A prevalência de sequelas cognitivas em pacientes diagnosticados com COVID-19 no Brasil – uma revisão de Literatura / The prevalence of cognitive sequelae in patients diagnosed with COVID-19 in Brazil – a Literature Review
DOI:
https://doi.org/10.34119/bjhrv5n2-346Keywords:
infecção por SARS-CoV-2, pandemia COVID-19, comprometimento cognitivo, deficiências cognitivas, distúrbio neurocognitivo leve, declínio cognitivo.Abstract
OBJETIVOS: Neste artigo propomos um estudo que visa relacionar os déficits cognitivos com pacientes infectados pelo vírus da COVID-19, de acordo com a compreensão de suas fisiopatologias atuais mais prováveis bem como sua prevalência nesses pacientes. MÉTODOS: Revisão de literatura de caráter exploratório, com uma ampla avaliação de estudos e casos da prática clínica, em que se fez uma análise sobre a COVID-19 relacionando-a com as disfunções neurocognitivas apresentadas pelos indivíduos infectados. RESULTADOS: Foram selecionados 40 estudos para compor essa revisão de literatura. Entre as bases de dados selecionadas, estão: PubMed, Google Scholar, Scielo, UpToDate e Scopus. DISCUSSÃO: Desse modo, durante a análise dos artigos foi evidente que há limitação dos estudos observacionais brasileiros que fazem a relação do vírus com a diminuição da cognição. Em resumo, foi analisado que os déficits das funções cognitivas em pacientes que tiveram a doença podem estar intimamente relacionados com a hipóxia e ao perfil inflamatório causados pelo vírus. Nos estudos selecionados, as repercussões cognitivas foram prevalentes entre os pacientes que tiveram COVID-19 e os déficits com maior incidência foram: dificuldade de aprendizado e de concentração, redução da atenção sustentada, perda de memória e diminuição da coordenação motora. Ademais, vale ressaltar que essa redução da cognição está presente tanto em pacientes que tiveram um quadro grave quanto os que tiveram um quadro leve da doença, sendo potencialmente danoso ao cotidiano da maioria desses indivíduos. CONCLUSÃO: Em suma, há claramente uma inerente relação entre os déficits cognitivos e a infecção com o vírus SARS-CoV-2, visto que a maioria dos pacientes infectados possuem pelo menos uma queixa relacionada à diminuição da cognição. Portanto, há necessidade de mais pesquisas e estudos observacionais que associem os déficits cognitivos à COVID-19 no Brasil, visto que é uma doença emergente e prevalente na atual situação global.References
Damiano RF, Caruso MJG, Cincoto AV, de Almeida Rocca CC, de Pádua Serafim A, Bacchi P, et al. Post-COVID-19 psychiatric and cognitive morbidity: Preliminary findings from a Brazilian cohort study. Gen Hosp Psychiatry 2022;75:38–45. https://doi.org/10.1016/j.genhosppsych.2022.01.002.
Munblit D, Nicholson TR, Needham DM, Seylanova N, Parr C, Chen J, et al. Studying the post-COVID-19 condition: research challenges, strategies, and importance of Core Outcome Set development. BMC Med 2022;20:50. https://doi.org/10.1186/s12916-021-02222-y.
Matos A de MB, Dahy FE, de Moura JVL, Marcusso RMN, Gomes ABF, Carvalho FMM, et al. Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series. Front Neurol 2021;12:678924. https://doi.org/10.3389/fneur.2021.678924.
Hentsch L, Cocetta S, Allali G, Santana I, Eason R, Adam E, et al. Breathlessness and COVID-19: A Call for Research. Respiration 2021;100:1016–26. https://doi.org/10.1159/000517400.
Barbosa-Silva MC, Lima MN, Battaglini D, Robba C, Pelosi P, Rocco PRM, et al. Infectious disease-associated encephalopathies. Crit Care 2021;25:236. https://doi.org/10.1186/s13054-021-03659-6.
Busatto GF, de Araújo AL, Duarte AJ da S, Levin AS, Guedes BF, Kallas EG, et al. Post-acute sequelae of SARS-CoV-2 infection (PASC): a protocol for a multidisciplinary prospective observational evaluation of a cohort of patients surviving hospitalisation in Sao Paulo, Brazil. BMJ Open 2021;11:e051706. https://doi.org/10.1136/bmjopen-2021-051706.
