Resumo
Objetivo: Analisar a mortalidade durante a pandemia do SARS-CoV-2 e suas consequências pós-infecção, destacando a epidemiologia, o tratamento clínico e as taxas de mortalidade nas unidades de terapia intensiva (UTIs). Revisão bibliográfica: A pandemia da COVID-19 enfatizou a importância das UTIs, revelando altas taxas de mortalidade e sequelas prolongadas entre sobreviventes, como fadiga, dispneia e problemas cognitivos, especialmente em mulheres e pessoas com comorbidades não vacinadas. A mortalidade foi significativamente ligada à idade avançada e a doenças preexistentes, evidenciando a necessidade de mais leitos de UTI e profissionais especializados. Estudos adicionais são necessários para compreender melhor as sequelas a longo prazo e desenvolver tratamentos terapêuticos. Considerações finais: Os resultados destacam a importância vital das UTIs na pandemia da COVID-19, com ênfase na necessidade contínua de melhorias frente às altas taxas de mortalidade e sequelas persistentes. A expansão dos leitos e qualificação dos profissionais foram essenciais, mas são necessários estudos adicionais para entender e tratar eficazmente as sequelas a longo prazo, fortalecendo as UTIs para enfrentar desafios futuros.
Referências
DUSHIANTHAN A, et al. Caring for COVID‐19 patients through a pandemic in the intensive care setting: a narrative review. WIREs Mechanisms of Disease, 2022; 14(6).
ARMSTRONG RA, et al. Mortality in patients admitted to intensive care with COVID‐19: an updated systematic review and meta‐analysis of observational studies. Anaesthesia, 2021; 76(4): 537–548.
BAYRAK V, et al. Risk factors associated with mortality in intensive care COVID-19 patients: the importance of chest CT score and intubation timing as risk factors. International Journal of Clinical Practice, 2021; 75(11).
KOSOVALI BD, et al. Can prognostic nutritional index predict mortality in intensive care patients with COVID‐19? International Journal of Clinical Practice, 2021; 75(11).
BELL ML, et al. COVID-19 and socioeconomic inequalities in health. Journal of Public Health, 2021; 43(1): 23-32.
BUONSENSO D, TANTISIRA KG. Long COVID and SARS-CoV-2 persistence: new answers, more questions. The Lancet Infectious Diseases, 2024; [online ahead of print].
CARFI A, et al. Persistent symptoms in patients after acute COVID-19. JAMA, 2020; 324(6): 603-605.
CAMPOS MR, et al. Carga de doença da COVID-19 e de suas complicações agudas e crônicas: reflexões sobre a mensuração (DALY) e perspectivas no Sistema Único de Saúde. Cadernos de Saúde Pública, 2020; 36(11).
DODT C, SCHNEIDER N. Notfallmedizinische und intensivmedizinische Aspekte von COVID-19-Infektionen. Der Radiologe, 2020; 60(10): 899–907.
VRBACKY F, et al. Intensive Care Infection Score (ICIS) is elevated in patients with moderate and severe COVID-19 in the early stages of disease. Journal of Infection and Public Health, 2022; 15(5): 533–538.
HUANG C, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet, 2021; 397(10270): 220-232.
MENDES JJ, et al. Update of the recommendations of the Sociedade Portuguesa de Cuidados Intensivos and the Infection and Sepsis Group for the approach to COVID-19 in intensive care medicine. DOAJ, 2022; 33(4): 487–536.
LU R, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet, 2020; 395(10224): 565–574.
PAROTTO M, et al. Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations. The Lancet Respiratory Medicine, 2023; 11(8): 739–754.
RAMADAN MS, et al. Cardiac sequelae after coronavirus disease 2019 recovery: a systematic review. Clinical Microbiology and Infection, 2021; 27(9): 1250–1261.
SEPANDI M, et al. Case fatality rate of COVID-19: a systematic review and meta-analysis. Journal of Preventive Medicine and Hygiene, 2021; 62(2): E311.
IMMOVILLI P, et al. COVID-19 mortality and ICU admission: the Italian experience. Critical Care, 2020; 24(1).
SINGH TK, et al. A post-pandemic enigma: the cardiovascular impact of post-acute sequelae of SARS-CoV-2. Circulation Research, 2023; 132(10): 1358–1373.
TAYLOR EH, et al. Factors associated with mortality in patients with COVID‐19 admitted to intensive care: a systematic review and meta‐analysis. Anaesthesia, 2021; 76(9): 1224–1232.
TEHRANI HA, et al. COVID-19 associated thrombotic thrombocytopenic purpura (TTP): a case series and mini-review. International Immunopharmacology, 2021; 93: 107397.
TSOLAKI V, MAKRIS D, ZAKYNTHINOS E. COVID-19 mortality differences: patient-related data and intensive care unit load are prerequisites. Annals of the American Thoracic Society, 2022; 19(9): 1622–1623.
WANG Z, YANG L. Post-acute sequelae of SARS-CoV-2 infection: a neglected public health issue. Frontiers in Public Health, 2022; 10.
WIESNER O, BUSCH M, DAVID S. Therapie schwerer COVID-19-Verläufe in der Intensivmedizin. Der Internist, 2020; 61(8): 804–812.
WILDE H, et al. A national retrospective study of the association between serious operational problems and COVID-19 specific intensive care mortality risk. PLoS ONE, 2021; 16(7): e0255377.
WU Z, McGOOGAN JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China. JAMA, 2021; 323(13): 1239-1242.
LIM ZJ, et al. Case fatality rates for patients with COVID-19 requiring invasive mechanical ventilation: a meta-analysis. American Journal of Respiratory and Critical Care Medicine, 2021; 203(1): 54–66.
