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Abordagem farmacológica anti-inflamatória para tratamento da COVID-19
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Resumo(s)
Desde o fim do ano de 2019 que houve uma ameaça à saúde pública que alterou
a rotina e a vida de todos nós. Houve o aparecimento do novo Coronavírus, o SARS-CoV-2, que dá origem à Covid-19 que levou a uma pandemia a nível mundial. Devido à
sua fácil transmissão e mecanismo heterogéneo houve a necessidade de estudar o seu
mecanismo e arranjar uma terapêutica eficaz. O vírus entra no organismo devido à
presença de uma enzina, a Enzima de Conversão da Angiotensina 2, que permite a entrada
do vírus que, após replicação pode levar a doença grave devido a uma tempestade de
citocinas que provoca então a Síndrome Respiratória Aguda em doentes graves. De
momento, existe várias terapêuticas aprovadas pela entidade reguladora em Portugal, o
INFARMED. Em geral, a terapêutica aprovada são imunomodeladores de modo a
contrariar a inflamação criada pela entrada do vírus, mas também se incluem alguns
antivirais que se mostraram eficazes no combate à doença. Em doentes não graves, em
que os sintomas variam entre febre, dores musculares, dor de cabeça, tosse, espirros, dores
de garganta, entre outros, a terapêutica é o alívio dos sintomas presentes com Anti-Inflamatórios Não Esteroides e/ou Paracetamol.
No entanto, houve alguma controvérsia no uso de Anti-Inflamatórios Não
Esteroides por haver suposta evidência que este regulava positivamente a Enzima de
Conversão da Angiotensina 2, o que poderia levar à mais fácil infeção ou por poderem
piorar então os sintomas e levar a doença grave e ainda por haver evidência de efeitos
cardiovasculares adversos dos AINEs que são considerados fatores de risco para Infeções
Agudas do Trato Respiratório, incluindo a COVID-19.
Esta monografia pretende rever então o mecanismo e as terapêuticas já aprovadas
incluindo a imunização com vacinas. Serão discriminados os mecanismos dos anti-inflamatórios mais utilizados assim como a abordagem deles no tratamento da COVID-19, e perceber se existe então evidência negativa ou positiva no seu uso.
Since the end of 2019, there has been a threat to public health that has changed the routine and lives of all of us. There was the emergence of the new coronavirus, SARS CoV-2, which gives rise to Covid-19 that take to a pandemic in mundial level. Due to its easy transmission and heterogeneous mechanism, there was a need to study its mechanism and find an efficacy treatment. The virus enters the body due to the presence of an enzyme, the Angiotensin Converting Enzyme 2, which allows the entry of the virus that after replication can lead to a serious illness due to a cytokine storm that then causes the Acute Respiratory Syndrome in pacients with serious illness. At the moment, there are several therapies approved by the regulatory authority in Portugal, INFARMED. Most approved therapeutics are immunomodulators or immunosuppressants to counteract the inflammation created by COVID-19, but also include some antivirals that showed efficacy against de disease. In non-serious patients, where symptoms vary from fever, muscle pain, headache, cough, sneezing, sore throat, among others, therapy is the relief of symptoms with Non-Steroidal Anti-Inflammatory Drugs and/or Paracetamol. However, there has been some controversy in the use of Non-Steroidal Anti Inflammatory Drugs because there is a suspicion that it regulates Angiotensin Converting Enzyme 2 positively, which could lead to an easier infection or could worsen the symptoms and lead to a serious disease and also because there is evidence of adverse cardiovascular effects of NSAIDs that are considered risk factors for Acute Respiratory Tract Infections, including COVID-19. This monograph intends to review the mechanism and the therapies already approved, including immunization with vaccines. Also includes the mechanisms of the most used anti-inflammatories as their approach in the treatment of COVID-19, and to understand if there is a negative or positive studys in their use.
Since the end of 2019, there has been a threat to public health that has changed the routine and lives of all of us. There was the emergence of the new coronavirus, SARS CoV-2, which gives rise to Covid-19 that take to a pandemic in mundial level. Due to its easy transmission and heterogeneous mechanism, there was a need to study its mechanism and find an efficacy treatment. The virus enters the body due to the presence of an enzyme, the Angiotensin Converting Enzyme 2, which allows the entry of the virus that after replication can lead to a serious illness due to a cytokine storm that then causes the Acute Respiratory Syndrome in pacients with serious illness. At the moment, there are several therapies approved by the regulatory authority in Portugal, INFARMED. Most approved therapeutics are immunomodulators or immunosuppressants to counteract the inflammation created by COVID-19, but also include some antivirals that showed efficacy against de disease. In non-serious patients, where symptoms vary from fever, muscle pain, headache, cough, sneezing, sore throat, among others, therapy is the relief of symptoms with Non-Steroidal Anti-Inflammatory Drugs and/or Paracetamol. However, there has been some controversy in the use of Non-Steroidal Anti Inflammatory Drugs because there is a suspicion that it regulates Angiotensin Converting Enzyme 2 positively, which could lead to an easier infection or could worsen the symptoms and lead to a serious disease and also because there is evidence of adverse cardiovascular effects of NSAIDs that are considered risk factors for Acute Respiratory Tract Infections, including COVID-19. This monograph intends to review the mechanism and the therapies already approved, including immunization with vaccines. Also includes the mechanisms of the most used anti-inflammatories as their approach in the treatment of COVID-19, and to understand if there is a negative or positive studys in their use.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2022, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
SARS-CoV-2 COVID-19 Anti-Inflamatórios Citocinas Mestrado integrado - 2022