REVIEW

Vasculite no Sistema Nervoso Central em Paciente com COVID-19: revisão sistemática e relato de caso

Central Nervous System Vasculitis in a Patient with COVID-19: a systematic review and case report

  • Maria Eduarda da Costa Brandão Justino (1)    Maria Eduarda da Costa Brandão Justino (1)
  • Rita de Cássia Ferreira Valença Mota (2)    Rita de Cássia Ferreira Valença Mota (2)
  • Jesuino Albino (3)    Jesuino Albino (3)
  • Thailane Marie Feitosa Chaves (3)    Thailane Marie Feitosa Chaves (3)
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  Downloads: 15

Resumo

A doença pelo Coronavírus-19, ou SARS-CoV-2 vírus, é uma patologia mundialmente conhecida como COVID-19 e com sintomatologia diversa, que vai desde apresentação assintomática até pneumonia grave e falência múltipla de órgãos. Apesar de ser doença de acometimento predominantemente pulmonar, pode lesar outros órgãos, como o sistema nervoso central e manifestar sintomas neurológicos. A vasculite do sistema nervoso central (SNC) é um grupo de patologias marcadas por infiltração de células inflamatórias e necrose das paredes dos vasos sanguíneos e apesar de todo conhecimento produzido desde 2019, o papel da COVID-19 dentro desse capítulo na Medicina intitulado “Vasculites do SNC” ainda é uma incógnita. Os objetivos desse estudo foram relatar um caso de vasculite no SNC em paciente com COVID-19 e revisar a literatura vigente. A revisão de literatura consistiu de relatos de casos publicados entre 2020 e outubro de 2022 nas bases de dados PubMed e Biblioteca Virtual em Saúde (BVS). Os dados do caso relatado foram coletados a partir dos registros de prontuário, com assinatura do TCLE pelo paciente. Dos 62 artigos encontrados, 7 foram incluídos. Apesar da dificuldade de confirmação diagnóstica de casos como o relatado nesse estudo, a apresentação e evolução, com manejo em uma unidade especializada, permitiram a hipótese diagnóstica e tomada de decisões com medidas precisas e em tempo adequado contribuindo para uma evolução satisfatória apesar da gravidade do caso. O registro dessa complicação rara e grave na COVID-19 é necessário para guiar o manejo de casos semelhantes e o estabelecimento de futuros protocolos da doença.

Palavras-chave

Vasculite; Acidente Vascular Cerebral; COVID-19; Coronavírus; Sistema Nervoso Central

Abstract

Coronavirus 19 disease or SARS-CoV-2 virus is a pathology known worldwide as COVID-19, and has diverse symptoms, ranging from asymptomatic presentation to severe pneumonia and multiple organ failure. Although it is a predominantly pulmonary disease, it can cause lesions in other organs such as the central nervous system and manifest neurological symptoms. Central nervous system (CNS) vasculitis is a group of pathologies marked by inflammatory cell infiltration and necrosis of blood vessel walls, and despite all the knowledge produced since 2019, the role of COVID-19 within this chapter in medicine entitled “CNS Vasculitides” is still an unknown. The objectives of this study were to perform a systematic review and report a case of CNS vasculitis in a patient with COVID-19 in order to analyze what is known so far about the symptoms, diagnosis, management, and possible outcomes of CNS vasculitis. A case report and a literature review of case reports published between 2020 and October 2022 in PubMed and Virtual Health Library (VHL) databases were performed. Of the 62 articles found, 7 were included. Despite the difficulty in confirming the diagnosis of cases such as the one reported in this study, presentation with severe evolution, the management in a specialized unit, with accurate and timely measures, allowed a satisfactory evolution.

Keywords

Vasculitis; Stroke; COVID-19; Coronavirus; Central Nervous System

References

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1MS, Medical student, Faculdade Pernambucana de Saúde - FPS, Recife, PE, Brazil.

2MD, MSc, Neurosurgeon, Hospital Metropolitano Oeste Pelópidas Silveira - HPS, Recife; Department of Neurosurgery, Hospital da Restauração - HR, Recife, PE, Brazil.

3MD, Neurosurgeon, Hospital Metropolitano Oeste Pelópidas Silveira - HPS, Recife; Department of Neurosurgery, Hospital da Restauração - HR, Recife, PE, Brazil.

 

Received Mar 9 , 2023

Accepted Mar 14, 2023

JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

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