O impacto da obesidade e do diabetes mellitus no desfecho clínico de pacientes portadores de Covid-19: uma revisão integrativa
DOI:
https://doi.org/10.11606/issn.1679-9836.v100i3p269-278Palavras-chave:
Diabetes, Obesidade, COVID-19, Fisiopatologia, PrognósticoResumo
Introdução: A COVID-19 (Coronavírus Doença-2019) é uma doença provocada pelo coronavírus SARS-CoV-2 (síndrome respiratória aguda grave Coronavírus-2), a qual representa um desafio à saúde pública global. Existem evidências científicas que indicam que pacientes com COVID-19 e diabetes mellitus (DM) e/ou obesidade tendem a ter um pior prognóstico. O objetivo deste estudo é revisar integrativamente a literatura disponível sobre o impacto do diabetes mellitus e obesidade no desfecho clínico de pacientes portadores de Covid-19. Métodos: Este artigo é uma revisão integrativa. Foram selecionados artigos, publicados de 2019 a 2020, no Pubmed, Biblioteca Virtual em Saúde (BVS) e Scielo usando os descritores: “diabetes”, “obesidade”, “Covid-19”, “fisiopatologia”, “prognóstico”. Os critérios de inclusão foram: estudos publicados em inglês, espanhol e português, caracterizados como ensaio clínico randomizado, estudo de coorte, metanálises e/ou revisões sistemáticas. Resultados: Foi observado que o DM descontrolado e a obesidade são importantes fatores de risco para COVID-19 grave, associados a um pior prognóstico e, consequente necessidade de tratamento intensivo. Tal fato, se justifica sob a ótica de alterações fisiopatológicas correlatas à ambas comorbidades (descontrole glicêmico e inflamação crônica característica de pacientes obesos e diabéticos, comprometimento respiratório, aumento na expressão de receptores de ligação à capsula viral), as quais em conjunto favorecem um pior desfecho clínico. Adicionalmente, foi observado que o estrito controle glicêmico em pacientes diabéticos é importante fator de proteção para a COVID-19 grave, considerando o fato de que pacientes contaminados pelo novo coronavírus os quais tiveram como desfecho clínico, o óbito, apresentaram maiores valores de glicemia em jejum.
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Copyright (c) 2021 Ana Flávia Freire de Andrade, Anne Moura Korthals, Edna Messias de Freitas Santos, João Antonio Martins Gomes Gomes, Laura Medeiros Costa, Maria Gabriela Gonçalves Rezende de Souza, Mateus Gonçalves de Sena Barbosa, Thaynara Faria Gomes
Este trabalho está licenciado sob uma licença Creative Commons Attribution-ShareAlike 4.0 International License.
