Citocinas, Infecção Por Coronavírus, Lesão Renal Aguda, Necrose Tubular Aguda
Resumo
INTRODUÇÃO: A Covid-19 é caracterizada por sua alta transmissibilidade e, em casos graves, pela sua acentuada resposta imune e sua tempestade de citocinas, que pode resultar em perda da tolerância periférica dos órgãos, ocasionando uma inflamação exacerbada e destruição tecidual. É sabido que o vírus Sars-CoV-2 pode gerar injúrias em órgãos e sistemas além do pulmonar e imune, como o sistema renal. Um importante ponto de análise foi a ação da enzima conversora de angiotensina 2 (ACE2), altamente presente nas células tubulares proximais e podócitos, levando a um quadro de hematúria e proteinúria. OBJETIVO: Validar a importância de observar-se a evolução do quadro renal em pacientes enfermos de Covid-19. MÉTODO: Trata-se de uma Revisão Integrativa de Literatura do tipo qualitativo-descritivo. A busca automática utilizou-se das bases SCIELO e PUBMED, adotando como critérios de inclusão artigos, publicados no período de 2017 a 2021, dentro da abordagem temática proposta e no idioma Inglês, e nos de exclusão, enquadrou-se aqueles divergentes das diretrizes estipuladas. RESULTADOS: Dentre os 10 artigos selecionados, foi factível analisar as características imunológicas da Insuficiência Renal Aguda (IRA) em pacientes com Covid-19. Evidenciou-se a presença de proteína do nucleocapsídeo, macrófagos CD68+ e C5b-9 na região tubular proximal, demonstrando que o novo coronavírus é capaz de lesionar direta e indiretamente, mediante células do complemento e ação dos macrófagos. Análises imuno-histoquímicas observaram a presença de neutrófilos nos glomérulos e tubulointersticial, agregados de eritrócitos bloqueando capilares peritubulares e trombos de fibrina segmentar na região glomerular. Ademais, o Sars-CoV-2 apresenta tropismo com células que expressam ACE2, de modo que envolve uma resposta adaptativa inadequada do sistema imunológico, acarretando em tempestade de citocinas e lesão renal. CONCLUSÃO: Em conformidade com os dados apresentados, conclui-se que as lesões renais se devem à superexpressão de ACE2 nas células tubulares proximais. A proteinúria, consequência desse mecanismo lesivo, é um fator importante para o desenvolvimento de IRA. A incidência desta é aumentada em grau conformativo com a gravidade do paciente com Covid-19, o que foi indicado pelos valores prognósticos. Devendo, portanto, haver uma maior preocupação com a função renal no cuidado desses pacientes.
Publicado
2021-04-24
Como Citar
Brandão, J. B. S., De Andrade, I. A., Santos, M. E. A., Rodriguez, P. C. R., & Cunha , R. X. (2021). INFECÇÃO POR SARS-COV-2 E RELAÇÃO FISIOPATOLÓGICA COM INJÚRIA RENAL. Revista Multidisciplinar Em Saúde, 2(2), 57. https://doi.org/10.51161/rems/1000
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Smarty_Template_Compiled.render(Object:Smarty_Internal_Template) % line 216, file: smarty_internal_template.php
Smarty_Internal_Template.render(false, 1) % line 232, file: smarty_internal_templatebase.php
Smarty_Internal_TemplateBase._execute(Object:Smarty_Internal_Template, null, 42362804174f266c598cdb32c3208fc745b92101, null, 1) % line 134, file: smarty_internal_templatebase.php
Smarty_Internal_TemplateBase.display(frontend/pages/article.tpl, null, 42362804174f266c598cdb32c3208fc745b92101, null) % line 924, file: PKPTemplateManager.inc.php
PKPTemplateManager.display(frontend/pages/article.tpl) % line 292, file: ArticleHandler.inc.php
ArticleHandler.view(Array[1], Object:Request) % line 391, file: PKPRouter.inc.php
PKPRouter._authorizeInitializeAndCallRequest(Array[2], Object:Request, Array[1], false) % line 231, file: PKPPageRouter.inc.php
PKPPageRouter.route(Object:Request) % line 143, file: Dispatcher.inc.php
Dispatcher.dispatch(Object:Request) % line 281, file: PKPApplication.inc.php
PKPApplication.execute() % line 68, file: index.php
