Manifestações cardíacas agudas em adultos com diagnóstico de COVID-19
DOI:
https://doi.org/10.33448/rsd-v12i11.43624Palavras-chave:
Cardiopatias; Doença cardíaca; COVID-19.Resumo
Introdução: Lesões cardíacas são frequentemente observadas em indivíduos com diagnóstico de COVID-19. No entanto, na maioria dos casos os pacientes são assintomáticos, podendo manifestar aumento dos níveis sanguíneos de troponina, disfunção miocárdica e anormalidades eletrocardiográficas. O presente estudo tem como objetivo revisar bibliograficamente as manifestações cardíacas agudas em adultos com diagnostico de SARS-CoV-2. Metodologia: Revisão integrativa de literatura, com levantamento nas bases de dados: PubMed, Scielo e UpToDate. Os critérios de inclusão e exclusão foram aplicados, totalizando uma seleção de 60 artigos para compor o estudo. Resultados e discussão: Na maioria dos casos a sintomatologia clínica dos pacientes com lesão cardíaca aguda é compatível com os sintomas típicos da COVID-19. As doenças cardíacas são diagnosticadas através de exames laboratoriais, eletrocardiogramas ou de imagem. Em relação a síndrome coronariana aguda, o infarto agudo do miocárdio é ocasionado devido a incompatibilidade entre a oferta e a demanda de oxigênio na maior parte dos casos. Relatos descrevendo miocardite suspeita foram publicados, no entanto até o momento não foi confirmado o diagnóstico de miocardite viral diretamente relacionada a COVID-19. Insuficiência cardíaca pode ser precipitada pelo SARS-CoV-2 em pacientes com cardiopatia prévia conhecida ou não diagnosticada. O distúrbio em destaque é a insuficiência respiratória relacionada a hipóxia resultando em choque cardiogênico. Conclusão: Comumente as lesões cardíacas relacionadas a COVID-19 se apresentam de forma assintomática. O diagnóstico precoce é de suma importância devido ao aumento nas taxas de mortalidade. Estudos buscando a confirmação de miocardite viral por COVID-19 são estimulados.
Referências
Akhmerov, A., & Marbán, E. (2020). COVID-19 and the Heart. Circulation research, 126(10), 1443–1455. https://doi.org/10.1161/CIRCRESAHA.120.317055
Alvarez-Garcia, J., Jaladanki, S., Rivas-Lasarte, M., Cagliostro, M., Gupta, A., Joshi, A., Ting, P., Mitter, S. S., Bagiella, E., Mancini, D., & Lala, A. (2021). New Heart Failure Diagnoses Among Patients Hospitalized for COVID-19. Journal of the American College of Cardiology, 77(17), 2260–2262. https://doi.org/10.1016/j.jacc.2021.03.006
Bader, F., Manla, Y., Atallah, B., & Starling, R. C. (2021). Heart failure and COVID-19. Heart failure reviews, 26(1), 1–10. https://doi.org/10.1007/s10741-020-10008-2
Bangalore, S., Sharma, A., Slotwiner, A., Yatskar, L., Harari, R., Shah, B., Ibrahim, H., Friedman, G. H., Thompson, C., Alviar, C. L., Chadow, H. L., Fishman, G. I., Reynolds, H. R., Keller, N., & Hochman, J. S. (2020). ST-Segment Elevation in Patients with Covid-19 - A Case Series. The New England journal of medicine, 382(25), 2478–2480. https://doi.org/10.1056/NEJMc2009020
Bapat, A., Maan, A., & Heist, E. K. (2020). Stress-Induced Cardiomyopathy Secondary to COVID-19. Case reports in cardiology, 2020, 8842150. https://doi.org/10.1155/2020/8842150
Bernal-Torres, W., Herrera-Escandón, Á., Hurtado-Rivera, M., & Plata-Mosquera, C. A. (2020). COVID-19 fulminant myocarditis: a case report. European heart journal. Case reports, 4(FI1), 1–6. https://doi.org/10.1093/ehjcr/ytaa212
Bilaloglu, S., Aphinyanaphongs, Y., Jones, S., Iturrate, E., Hochman, J., & Berger, J. S. (2020). Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System. JAMA, 324(8), 799–801. https://doi.org/10.1001/jama.2020.13372
Caforio, A. L. P., Baritussio, A., Basso, C., & Marcolongo, R. (2022). Clinically Suspected and Biopsy-Proven Myocarditis Temporally Associated with SARS-CoV-2 Infection. Annual review of medicine, 73, 149–166. https://doi.org/10.1146/annurev-med-042220-023859
