Aspectos epidemiológicos, fisiopatológicos, clínicos e capacidade funcional de pacientes pós-Covid-19
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Jul 23, 2024
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Objetivo: Descrever os aspectos epidemiológicos, fisiopatológicos, clínicos e capacidade funcional de pacientes pós-COVID-19. Revisão Bibliográfica: A literatura reporta a evidência da persistência global de sintomas pós-COVID-19, onde, de 10 e 20% dos pacientes que tiveram COVID-19 agudo sintomático evoluíram para fase de persistência de manifestações clínicas, dentre elas; fadiga, dispneia, dor torácica, arritmias, taquicardias, disfunção autonômica, ansiedade e depressão, ainda que pouco esclarecida os meios fisiopatológicos. Nota-se que a avaliação da capacidade funcional (CF) nestes pacientes é crucial devido às frequentes sequelas que impactam as atividades diárias, prejudicando a qualidade de vida (QV). Além de informar sobre tratamentos e intervenções de reabilitação, a avaliação da CF auxilia a identificar pacientes que podem necessitar de apoio a longo prazo, contribuindo para uma recuperação eficaz e aprimoramento da QV pós-infecção pela COVID-19. Considerações finais: a interação complexa entre respostas imunológicas e efeitos diretos do vírus resulta em sintomas persistentes, destacando a necessidade de compreensão clínica e avaliação da CF para assim, orientar estratégias de reabilitação e suporte em pacientes pós-COVID-19.
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SilveiraM. S., NevesV. R., Ferreira Ádrya A., RorizP. I. L., SkrapecM. V. C., SoteroA. M., VianaK. W. C., GoisA. R. da S., SilvaD. F. dos S., & SchwingelP. A. (2024). Aspectos epidemiológicos, fisiopatológicos, clínicos e capacidade funcional de pacientes pós-Covid-19. Revista Eletrônica Acervo Saúde, 24(7), e15928. https://doi.org/10.25248/reas.e15928.2024
Seção
Revisão Bibliográfica
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Referências
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12. FERNÁNDEZ-CASTAÑEDA A, et al. Mild respiratory SARS-CoV-2 infection can cause multi-lineage cellular dysregulation and myelin loss in the brain. bioRxiv: the preprint server for biology. 2022.
13. GAO Y, et al. Cardiopulmonary Exercise Testing Might Be Helpful for Interpretation of Impaired Pulmonary Function in Recovered COVID-19 Patients. Eur Respir J, 2021; 57, 2004265.
14. GREENHALGH T, et al. Long covid—an update for primary care. BMJ, 2022; 378, e072117.
15. HOCKELE LF, et al. Pulmonary and Functional Rehabilitation Improves Functional Capacity, Pulmonary Function and Respiratory Muscle Strength in Post COVID-19 Patients: Pilot Clinical Trial. Int J Environ Res Public Health, 2022; 19 (22), 14899.
16. HOFFMANN M, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell, 2020; 181, 271–280e8.
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19. KLEIN J, et al. Distinguishing features of Long COVID identified through immune profiling. Preprint on medRxiv, 2022; 2022.
20. KLOK FA, et al. The Post-COVID-19 functional status scale: a tool to measure functional status over time after COVID-19. Eur Respir J, 2020; 56, 2001494.
21. MACHADO FVC, et al. Construct validity of the Post-COVID-19 functional status scale in adult subjects with COVID-19. Health Qual Life Outcomes, 2021; 19,40.
22. NALBANDIAN A, et al. Post-acute COVID-19 syndrome. Nature medicine, 2021; 27 (4), 601–615.
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24. OYUNGEREL B, et al. Impact of COVID-19 vaccination on long COVID: a systematic review and meta-analysis. Medrxiv, 2022.
25. PATTERSON BK, et al. Persistence of SARS CoV-2 S1 protein in CD16+ monocytes in post-acute sequelae of COVID-19 (PASC) up to 15 months post-infection. Front Immunol, 2021;12.
