Introduction / background / objectives:

Given the devastating impact that the COVID-19 pandemic is causing and will cause, it was intended to summarize in this bibliographic review the most relevant data published in scientific journals.

Methodology:

It is a Scoping Review, initiated through a survey conducted in March 2020 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP ”.

Content:

Some health professionals were alerted by an abnormal number of pneumonias that appeared in the city of Wuhan (Hubei Province, China), during the month of December 2019. COVID-19 is believed to have presented zoonotic transmission from a local market through live wild animals, keep in badly hygienic conditions. However, although speculated on the exact host, there are no certainties.

Like other coronaviruses, the incubation period can range from two to fourteen days (an average of 5.2 days).

Contagion is thought to occur through contact with contaminated respiratory secretions, namely aerosols, droplets and/ ou direct contact and later touching the mouth, nose and maybe eyes. Contagion is more likely at less than two meters. The microorganism can also be present in the stool (especially if there is diarrhea) and urine.

Individuals with milder symptoms did not seek medical attention so much, so they will be very likely to spread the disease; in addition, there is also the possibility of infectiousness before any symptoms appear.

The clinical presentation varies from an asymptomatic situation, passing through mild symptoms to situations of fatal pneumonia, sometimes also involving other organs and systems (such as the gastrointestinal tract, skeletal and neurological muscle) or even sepsis/ septic shock.

The most common symptoms are fever (98% of cases), cough (82%) without sputum and dyspnea (55%).

These symptoms are common to many bacterial and viral infections, usually self-limiting. Generally the most symptomatic are the most contagious, but contagion is possible with asymptomatic individuals.

Diagnostic methods can use techniques associated with ELISA (Enzyme Linked Immunosorbent Assay) or Western Blot methodology. Molecular techniques such as RT-PCR (Real Time Protein Chain Reaction) or Northern Blot hybridization can also be used. Viral antigens can be detected using IFA (Immune Fluorescent Assay) technology. Among these, the RT-PCR method is used more frequently to detect viruses in respiratory secretions; that is, through sputum, smears from the oropharynx/ tracheal or in samples of lower respiratory secretions, for example obtained by bronchoalveolar lavage.

Regarding treatment, there is currently no approved drug. It is therefore based on ventilatory support, hydration and antipyretics. If bacterial infection develops, antibiotics may be used. Several researchers are trying to get a vaccine, but none have yet been approved.

Most severe cases occur in the elderly population; part of it needs hospitalization and eventually dies. The overall associated mortality rate is about 2 to 4%; among hospitalized patients it is about 10 to 14%.

Mild cases usually recover after a week; serious situations progressively evolve to respiratory failure due to alveolar damage, which can be fatal, especially at older ages and/ or with a relevant clinical history. A fifth of individuals require hospitalization and a fifth of these will have criteria to access the Intensive Care Unit.

Conclusions:

COVID-19 is not the first or even second pandemic associated with coronavirus (although these have passed unnoticed by many) and it will almost certainly not be the last, associated with this family of viruses or any other. The incredible ease of alteration in the genetic material of microorganisms randomly creates many new mutations; a small protein difference in a capsule/ membrane/ elements that contribute to adherence, will change the organisms that there is possibility of “hosting” and/ or causing disease and thus causing an impact as brutal as we are seeing, at human, social and economic levels. Microorganisms have been around for a longer time than humans and they will stay longer, as they are incredibly better adapted to the environment.

After this distress, it is necessary to rethink the way we manage some issues and invest in technological development at the drug level (whose evolution is incredibly slower than the microorganisms), pre and/ or post exposure vaccines and software installed on mobile phones, to identify contacts with confirmed or suspected cases and mathematical/ epidemiological management of these data.

        · resumo em Português     · texto em Português     · Português ( pdf )