Alterações Pulmonares na COVID-19

Loureiro, Camila Melo Coelho; Serra, Juliane Penalva Costa; Loureiro, Bruna Melo Coelho; Souza, Thaís Dourado Matos de; Góes, Thiago Meira; Neto, José de Souza Almeida; Dantas, Fernanda de Souza e Silva; Valverde, Antonio Bruno Castro Magalhães; Marinho, Jamocyr Moura

doi:10.35753/rchsi.v4i2.175

Cited by 5 publications

(4 citation statements)

References 26 publications

(35 reference statements)

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“…Comorbidities (DM, SAH, heart disease, kidney disease, neoplasms, immunosuppression, among others) associated with age may confer a worse prognosis of the disease, and therefore corticosteroid therapy is an alternative already observed and used. Some manifested symptoms are fever, myalgia, cough, dyspnea, lack of appetite, and diarrhea among others (LOUREIRO et al, 2020) The clinical efficacy of corticosteroid therapy depends on the dose, time of onset, route of administration, duration, and dose reduction. Steroid doses equivalent to prednisone less than 7.5 mg/day produce glucocorticoid receptor saturation of less than 40% with mild adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic perspective of COVID-19 against corticosteroids

Lima¹,

Rodrigues²,

Vasconcelos³

et al. 2023

Development and Its Applications in Scientific Knowledge

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Coronaviruses belong to a broad family called Coronoviridae, they are simple RNA viruses. In SARS-CoV-2 infection, a cytokine storm occurs in the body, responsible for tissue damage, and pulmonary and systemic inflammation. For this reason, corticosteroids appear as a viable option. This study conducted a systematic review of the pharmacotherapy of steroidal anti-inflammatory drugs used in hospitalized patients with COVID-19. The study was conducted in January 2023, using the SCIELO and PUBMED databases. The keywords were: corticosteroid, SARS-CoV-2, therapy, corticosteroids, hospitalized, and COVID-19 combined with the Boolean operators AND and OR. Articles published from 2020 to 2022 in the languages Portuguese and English were included. Of the 8 articles included in this review, 50% (n=4) are cohort studies, 37.5% (n=3) are clinical studies, and 12.5% (n=1) are observational studies. As for the year of publication, 25% (n=2) are from 2020, 62.5% (n=5) are from 2021 and 12.5% (n=1) are from 2022. Of the country where the survey was conducted, 37.5% (n=3) were conducted in Iran. China, South Africa, Spain, Colombia, and Lisbon had 12.5% (n=1) of studies each. The population samples visualized in the 8 studies ranged from 62 patients to 774 patients, with a mean age ranging from 53.5 to 64 years, 55.8% men, and 44.1% women. Among the comorbidities observed in each study, Diabetes Mellitus and hypertension were the most common, followed by cardiovascular events, Chronic Obstructive Pulmonary Disease, dyslipidemia, and obesity or HIV. Regarding the severity of COVID-19, 50% (n=4) of the studies were done with patients who had the severe form of the disease, 37.5% (n=3) moderate to severe, and 12.5% (n=1) of the studies reported that 63.6% of the sample (49/77) evolved to the severe form of the disease. Among the corticosteroids included in the studies, those that presented the best clinical outcomes were methylprednisolone in 50% (n=4) of the studies with doses ranging from 80mg/day to 500mg/day during the range of 3 to 14 days of treatment. Prednisolone was followed in 12.5% (n=1) of the studies at a dose of 25mg/day for 5 days of treatment and dexamethasone in 25% (n=2) of the studies. The therapeutic benefit of corticosteroids for the control of moderate and severe cases caused by the so-called "cytokine storm" that occurred in the body of human beings infected by SARS-CoV-2 is evident.

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Section: Discussionmentioning

confidence: 99%

Therapeutic perspective of COVID-19 against corticosteroids

Lima¹,

Rodrigues²,

Vasconcelos³

et al. 2023

Development and Its Applications in Scientific Knowledge

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“…El daño causado por el Sars-CoV-2 se produce por la infiltración de TCD4, TCD8 y macrófagos en el intersticio, en los márgenes bronquiolares de los pulmones y la presencia de fibrina en los espacios alveolares que dañan el tejido a través de fibrosis, degeneración, congestión y dilatación capilar, dando lugar a hipoxemia e insuficiencia respiratoria donde algunos de los afectados por la infección necesitan cuidados intensivos y son hospitalizados en Unidades de Cuidados Intensivos (UCI) (4)(5)(6) . Una de las tecnologías de diagnóstico utilizadas en la atención de la UCI es la puntuación de evaluación secuencial de insuficiencia orgánica (SOFA).…”

Section: Introductionunclassified

“…Aunque el puntaje SOFA es importante en el diagnóstico, la Tomografía Computarizada (TC) de tórax (7) representa el estándar de oro en la evaluación clínica de pacientes hospitalizados y sintomáticos (5) . Los hallazgos de la TC de tórax son similares a los de la neumonía, con vidrio deslustrado periférico bilateral, inferior y periférico, lo que permite cuantificar la extensión del compromiso pulmonar y permitir la intervención adecuada (8) .…”

