SÍNDROME DE CUSHING E COVID-19: UMA REVISÃO DE LITERATURA.

Júlia Leitão  Cabral; Beatriz Diniz  Oliveira; Maria Luiza Paiva da  Silva; Marilya Oliveira  Ellery; Silvia Fernandes Ribeiro da  Silva

doi:10.51161/rems/2968

SÍNDROME DE CUSHING E COVID-19: UMA REVISÃO DE LITERATURA.

Autores

Júlia Leitão Cabral
Beatriz Diniz Oliveira
Maria Luiza Paiva da Silva
Marilya Oliveira Ellery
Silvia Fernandes Ribeiro da Silva

DOI:

https://doi.org/10.51161/rems/2968

Palavras-chave:

COVID-19, HIPERCORTISOLISMO, SÍNDROME DE CUSHING

Resumo

Introdução: A Síndrome de Cushing (SC) é considerada uma doença complexa, caracterizada pelo excesso crônico de glicocorticoides (GC), podendo ser de origem endógena, devido a uma hiperprodução de cortisol pela glândula suprarrenal, ou exógena, decorrente da administração crônica de GC. Alguns dos efeitos metabólicos do GC incluem resistência insulínica, obesidade, diabetes, doenças cardiovasculares e risco de acidente vascular cerebral. Diante disso, a SC torna-se uma comorbidade multifatorial para a Covid-19. Objetivos: Avaliar a susceptibilidade de pacientes com SC contraírem o Sars-CoV-2 e apresentarem complicações da Covid-19. Material e métodos: Este resumo foi elaborado com base em uma revisão literária de quatro artigos, publicados entre 2020 e 2021 e pesquisados nas bases de dados PubMed e BVS, cujos descritores foram “Cushing”, “Covid-19” e "corticosteróides". Resultados: Pacientes com SC apresentam um maior risco de infecção pelo Sars-CoV-2 devido à imunossupressão causada pela exposição excessiva ao GC, podendo acarretar aumento da secreção de citocinas pró-inflamatórias (IL-6 e TNF-alfa), com consequente dano tecidual decorrente de hiperinflamação. Além disso, o GC em excesso pode promover a diminuição do número de linfócitos e inibição da função dos linfócitos T auxiliares, favorecendo o desenvolvimento de infecção por microrganismo intracelular, como o Sars-CoV-2. Ademais, as comorbidades metabólicas associadas ao hipercortisolismo estão associadas com o elevado risco de mortalidade da Covid-19. Por exemplo, a obesidade visceral, por excesso de GC, potencializa o depósito de gordura no tecido adiposo que expressa receptores da enzima conversora da angiotensina 2 (ECA2), facilitando, assim, a entrada do Sars-CoV-2 nas células adiposas pela ligação da sua proteína Spike ao receptor ECA-2. Vale ressaltar que o tratamento de pacientes com SC infectados pelo Sars-CoV-2 é desafiador, pois além de não ser recomendado o uso de GC como em pacientes normometabólicos, existe um alto risco de tromboembolismo. Conclusão: Pacientes com hipercortisolismo, e consequente deterioração imunológica, possuem alta susceptibilidade à infecção pelo Sars-CoV-2, podendo experienciar um quadro clínico de Covid grave e enfrentar dificuldades associadas ao tratamento com GC.

Publicado

2021-12-21

Como Citar

Cabral, J. L. ., Oliveira, B. D. ., Silva, M. L. P. da ., Ellery, M. O. ., & Silva, S. F. R. da . (2021). SÍNDROME DE CUSHING E COVID-19: UMA REVISÃO DE LITERATURA. Revista Multidisciplinar Em Saúde, 2(4), 202. https://doi.org/10.51161/rems/2968

Baixar Citação

Edição

v. 2 n. 4 (2021)

Seção

I Congresso Brasileiro de Saúde Pública On-line: Uma abordagem Multiprofissional

Licença

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

O conteúdo desta revista foi migrado para https://editoraintegrar.com.br

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Dispatcher.dispatch(Object:Request) % line  281, file: PKPApplication.inc.php
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