26. PIERCE JD. et al. Post-COVID-19 syndrome. Nurs Res, 2022; 71,164-174.
27. PINZON RT. et al. Persistent neurological manifestations in long COVID-19 syndrome: a systematic review and meta-analysis. J Infect Public Health, 2022; 15, 856-869.
28. RAJAN S. et al. In the wake of the pandemic: preparing for Long COVID. Copenhagen (Denmark): European Observatory on Health Systems and Policies, 2021.
29. RAMAN B. et al. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J. 2022; 14 (43), 1157-1172.
30. SADR S. et al. Isolated severe thrombocytopenia in a patient with COVID‐19: a case report. IDCases, 2020; 21.
31. SORIANO JB. et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis, 2022; 4,102 – 107.
32. SSENTONGO P. et al. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PloS one, 2020; 15 (8), e0238215.
33. SWANK Z. et al. Persistent circulating severe acute respiratory syndrome coronavirus 2 spike is associated with post-acute coronavirus disease 2019 sequelae. Clin Infect Dis, 2022; 76 (3).
34. TABOADA M. et al. Post-COVID-19 functional status six-months after hospitalization. J. Infect., 2021; 82, e31–e33.
35. WANG SY. et al. Characteristics of patients referred to a cardiovascular disease clinic for post-acute sequelae of SARS-CoV-2 infection. Am Heart J, 2022, 18.
36. WIERSINGA WJ. et al. Fisiopatologia, transmissão, diagnóstico e tratamento da doença por coronavírus 2019 (COVID-19): uma revisão. JAMA, 2020; 324 (8), 782–793.
37. WORLD HEALTH ORGANIZATION (WHO). WHO Coronavirus (COVID-19) Dashboard, 2023.
38. XIONG Q. et al. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clin Microbiol Infect, 2021; 27, 89–95.
39. ZIEGLER CGK. et al. SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues. Cell, 2020; 181, 1016–1035e19.
40. ZUBCHENKO S. et al. Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study. Rheumatology international, 2022; 42 (9), 1523–1530.
2. ALWAN N. A. Surveillance is underestimating the burden of the COVID-19 pandemic. Lancet, 2020; 396, 24.
3. BAI C, et al. Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020). Eur Respir Rev, 2020; 157 (29), 200287.
4. BENKALFATE N, et al. Evaluation of the Post-COVID-19 Functional Status (PCFS) Scale in a cohort of patients recovering from hypoxemic SARS-CoV-2 pneumonia. BMJ Open Respir Res, 2022; 9 (1), e001136.
5. BRASIL. Ministério da Saúde. 2023. Painel de casos de doença pelo coronavírus 2019 (COVID-19) no Brasil pelo Ministério da Saúde. Acessado em 16 de setembro de 2023.
6. CASTANARES-ZAPATERO D, et al. Pathophysiology and mechanism of long COVID: a comprehensive review. Annals of Medicine, 2022; 54, 1473–1487.
7. CHEN H, et al. Effect of pulmonary rehabilitation for patients with post-COVID-19: A systemic review and meta-analysis. Frontiers in Medicine, 2022; 9, 837420.
8. CONTRERAS-BRICEÑO F, et al. Eccentric Training in Pulmonary Rehabilitation of Post-COVID-19 Patients: An Alternative for Improving the Functional Capacity, Inflammation, and Oxidative Stress. Biology, 2022; 11 (10), 1446.
9. CURCI C, et al. Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 rehabilitation unit and proposal of a treatment protocol: a cross-sectional study. Eur J Phys Rehabil Med, 2020; 56 (5), 633-641.
10. DAVIS HE, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine, 2021; 38, 101019.
11. DE FACIO CA, et al. Post-COVID-19 functional status scale: Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version. Braz J Phys Ther, 2023; 27 (3), 100503.
12. FERNÁNDEZ-CASTAÑEDA A, et al. Mild respiratory SARS-CoV-2 infection can cause multi-lineage cellular dysregulation and myelin loss in the brain. bioRxiv: the preprint server for biology. 2022.