Section: Introductionunclassified

Evaluación de tomografía computarizada y score SOFA pulmonar: relación de evaluación en pacientes con covid-19 y mortalidad en UCI

Martinelli

Bonatto²,

Silva

et al. 2023

Enf Global

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Objective: To evaluate the pulmonary severity of COVID-19 patients throug the SOFA score computed with pulmonary involvement in Chest Computed Tomography. Method: This is a descriptive epidemiological study conducted out in an Intensive Care Unit, which aimed to study the pulmonary treatment of COVID-19 patients through the calculation of the pulmonary SOFA score relating to Chest Tomography and whether these were related to clinical treatment. Results: The study population consisted of 704 patients, of which 43.7% were women and 56.2% men, with a mean age of 61 years and a mean hospitalization time of 13 days. Most patients had a pulmonary behavior of 75%, a pulmonary SOFA score of 2 and a PaO²/FiO² ratio between 100 and 200. Conclusion: Patients who had more extensive pulmonary involvement/consequently had a lower PaO²/FiO² ratio and remained longer hospitalized with a higher incidence of death. Objetivo: Evaluar la gravedad pulmonar de pacientes con Covid-19 a través de la correlación del puntaje SOFA pulmonar con el de afectación pulmonar en Tomografía Computarizada de Tórax. Método: Se trata de un estudio epidemiológico retrospectivo analítico descriptivo realizado en una Unidad de Cuidados Intensivos que buscó analizar el compromiso pulmonar de pacientes con Covid a través del cálculo del SOFA pulmonar relacionando la Tomografía de Tórax y si estos tenían relación con el desenlace clínico. Resultados: La población de estudio incluyó a 704 pacientes, de los cuales el 43,7% eran mujeres y el 56,2% hombres, con una edad media de 61 años y una estancia media de 13 días. La mayoría de la población presentó afectación pulmonar del 75%, puntuación SOFA pulmonar de 2 y relación PaO²/FiO² entre 100 y 200. Conclusión: Los pacientes que tenían afectación pulmonar más extensa en consecuencia tenían menor relación PaO²/FiO² y permanecían hospitalizados por un tiempo más largo con una mayor incidencia de muerte.

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“…As complicações que doentes graves geralmente apresentam são pneumonia, síndrome do desconforto respiratório agudo (SDRA), insuficiência renal, insuficiência cardíaca, anormalidades de coagulação e eventos tromboembólicos, sepse e até morte. Pessoas de todas as idades são suscetíveis a contaminação, a mortalidade pela doença é significativamente mais elevada em indivíduos portadores de comorbidades, como diabetes, doenças cardiovasculares e em pacientes idosos, variando a taxa de mortalidade de 2 a 3% (ESTEVÃO, 2020;JUTZELER et al 2020;LOUREIRO, et al 2020).…”

Section: Introductionunclassified

Relatos clínicos de sequelas respiratórias dos pacientes que testaram positivo para COVID-19 nos territórios de saúde Krahô ii e Apinajé na cidade de Palmas-TO

Durães¹,

Souza²,

Sousa³

et al. 2022

Cereus

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Recebido em: 31/01/2022 Aceito em: 15/05/2022. Relatos clínicos de sequelas respiratórias dos pacientes que testaram positivo para COVID-19 nos territórios de saúde Krahô ii e Apinajé na cidade de Palmas-TO Clinical reports of respiratory sequels of patients who tested positive for COVID-19 in the Krahô ii and Apinajé health territories in the city of Palmas-to RESUMO O vírus SARS-CoV-2 é causador da COVID-19, doença que se espalhou rapidamente, sendo declarada pandemia. O meio de transmissão se dá por contato direto com pessoas contaminadas através de secreções respiratórias, saliva ou contato indireto, através de objetos contaminados. Segundo a Organização Mundial da Saúde, cerca de 80% das pessoas contaminadas podem ser assintomáticas ou com sintomas leves, 20% aproximadamente, requerem atendimento hospitalar e 5% podem necessitar de suporte ventilatório. Trata-se de um estudo quantitativo que objetivou-se descrever as sequelas respiratórias dos pacientes que testaram positivo para COVID-19 e que apresentaram sintomas após 14 dias de isolamento em dois territórios de saúde de Palmas-TO. As principais sequelas respiratórias relatadas foram falta de ar 26,7%, fraqueza muscular 22,2%, cansaço ao esforço 15,6% e ao repouso 15,6%. A contaminação causada pela infecção da COVID-19 gera repercussões funcionais e hemodinâmicas, gerando no indivíduo prejuízos da capacidade funcional e nas atividades de vida diária e laboral, resultando em um impacto negativo na qualidade de vida.

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Alterações Pulmonares na COVID-19

Cited by 5 publications

References 26 publications

Therapeutic perspective of COVID-19 against corticosteroids

Therapeutic perspective of COVID-19 against corticosteroids

Evaluación de tomografía computarizada y score SOFA pulmonar: relación de evaluación en pacientes con covid-19 y mortalidad en UCI

Relatos clínicos de sequelas respiratórias dos pacientes que testaram positivo para COVID-19 nos territórios de saúde Krahô ii e Apinajé na cidade de Palmas-TO

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