Introdução: Além das manifestações já conhecidas, como dispneia, astenia e tosse seca, pacientes com COVID-19 também podem apresentar alterações neurológicas. Dentre as mais comuns, foram identificadas: acidente vascular encefálico (AVE), Síndrome de Guillain-Barré, encefalopatia e encefalite aguda. Objetivos: Explicar os mecanismos fisiopatológicos responsáveis pelo aparecimento de encefalite aguda após infecção por COVID-19. Materiais e Métodos: Trata-se de uma revisão integrativa, em que se combinou, estrategicamente, os seguintes descritores: “SARS-CoV-2”, “COVID-19” e “Encephalitis” na base de dados PUBMED para buscar artigos que se enquadrassem nos seguintes critérios de inclusão: responder à pergunta norteadora do estudo (Quais os mecanismos envolvidos para o surgimento de encefalite aguda em pacientes com COVID-19?) e publicação na língua inglesa. Os resultados (n = 113) foram organizados no programa de revisão Rayyan QCRI e, após a leitura do título e do resumo, excluiu-se 51 artigos por não responderem à pergunta norteadora, 3 por realização de experimentos em animais e 36 devido ao desenho de estudo incompatível com a proposta desta pesquisa, restando, então, 23 artigos. Posteriormente, após a leitura completa, obteve-se uma amostra final de 6 artigos. Resultados: A neuroinflamação é o mecanismo fisiopatológico predominante observado em pacientes que apresentaram encefalite aguda após infecção por COVID-19. O vírus SARS-COV-2 integra-se com a enzima conversora de angiotensina-II (ECA2) no endotélio capilar, causando um aumento na produção de angiotensina II e a ativação da resposta imune por exacerbação de estímulos no receptor de angiotensina II (ATR2), culminando, assim, na encefalite. Sinais de neuroinflamação podem ser observados tanto no líquido cefalorraquidiano (LCR) quanto na neuroimagem nesses casos. Além disso, alguns pacientes, raramente, exibiram uma resposta autoimune que levou à encefalite, mas o mecanismo para que isso ocorresse ainda não foi esclarecido. Conclusão: Observou-se que a neuroinflamação é o mecanismo potencializador de encefalite aguda mais recorrente após infecção por COVID-19. Todavia, outros mecanismos fisiopatológicos, como a resposta autoimune, precisam de uma maior investigação para compreender sua atuação neste processo patológico.
Publicado
2021-07-28
Como Citar
Oliveira, M. de J., & Santos, A. C. D. D. . (2021). ANÁLISE DOS MECANISMOS FISIOPATOLÓGICOS PARA O SURGIMENTO DE ENCEFALITE AGUDA EM PACIENTES COM COVID-19. Revista Multidisciplinar Em Saúde, 2(3), 79. https://doi.org/10.51161/rems/1490
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