Implicações Cardiovasculares na Covid-19: Uma Revisão Sistemática / Cardiovascular Implications in Covid-19: A Systematic Review

Arthur Neves Egidio, Bárbara Neto Campos, Camila Fonseca Silva Junqueira, Fernanda Rodrigues Martins, José Fabri Júnior, Julia Freitas Rodrigues, Leonardo Gasparoni Gazolla de Siqueira, Ludymilla Ribeiro Bordoni de Oliveira, Maria Beatriz Silva Ferreira, Victor Rocha Moreira Antunes, Vinícius Penna Torres

Abstract


INTRODUÇÃO: A infecção pelo SARS-CoV-2 tem sido associada à múltiplas repercussões clínicas, descritas em diversos órgãos e sistemas. A associação entre a COVID-19 e o acometimento do sistema cardiovascular ainda é pouco documentada, bem como as suas possíveis consequências. METODOLOGIA: Foi conduzida uma revisão sistemática da literatura. As buscas foram realizadas no mês de agosto de 2020, na base de dados National Library of Medicine (MEDLINE). Os descritores utilizados foram: "COVID-19" [Supplementary Concept] e "Cardiovascular Diseases"[Mesh]. Inicialmente foram encontrados 70 artigos e, após a análise dos resumos e da aplicação dos critérios de inclusão e exclusão, 25 artigos foram selecionados. Foi realizada a busca continuada nas referências dos artigos encontrados, resultando em um escopo final de 27 artigos. Por fim, os estudos foram submetidos à análise quantitativa e qualitativa, resultando em 20 artigos que estão incluídos nesta revisão sistemática. A escala de sistematização PRISMA foi utilizada a fim de aprimorar os resultados desta revisão. RESULTADOS: Os estudos demonstraram que a ocorrência de manifestações cardiovasculares inclui complicações tromboembólicas, elevação dos marcadores cardíacos e afecção miocárdica. Entretanto, diversos estudos apresentam limitações como dificuldade na obtenção de dados, escassez de recursos e curto tempo de acompanhamento. CONCLUSÃO: Apesar dos resultados encontrados e das evidências disponíveis, a condução de novos estudos ainda é necessária para esclarecer o envolvimento cardiovascular na COVID-19.


Keywords


COVID-19, Fisiopatologia, Clínica, Cardiovascular, Cardiopatias.

References


AL-SAMKARI H, KARP LEAF RS, DZIK WH, et al. COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection. Blood, v. 136, n 4. p. 489-500, 2020.

ARTIFONI M, DANIC G, GAUTIER G, et al. Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors. J Thromb Thrombolysis, v 50, n 1. p. 211-216, 2020.

DENG Q, HU B, ZHANG Y, et al. Suspected myocardial injury in patients with COVID-19: Evidence from front-line clinical observation in Wuhan, China. Int J Cardiol, v. 311. p. 116-121, 2020.

GAO C, CAI Y, ZHANG K, et al. Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. Eur Heart J, v. 41, n 22. p. 2058-2066, 2020.

GATTO M, PERRICONE C, TONELLO M, et al. Frequency and clinical correlates of antiphospholipid antibodies arising in patients with SARS-CoV-2 infection: findings from a multicentre study on 122 cases. Clin Exp Rheumatol, v. 38, n 4. p. 754-759, 2020.

GIL-RODRIGO A, MIRÓ Ò, PIÑERA P, et al. Analysis of clinical characteristics and outcomes in patients with COVID-19 based on a series of 1000 patients treated in Spanish emergency departments. Emergencias, v. 32, n 4. p. 233-241, 2020.

GOSHUA G, PINE AB, MEIZLISH ML, et al. Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. Lancet Haematol, v. 7, n 8. e575-e582, 2020.

HELMS J, TACQUARD C, SEVERAC F, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med, v. 46, n 6. p. 1089-1098, 2020.

LALA A, JOHNSON KW, JANUZZI JL, et al. Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection. J Am Coll Cardiol, v. 76, n 5. p. 533-546, 2020.

LLITJOS JF, LECLERC M, CHOCHOIS C, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J Thromb Haemost, v. 18, n 7. p. 1743-1746, 2020.

MCCULLOUGH SA, GOYAL P, KRISHNAN U, CHOI JJ, SAFFORD MM, OKIN PM. Electrocardiographic Findings in Coronavirus Disease-19: Insights on Mortality and Underlying Myocardial Processes. J Card Fail, v. 26, n 7. p. 626-632, 2020.

MORASSI M, BAGATTO D, COBELLI M, et al. Stroke in patients with SARS-CoV-2 infection: case series. J Neurol, v. 267, n 8. p. 2185-2192, 2020.

PAVONI V, GIANESELLO L, PAZZI M, STERA C, MECONI T, FRIGIERI FC. Evaluation of coagulation function by rotation thromboelastometry in critically ill patients with severe COVID-19 pneumonia. J Thromb Thrombolysis, v. 50, n 2. p. 281-286, 2020.

SALEH M, GABRIELS J, CHANG D, et al. Effect of Chloroquine, Hydroxychloroquine, and Azithromycin on the Corrected QT Interval in Patients With SARS-CoV-2 Infection. Circ Arrhythm Electrophysiol, v. 13, n 6. e008662, 2020.

SHI S, QIN M, SHEN B, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol, v. 5, n 7. p. 802–810, 2020.

SONG J, HU W, YU Y, et al. A Comparison of Clinical Characteristics and Outcomes in Elderly and Younger Patients with COVID-19. Med Sci Monit, v. 26, e925047, 2020.

VERDONI L, MAZZA A, GERVASONI A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet, v. 395, n 10239. p. 1771-1778, 2020.

VICENZI M, DI COSOLA R, RUSCICA M, et al. The liaison between respiratory failure and high blood pressure: evidence from COVID-19 patients. Eur Respir J, v. 56, n 1. 2001157, 2020.

VOICU S, BONNIN P, STÉPANIAN A, et al. High Prevalence of Deep Vein Thrombosis in Mechanically Ventilated COVID-19 Patients. J Am Coll Cardiol, v. 76, n 4. p. 480-482, 2020.

ZHANG P, ZHU L, CAI J, et al. Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19. Circ Res, v. 126, n 12. p. 1671-1681, 2020.




DOI: https://doi.org/10.34117/bjdv6n10-588

Refbacks

  • There are currently no refbacks.