Introdução: A pandemia global causada pelo novo coronavírus (COVID-19) cursa com infecção predominantemente no sistema respiratório. O quadro clinico é classificado em leve, moderado e grave a depender do grau de virulência e/ou da resposta hiper inflamatória do hospedeiro. Sendo de caráter grave quando há aumento exacerbado dos níveis de citocinas pró-inflamatórias (IL-1, IL-6 e TNF), que por conseguinte pode resultar na Síndrome da Angústia Respiratória Aguda (SARS), Síndrome do Desconforto Respiratório Agudo (SDRA) e uma resposta inflamatória sistêmica. Portanto, o emprego dos fármacos imunomoduladores em pacientes graves tem como intuito atenuar a resposta inflamatória em prol de um melhor prognóstico para esses pacientes. Objetivo: Avaliar as evidências disponíveis sobre o efeito do tratamento da terapia imunomoduladora na COVID-19. Material e Métodos: Trata-se de uma revisão sistemática sobre os fármacos Anakinra, Inibidor de fator de necrose tumoral, Tocilizumab, Siltuximab, Sarilumab, Tofacitinib e Baracitinibe. A coleta dos dados foi realizada pelas plataformas eletrônicas Scielo, NCBI, PubMed e Clinicaltrials.gov onde foram incluídos artigos científicos publicados entre os anos de 2020 a 2021, nos idiomas português, espanhol e inglês. Sendo selecionados os estudos sobre coorte prospectivo e retrospectivo, ensaio clinico, ensaio clínico randomizado. A análise dos dados fora tabulada por meio do software Microsoft Excel® 2010 para análise descritiva. Resultados: Foram incluídos 42 estudos. Onde verificou-se redução do parâmetro inflamatório com uso de Anakinra e Siltuximabe. E diminuição da necessidade de ventilação mecânica com o emprego de Anakinra, Tocilizumabe e Siltuximabe. O aumento da sobrevida fora evidenciado com a administração de Anakinra, Siltuximabe, Tofacitinib e Baracitinib. Salienta-se que Tocilizumabe e Tofacitinib obtiveram resultados contraditórios nesse parâmetro. O tempo de internação atenuou-se com a aplicação de Anakinra e Tocilizumabe. O Inibidor De Fator De Necrose Tumoral não apresentou benefício com relação ao tempo hospitalização ou mortalidade. Conclusão: Há indícios de que o uso de imunomoduladores na COVID-19 grave podem melhorar o prognóstico dos pacientes. Entretanto, esses resultados devem ser confirmados uma vez que há estudos contraditórios e com pouca amostragem. Tal fato deve ser realizado por meio de ensaios clínicos controlados antes sua implementação como cuidado padrão na COVID-19.
Publicado
2021-10-07
Como Citar
Ribas, A. L. de A. ., Alves, D. F. D. B. ., Lucas, F. T. ., Santos, A. O. D. ., & Souza, L. F. B. . (2021). O POTENCIAL TERAPÊUTICO DOS IMUNOMODULADORES NA COVID-19. Revista Multidisciplinar Em Saúde, 2(4), 18. https://doi.org/10.51161/rems/2159
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