Acidente vascular encefálico como complicação neurológica pelo Sars-Cov-2
DOI:
https://doi.org/10.34117/bjdv9n4-053Keywords:
SARS-CoV-2, acidente vascular encefálico, COVID-19Abstract
A COVID-19, infecção causada pelo coronavírus SARS-CoV-2, apresenta amplo espectro clínico, que pode gerar desde sequelas primários no sistema respiratório e cardíaco, até sintomas neurológicos com potencial para gerar complicações neurais, tendo como principais sinais a tontura, cefaleia, hipogenesia cerebral e neuralgia. O processo de inflamação e coagulação excessivas em todo o corpo, incluindo no sistema nervoso central (SNC), podem aumentar o risco de desenvolver um Acidente Vascular Encefálico (AVE). O objetivo deste trabalho foi descrever as complicações neurológicas decorrentes da infecção por SARS-CoV-2, com ênfase no AVE, utilizando revisão de literatura. Existem evidências crescentes de que a infecção por COVID-19 pode aumentar o risco de um acidente vascular encefálico, devido ao envolvimento cardiovascular. Os sintomas do AVE incluem dor de cabeça intensa, fraqueza ou dormência em um lado do corpo, dificuldade em falar, problemas de visão, tontura e perda de equilíbrio. A incidência de AVE foi detectada em 3,7 a 5% dos pacientes acometidos pela COVID-19. Os altos índices de morbimortalidade e déficits do AVE, associados a infecção com coronavírus, contribui para um prognóstico desfavorável ao paciente. As sequelas neurológicas geradas por consequência da infecção pela COVID-19 podem ser graves, prejudicando a saúde e bem-estar do paciente acometido ou levar a óbito. Desta maneira, torna-se indispensável estudos e investigações acerca da relação entre COVID-19 e AVE de modo que, no futuro seja possível oferecer um melhor manejo clínico e tratamento destes pacientes.
References
AHMAD, I.; RATHORE, F. A. Neurological manifestations and complications of COVID-19: A Literature Review. Journal of Clinical Neuroscience, v. 77, p. 8-12, 2020.
ARAÚJO, J. S. et al. O lado paralelo do cuidar desvelado pelas representações dos cuidadores de adoecidos após acidente vascular cerebral. Revista Brasileira de Ciências da Saúde, v. 18, n. 2, p. 109-114, 2014.
BAIG, A. M. et al. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS chemical neuroscience, v. 11, n. 7, p. 995-998, 2020.
BAIG, A. M. Neurological manifestations in COVID-19 caused by SARS-CoV-2. CNS neuroscience & therapeutics, v. 26, n. 5, p. 499-501, 2020.
CHEN, J. et al. Angiotensin-Converting Enzyme 2 Priming Enhances the Function of Endothelial Progenitor Cells and Their Therapeutic Efficacy. Hypertension, v. 61, n. 3, p. 681-689, 2013.
CHEN, J. et al. Neuronal over-expression of ACE2 protects brain from ischemia-induced damage. Neuropharmacology, v. 79, p. 550-558, 2014.
CO, C. O. C. et al. Intravenous Thrombolysis for Stroke in a COVID-19 Positive Filipino Patient, a Case Report. Journal of Clinical Neuroscience, v. 77, p. 234-236, 2020.
DESFORGES, M. et al. Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System?. Viruses, v. 12, n. 1, 2019.
DONOGHUE, M. et al. A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circulation Research, v. 87, n. 5, 2000.
FELICE, F. G. et al. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Central Nervous System. Trends in neurosciences, v. 43, n. 6, p. 355-357, 2020.
GUAN, W. J. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine, v. 382, n. 18, p. 1708-1720, 2020a.
GUAN, W. J. et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. The European respiratory journal, v. 55, n. 5, 2020b.
HAMMING, I. et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. The Journal of pathology, v. 203, n. 2, p. 631-637, 2004.
HESS, D. C.; ELDAHSHAN, W.; RUTKOWSKI, E. COVID-19-related stroke. Translational Stroke Research, v. 11, n. 3, p. 322-325, 2020.
JIN, H. et al. Consensus for prevention and management of coronavirus disease 2019 (COVID-19) for neurologists. Stroke and Vascular Neurology, v. 5, n. 2, p. 146-151, 2020.
MAO, L. et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurology, v. 77, n. 6, p. 683-690, 2020.
MORALES, A. J. R. et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel medicine and infectious disease, v. 34, 2020.
NETLAND, J. et al. severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. Journal of virology, v. 82, n. 15, p. 7264-7275, 2008.
ORTIZ, M. et al. ACV y covid-19: una revisión de los estudios observacionales publicados en época de pandemia. Acta Neurológica Colombiana, v. 36, n. 2, p. 63–74, 2020.
PANIZ-MONDOLFI, A. et al. Central nervous system involvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Journal of medical virology, v. 92, n. 7, p. 699-702, 2020.
SANTOS, I. H. A. et al. O Acidente Vascular Encefálico como complicação neurológica da COVID-19. Research, Society and Development, v. 10, n. 1, e19610111535, 2021.
VARATHARAJ, A. et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry, v. 7, n. 10, p. 875-882, 2020.
WANG, L. et al. Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. International Journal of Antimicrobial Agents, v. 55, n. 6, 2020a.
WANG, A. et al. Stroke and mechanical thrombectomy in patients with COVID-19: technical observations and patient characteristics. Journal of NeuroInterventional Surgery, v. 12, n. 7, p. 648-653, 2020b.
WEI, P. F. Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7). Chinese Medical Journal, v. 133, n. 9, p. 1087-1095, 2020.
WHITTAKER, A.; ANSON, M.; HARKY, A. Neurological Manifestations of COVID-19: A systematic review and current update. Acta Neurologica Scandinavica, v. 142, n. 1, p. 14–22, 2020.
WHO (WORLD HEALTH ORGANIZATION). Statement on the second meeting of the international health regulations (2005) emergency committee regarding the outbreak of novel coronavirus (2019- nCoV). Geneva: World Health Organization; 2020.
