Mecanismos imunológicos da infecção pelo SARS-CoV-2 nas complicações gestacionais

Autores

DOI:

https://doi.org/10.33448/rsd-v11i4.27654

Palavras-chave:

Fatores Imunológicos; Complicações da gravidez; COVID-19; Resultado da gravidez.

Resumo

Objetivo: Analisar e sintetizar os principais mecanismos imunológicos relacionados à maior gravidade ou pior desfecho em gestantes infectadas pelo SARS-CoV-2. Métodos: Trata-se de uma revisão sistematizada de literatura que realizou buscas no Medline (via PubMed), de outubro de 2021 a janeiro de 2022, com os descritores Pregnancy complications; Immunological Factors; SARS-CoV-2, Covid-19, que buscou responder ao questionamento: “Quais mecanismos imunológicos estão relacionados à maior gravidade ou pior desfecho em gestantes infectadas pelo SARS-CoV-2?”. Elegeram-se títulos originais, escritos na língua inglesa e publicados a partir de 2020. Excluíram-se revisões ou metanálises, editoriais e títulos duplicados. A busca resultou em 189 artigos, dos quais 11 foram selecionados por preencherem os critérios de elegibilidade. Resultados: Foram encontradas alterações no funcionamento imunológico do organismo grávido que podem predispor a gestante a uma maior suscetibilidade ao SARS-CoV-2 e ao curso mais grave da doença. Incluem-se nessas alterações os níveis reduzidos de células Natural Killer e células T auxiliares do tipo 1, além do aumento do estado hiperinflamatório relacionado à ativação excessiva do sistema complemento e aumento de citocinas pró-inflamatórias, como interleucina-6 e fator de necrose tumoral-α. Além do aumento da enzima conversora de angiotensina 2 na circulação materna, que leva ao aumento da ligação viral na célula hospedeira e da infectividade. Conclusão: Devido ao impacto que os mecanismos imunológicos exercem sobre a evolução da COVID-19 na saúde materna, é evidente a importância de identificar a elevação desses biomarcadores imunológicos, que podem auxiliar na predição do prognóstico materno e na definição do tratamento adequado precoce.

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24/03/2022

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LINS, J. J. da S. C.; SOUZA, G. S. de .; MORAIS , E. M. D. de .; SILVA NETO, . P. de C. .; MAGALHÃES, J. J. F. de .; LUNA, V. L. M. .; SILVA, C. M. da .; GALVÃO, P. V. M.; CONRADO, G. A. M. Mecanismos imunológicos da infecção pelo SARS-CoV-2 nas complicações gestacionais. Research, Society and Development, [S. l.], v. 11, n. 4, p. e49211427654, 2022. DOI: 10.33448/rsd-v11i4.27654. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/27654. Acesso em: 8 jul. 2024.

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