective surgeries for non-communicable chronic diseases, as a result of rescheduling appointments, without renewing prescriptions [61] .…”

Mudanças assistenciais e gerenciais vivenciadas por enfermeiros durante o período de crise pela pandemia da COVID-19

“…A pandemia da COVID -19, acarretou em crise e desafios emergentes para as organizações com ênfase aos sistemas de saúde em razão da alta demanda de pacientes infectados e com evoluções para quadros graves em tempo ágil e sem perspectiva de tratamentos cientificamente comprovados (Oliveira, et al, 2020;Avelar, et al, 2021). Ocasionando colapsos nos sistemas de saúde em escala assistencial e administrativa, com a necessidade rápida de medidas preventivas e de controle de contágio (Malta, et al, 2020).…”