Deprecated: Function get_magic_quotes_runtime() is deprecated in /home/editoraime/public_html/revistas/lib/pkp/lib/vendor/adodb/adodb-php/adodb.inc.php on line 2067
Deprecated: Function get_magic_quotes_runtime() is deprecated in /home/editoraime/public_html/revistas/lib/pkp/lib/vendor/adodb/adodb-php/adodb.inc.php on line 2067
ADOConnection.CacheExecute(3600, SELECT o.submission_id, MAX(s.context_id) AS journal_id, MAX(i.date_published) AS i_pub, MAX(p.date_published) A..., Array[2]) % line 132, file: DAO.inc.php
DAO.retrieveCached(SELECT o.submission_id, MAX(s.context_id) AS journal_id, MAX(i.date_published) AS i_pub, MAX(p.date_published) A..., Array[2], 3600) % line 91, file: ArticleSearchDAO.inc.php
ArticleSearchDAO.getPhraseResults(Object:Journal, Array[1], null, null, , 500, 1) % line 201, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedPhraseResults(Object:Journal, Array[1], , null, null, 500, 1) % line 146, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[4], , null, null, 500, 1) % line 194, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedPhraseResults(Object:Journal, Array[4], null, null, null, 500, 1) % line 146, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[3], null, null, null, 500, 1) % line 132, file: SubmissionSearch.inc.php
SubmissionSearch._getMergedArray(Object:Journal, Array[1], null, null) % line 263, file: SubmissionSearch.inc.php
SubmissionSearch.retrieveResults(Object:Request, Object:Journal, Array[1], null, null, null, Object:DBResultRange, Array[1]) % line 92, file: RecommendBySimilarityPlugin.inc.php
RecommendBySimilarityPlugin.callbackTemplateArticlePageFooter(Templates::Article::Footer::PageFooter, Array[3]) % line 107, file: HookRegistry.inc.php
HookRegistry.call(Templates::Article::Footer::PageFooter, Array[3]) % line 1267, file: PKPTemplateManager.inc.php
PKPTemplateManager.smartyCallHook(Array[1], Object:Smarty_Internal_Template) % line 43, file: 42362804174f266c598cdb32c3208fc745b92101^1c372c95cd85572e0fbc9a53d0323a0b229cfc78_0.app.frontendpagesarticle.tpl.php
content_6781613650b432_13896783(Object:Smarty_Internal_Template) % line 123, file: smarty_template_resource_base.php
Smarty_Template_Resource_Base.getRenderedTemplateCode(Object:Smarty_Internal_Template) % line 114, file: smarty_template_compiled.php
Smarty_Template_Compiled.render(Object:Smarty_Internal_Template) % line 216, file: smarty_internal_template.php
Smarty_Internal_Template.render(false, 1) % line 232, file: smarty_internal_templatebase.php
Smarty_Internal_TemplateBase._execute(Object:Smarty_Internal_Template, null, 42362804174f266c598cdb32c3208fc745b92101, null, 1) % line 134, file: smarty_internal_templatebase.php
Smarty_Internal_TemplateBase.display(frontend/pages/article.tpl, null, 42362804174f266c598cdb32c3208fc745b92101, null) % line 924, file: PKPTemplateManager.inc.php
PKPTemplateManager.display(frontend/pages/article.tpl) % line 292, file: ArticleHandler.inc.php
ArticleHandler.view(Array[1], Object:Request) % line 391, file: PKPRouter.inc.php
PKPRouter._authorizeInitializeAndCallRequest(Array[2], Object:Request, Array[1], false) % line 231, file: PKPPageRouter.inc.php
PKPPageRouter.route(Object:Request) % line 143, file: Dispatcher.inc.php
Dispatcher.dispatch(Object:Request) % line 281, file: PKPApplication.inc.php
PKPApplication.execute() % line 68, file: index.php
Notice: Deprecated call to Smarty2 function get_template_vars in /home/editoraime/public_html/revistas/lib/pkp/classes/template/PKPTemplateManager.inc.php on line 1930
Notice: Deprecated call to Smarty2 function get_template_vars in /home/editoraime/public_html/revistas/lib/pkp/classes/template/PKPTemplateManager.inc.php on line 1930
Notice: Deprecated call to Smarty2 function get_template_vars in /home/editoraime/public_html/revistas/lib/pkp/classes/template/PKPTemplateManager.inc.php on line 1930
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