COVID-19 e Doença Cardiovascular: O Impacto da Pandemia
DOI:
https://doi.org/10.24950/R/163/20/1/2021Palavras-chave:
COVID-19, Doenças Cardiovasculares, Infecções por Coronavírus, SARS-CoV-2Resumo
SARS-CoV-2, o novo coronavírus, surpreendeu o mundo com a sua capacidade de infecção, causando uma preocupação emergente de saúde pública com mais de 3 milhões de pessoas afetadas em apenas quatro meses. A taxa de mortalidade é variável entre os países, considerando as suas estruturas etárias e o percentual de comorbilidades. Os Idosos e as pessoas com doenças subjacentes são mais suscetíveis ao desenvolvimento de casos graves de COVID-19 e têm maior taxa de mortalidade. As doenças cardiovasculares têm uma importância particular, uma vez que a sua prevalência é elevada e considerando a fisiopatologia da infecção. O vírus usa os receptores da enzima de conversão da angiotensina (ECA) 2 para invadir as células humanas. Esses receptores estão principalmente nos pulmões e no coração. Além do dano viral direto, a hipóxia, a tempestade de citocinas e a libertação de catecolaminas também afetam esses órgãos. No coração, estudos mostraram que a COVID-19 pode causar miocardite, arritmias ventriculares, síndrome coronária aguda e insuficiência cardíaca. Além disso, a lesão cardiovascular pode ser a primeira manifestação de infecção viral em alguns casos, motivo de maior preocupação durante esta pandemia. Os inibidores da ECA e os bloqueadores dos receptores da angiotensina (BRA) são medicamentos de suma importância no tratamento de doenças cardiovasculares. No entanto, alguns estudos sugeriram preocupação com esses medicamentos na COVID-19, pois eles poderiam causar um aumento da ECA2 e aumentar a gravidade da infeção. Até onde sabemos, nenhum estudo demonstrou que inibidores da ECA ou ARA são prejudiciais e as principais sociedades cardiovasculares recomendam a continuidade do tratamento.
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