13. GAO Y, et al. Cardiopulmonary Exercise Testing Might Be Helpful for Interpretation of Impaired Pulmonary Function in Recovered COVID-19 Patients. Eur Respir J, 2021; 57, 2004265.
14. GREENHALGH T, et al. Long covid—an update for primary care. BMJ, 2022; 378, e072117.
15. HOCKELE LF, et al. Pulmonary and Functional Rehabilitation Improves Functional Capacity, Pulmonary Function and Respiratory Muscle Strength in Post COVID-19 Patients: Pilot Clinical Trial. Int J Environ Res Public Health, 2022; 19 (22), 14899.
16. HOFFMANN M, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell, 2020; 181, 271–280e8.
17. HU B.; HUANG S.; YIN L. The cytokine storm and COVID-19. Journal of medical virology, 2021; 93 (1), 250–256.
18. HUANG L, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. The Lancet, 2021; 398 (10302), 747–758.
19. KLEIN J, et al. Distinguishing features of Long COVID identified through immune profiling. Preprint on medRxiv, 2022; 2022.
20. KLOK FA, et al. The Post-COVID-19 functional status scale: a tool to measure functional status over time after COVID-19. Eur Respir J, 2020; 56, 2001494.
21. MACHADO FVC, et al. Construct validity of the Post-COVID-19 functional status scale in adult subjects with COVID-19. Health Qual Life Outcomes, 2021; 19,40.
22. NALBANDIAN A, et al. Post-acute COVID-19 syndrome. Nature medicine, 2021; 27 (4), 601–615.
23. NALBANDIAN A, DESAI AD, WAN EY. Post-COVID-19 Condition. Annual review of medicine,2023; 74, 55–64.
24. OYUNGEREL B, et al. Impact of COVID-19 vaccination on long COVID: a systematic review and meta-analysis. Medrxiv, 2022.
25. PATTERSON BK, et al. Persistence of SARS CoV-2 S1 protein in CD16+ monocytes in post-acute sequelae of COVID-19 (PASC) up to 15 months post-infection. Front Immunol, 2021;12.
26. PIERCE JD. et al. Post-COVID-19 syndrome. Nurs Res, 2022; 71,164-174.
27. PINZON RT. et al. Persistent neurological manifestations in long COVID-19 syndrome: a systematic review and meta-analysis. J Infect Public Health, 2022; 15, 856-869.
28. RAJAN S. et al. In the wake of the pandemic: preparing for Long COVID. Copenhagen (Denmark): European Observatory on Health Systems and Policies, 2021.
29. RAMAN B. et al. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J. 2022; 14 (43), 1157-1172.
30. SADR S. et al. Isolated severe thrombocytopenia in a patient with COVID‐19: a case report. IDCases, 2020; 21.
31. SORIANO JB. et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis, 2022; 4,102 – 107.
32. SSENTONGO P. et al. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PloS one, 2020; 15 (8), e0238215.
33. SWANK Z. et al. Persistent circulating severe acute respiratory syndrome coronavirus 2 spike is associated with post-acute coronavirus disease 2019 sequelae. Clin Infect Dis, 2022; 76 (3).
34. TABOADA M. et al. Post-COVID-19 functional status six-months after hospitalization. J. Infect., 2021; 82, e31–e33.
35. WANG SY. et al. Characteristics of patients referred to a cardiovascular disease clinic for post-acute sequelae of SARS-CoV-2 infection. Am Heart J, 2022, 18.
36. WIERSINGA WJ. et al. Fisiopatologia, transmissão, diagnóstico e tratamento da doença por coronavírus 2019 (COVID-19): uma revisão. JAMA, 2020; 324 (8), 782–793.
37. WORLD HEALTH ORGANIZATION (WHO). WHO Coronavirus (COVID-19) Dashboard, 2023.
38. XIONG Q. et al. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clin Microbiol Infect, 2021; 27, 89–95.
39. ZIEGLER CGK. et al. SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues. Cell, 2020; 181, 1016–1035e19.
40. ZUBCHENKO S. et al. Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study. Rheumatology international, 2022; 42 (9), 1523–1530.