Damiano RF, Guedes BF, de Rocca CC, de Pádua Serafim A, Castro LHM, Munhoz CD, et al. Cognitive decline following acute viral infections: literature review and projections for post-COVID-19. Eur Arch Psychiatry Clin Neurosci 2022;272:139–54. https://doi.org/10.1007/s00406-021-01286-4.
Zhou H, Lu S, Chen J, Wei N, Wang D, Lyu H, et al. The landscape of cognitive function in recovered COVID-19 patients. Journal of Psychiatric Research 2020;129:98–102. https://doi.org/10.1016/j.jpsychires.2020.06.022.
Yachou Y, El Idrissi A, Belapasov V, Ait Benali S. Neuroinvasion, neurotropic, and neuroinflammatory events of SARS-CoV-2: understanding the neurological manifestations in COVID-19 patients. Neurol Sci 2020;41:2657–69. https://doi.org/10.1007/s10072-020-04575-3.
Mazza MG, Palladini M, De Lorenzo R, Magnaghi C, Poletti S, Furlan R, et al. Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up. Brain Behav Immun 2021;94:138–47.
Campos MR, Schramm JM de A, Emmerick ICM, Rodrigues JM, Avelar FG de, Pimentel TG. 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. Cad Saúde Pública 2020;36:e00148920. https://doi.org/10.1590/0102-311x00148920.
Lima MVB, Silva BRT da, Pinto MJ da S. Disfunção cognitiva e infecção por SARS-CoV-2: Revisão Integrativa / Cognitive Dysfunction and SARS-CoV-2 Infection: Integrative Review. Brazilian Journal of Development 2021;7:95642–56. https://doi.org/10.34117/bjdv7n10-62.
Garrigues E, Janvier P, Kherabi Y, Bot AL, Hamon A, Gouze H, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. Journal of Infection 2020;81:e4–6. https://doi.org/10.1016/j.jinf.2020.08.029.
Anaya J-M, Rojas M, Salinas ML, Rodríguez Y, Roa G, Lozano M, et al. Post-COVID syndrome. A case series and comprehensive review. Autoimmunity Reviews 2021;20:102947. https://doi.org/10.1016/j.autrev.2021.102947.
INSTITUTO DO CORAÇÃO DO HOSPITAL DAS CLÍNICAS DA FMUSP (INCOR). Estudo inédito no mundo realizado no InCor mostra que pacientes que tiveram Covid-19 podem sofrer disfunções cognitivas. São Paulo, 1 de fevereiro de 2021. Disponível em: http://www.incor.usp.br/sites/incor2013/docs/2021_Fevereiro_Estudo_Mental_Plus.p
Koyuncu OO, Hogue IB, Enquist LW. Virus Infections in the Nervous System. Cell Host & Microbe 2013;13:379–93. https://doi.org/10.1016/j.chom.2013.03.010.
Yavarpour-Bali H, Ghasemi-Kasman M. Update on neurological manifestations of COVID-19. Life Sciences 2020;257:118063. https://doi.org/10.1016/j.lfs.2020.118063.
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet 2020;395:1033–4. https://doi.org/10.1016/S0140-6736(20)30628-0.
Puelles VG, Lütgehetmann M, Lindenmeyer MT, Sperhake JP, Wong MN, Allweiss L, et al. Multiorgan and Renal Tropism of SARS-CoV-2. N Engl J Med 2020;383:590–2. https://doi.org/10.1056/NEJMc2011400.
Paniz‐Mondolfi A, Bryce C, Grimes Z, Gordon RE, Reidy J, Lednicky J, et al. Central nervous system involvement by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). J Med Virol 2020;92:699–702. https://doi.org/10.1002/jmv.25915.
Crunfli F, Carregari VC, Veras FP, Vendramini PH, Valença AGF, Antunes ASLM, et al. Morphological, cellular and molecular basis of brain infection in COVID-19 patients. Neurology; 2020. https://doi.org/10.1101/2020.10.09.20207464.
Detje CN, et al. Upon intranasal vesicular stomatitis virus infection, astrocytes in the olfactory bulb are important interferon beta producers that protect from lethal encephalitis. J Virol. 2015;89:2731–2738. doi: 10.1128/jvi.02044-14.
