A SÍNDROME INFLAMATÓRIA MULTISSISTÊMICA PEDIÁTRICA (SIM-P) RELACIONADA À COVID-19: UM ALERTA NECESSÁRIO
DOI:
https://doi.org/10.47820/recima21.v4i3.2918Palavras-chave:
citocinas, inflamação, coronavírus, SIM-PResumo
O severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), responsável pela coronavírus disease 2019 (COVID-19), causa uma doença com apresentação clínica variável desde pacientes assintomáticos até quadros infecciosos respiratórios graves. Estudos recentes demonstraram que uma parcela de pacientes pediátricos apresenta semanas após o contato com o vírus uma resposta imunológica exacerbada, conhecida como Síndrome Inflamatória Multissistêmica Pediátrica (SIM-P). Objetivo: Conhecer as características da SIM-P no contexto da pandemia do COVID-19 em crianças. Metodologia: Revisão integrativa da literatura realizada nas bases de dados: PUBMED/Medline, Periódicos/CAPES e SciELO, utilizando-se os termos “Síndrome Inflamatória Multissistêmica Pediátrica” e “COVID-19”. Critérios de inclusão: estudos publicados entre março de 2020 e outubro de 2021, sem restrição de idioma, excluindo-se notícias, notificações, comentários ou cartas de apresentação. Resultados: Os pacientes costumam ser mais velhos predominando em hispânicos, latinos e afrodescendentes. Entre os sintomas destacam-se: febre, lesões cutâneo-mucosas, fadiga, mialgia, sintomas gastrointestinais, respiratórios, cardiovasculares e neurológicos e clinicamente possui similaridades com a doença de Kawasaki. Acredita-se que a doença é desencadeada por processo mediado por anticorpos e/ou imunocomplexos em resposta à infecção prévia, resultando em uma resposta inflamatória sistêmica intensa com aumento de citocinas pró-inflamatórias tais como: IL-1, IL-6, TNF-α. Os pacientes foram tratatos com imunomoduladores e esteróides e a maioria apresentou melhora dos sintomas em poucos dias. Conclusão: o SARS-CoV-2 possui papel central no desenvolvimento da SIM-P e, portanto, sendo importante identificação e diagnóstico precoce da SIM-P para tratar os pacientes e previnir complicações de maneira efetiva.
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