Steardo L, et al. Neuroinfection may contribute to pathophysiology and clinical manifestations of covid-19. Acta Physiol (Oxf) 2020;229:e13473. doi: 10.1111/apha.13473.
Sheng W.H., Chiang B.L., Chang S.C., Ho H.N., Wang J.T., Chen Y.C. Clinical manifestations and inflammatory cytokine responses in patients with severe acute respiratory syndrome. J. Formosan. Med. Assoc. Taiwan Yi Zhi. 2005;104:715–723
Zheng F., Xie W. High-sensitivity C-reactive protein and cognitive decline: the English longitudinal study of ageing. Psychol. Med. 2018;48:1381–1389. 2018
Vintimilla R., Hall J., Johnson L., O'Bryant S. The relationship of CRP and cognition in cognitively normal older Mexican Americans: a cross-sectional study of the HABLE cohort. Medicine. 2019
Mitko A., Rothlein D., Poole V., Robinson M., McGlinchey R., DeGutis J. Individual differences in sustained attention are associated with cortical thickness. Hum. Brain Mapp. 2019;40:3243–3253
Han H.B., Lee K.E., Choi J.H. Functional dissociation of theta oscillations in the frontal and visual cortices and their long-range network during sustained attention. eNeuro. 2019;6
Larson EB et al. Evaluation of cognitive impairment and dementia. Waltham, MA: UpToDate Inc. [Acesso em: 13 março. 2022] Disponível em: https://www.uptodate.com/contents/evaluationof-cognitive-impairment-and-dementia
SARS-CoV2 Infection on Cognitive Function: A Systematic Review. Front Psychiatry, 2021; 11:621773.https://doi.org/10.3389/fpsyt.2020.621773
Gonçalves LF, Haas P. Cognitive disorders in patients infected with Covid-19: A narrative review. Rev Cientí Mult. 2021; 2(5) e25335. https://doi.org/10.47820/recima21.v2i5.335
Beaud V, Crottaz-Herbette S, Dunet V, Vaucher J, Bernard-Valnet R, Pasquier RD. Et al. Pattern of cognitive deficits in severe COVID-19. J of Neurol, Neuros. & Psych., 2021; 92(5):567-8. https://doi.org/10.1136/jnnp-2020-325173
Ferrucci R, Dini M, Groppo E, Rosci C, Reitano MR, Bai F. et al. Long-lasting cognitive abnormalities after COVID-19. B Sci., 2021; 11(2):235. https://doi.org/10.3390/brainsci11020235
Miskowiak KW, Johnsen S, Sattler SM, Nielsen S, Kunalan K, Rungby J. et al. Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables. Eur Neuropsychopharm., 2021; 46:39-48. https://doi.org/10.1016/j.euroneuro.2021.03.019
Del Brutto OH, Wu S, Mera RR, Costa AF, Recalde BY, Issaet NP. Cognitive decline among individuals with history of mild symptomatic SARS‐CoV‐2 infection: A longitudinal prospective study nested to a population cohort. Europ J of Neurol, 2021. https://doi.org/10.1111/ene.14775
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382((18)):1708–20.
Chen L, Liu HG, Liu W, Liu J, Liu K, Shang J, et al. Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia. Zhonghua Jie He Hu Xi Za Zhi. 2020 Feb 6;43((0)):E005
Coen M, Allali G, Adler D, Serratrice J. Hypoxemia in COVID-19; Comment on: The neuroinvasive potential of SARS–CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020 May 17;92:1705–6.
Mazza MG, De Lorenzo R., Conte C., Poletti S., Vai B., Bollettini I., Melloni EMT, Furlan R., Ciceri F., Rovere-Querini P., Benedetti F. Ansiedade e depressão no COVID- 19 sobreviventes: papel dos preditores inflamatórios e clínicos. Comportamento do Cérebro. Imun. 2020; 89 :594-600
Taquet M, Dercon Q, Luciano S, Geddes JR, Husain M, Harrison PJ. Incidence, co-occurrence, and evolution of long-COVID features: a 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med. 2021;18(9):e1003773. doi: 10.1371/journal.pmed.1003773