Chen, T., Wu, D., Chen, H., Yan, W., Yang, D., Chen, G., Ma, K., Xu, D., Yu, H., Wang, H., Wang, T., Guo, W., Chen, J., Ding, C., Zhang, X., Huang, J., Han, M., Li, S., Luo, X., Zhao, J., … Ning, Q. (2020). Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ (Clinical research ed.), 368, m1091. https://doi.org/10.1136/bmj.m1091
China CDC Weekly. (2020). The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19). China
Clerkin, K. J., Fried, J. A., Raikhelkar, J., Sayer, G., Griffin, J. M., Masoumi, A., Jain, S. S., Burkhoff, D., Kumaraiah, D., Rabbani, L., Schwartz, A., & Uriel, N. (2020). COVID-19 and Cardiovascular Disease. Circulation, 141(20), 1648–1655. https://doi.org/10.1161/CIRCULATIONAHA.120.046941
Creel-Bulos, C., Hockstein, M., Amin, N., Melhem, S., Truong, A., & Sharifpour, M. (2020). Acute Cor Pulmonale in Critically Ill Patients with Covid-19. The New England journal of medicine, 382(21), e70. https://doi.org/10.1056/NEJMc2010459
Daniels, C. J., Rajpal, S., Greenshields, J. T., Rosenthal, G. L., Chung, E. H., Terrin, M., Jeudy, J., Mattson, S. E., Law, I. H., Borchers, J., Kovacs, R., Kovan, J., Rifat, S. F., Albrecht, J., Bento, A. I., Albers, L., Bernhardt, D., Day, C., Hecht, S., Hipskind, A., … Big Ten COVID-19 Cardiac Registry Investigators (2021). Prevalence of Clinical and Subclinical Myocarditis in Competitive Athletes With Recent SARS-CoV-2 Infection: Results From the Big Ten COVID-19 Cardiac Registry. JAMA cardiology, 6(9), 1078–1087. https://doi.org/10.1001/jamacardio.2021.2065
DeFilippis, E. M., Reza, N., Donald, E., Givertz, M. M., Lindenfeld, J., & Jessup, M. (2020). Considerations for Heart Failure Care During the COVID-19 Pandemic. JACC. Heart failure, 8(8), 681–691. https://doi.org/10.1016/j.jchf.2020.05.006
Dong, N., Cai, J., Zhou, Y., Liu, J., & Li, F. (2020). End-Stage Heart Failure With COVID-19: Strong Evidence of Myocardial Injury by 2019-nCoV. JACC. Heart failure, 8(6), 515–517. https://doi.org/10.1016/j.jchf.2020.04.001
Driggin, E., Madhavan, M. V., Bikdeli, B., Chuich, T., Laracy, J., Biondi-Zoccai, G., Brown, T. S., Der Nigoghossian, C., Zidar, D. A., Haythe, J., Brodie, D., Beckman, J. A., Kirtane, A. J., Stone, G. W., Krumholz, H. M., & Parikh, S. A. (2020). Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. Journal of the American College of Cardiology, 75(18), 2352–2371. https://doi.org/10.1016/j.jacc.2020.03.031
Escher, F., Pietsch, H., Aleshcheva, G., Bock, T., Baumeier, C., Elsaesser, A., Wenzel, P., Hamm, C., Westenfeld, R., Schultheiss, M., Gross, U., Morawietz, L., & Schultheiss, H. P. (2020). Detection of viral SARS-CoV-2 genomes and histopathological changes in endomyocardial biopsies. ESC heart failure, 7(5), 2440–2447. https://doi.org/10.1002/ehf2.12805
Faqihi, F., Alharthy, A., Alshaya, R., Papanikolaou, J., Kutsogiannis, D. J., Brindley, P. G., & Karakitsos, D. (2020). Reverse takotsubo cardiomyopathy in fulminant COVID-19 associated with cytokine release syndrome and resolution following therapeutic plasma exchange: a case-report. BMC cardiovascular disorders, 20(1), 389. https://doi.org/10.1186/s12872-020-01665-0
Fried, J. A., Ramasubbu, K., Bhatt, R., Topkara, V. K., Clerkin, K. J., Horn, E., Rabbani, L., Brodie, D., Jain, S. S., Kirtane, A. J., Masoumi, A., Takeda, K., Kumaraiah, D., Burkhoff, D., Leon, M., Schwartz, A., Uriel, N., & Sayer, G. (2020). The Variety of Cardiovascular Presentations of COVID-19. Circulation, 141(23), 1930–1936. https://doi.org/10.1161/CIRCULATIONAHA.120.047164
Giustino, G., Croft, L. B., Oates, C. P., Rahman, K., Lerakis, S., Reddy, V. Y., & Goldman, M. (2020). Takotsubo Cardiomyopathy in COVID-19. Journal of the American College of Cardiology, 76(5), 628–629. https://doi.org/10.1016/j.jacc.2020.05.068
Hu, H., Ma, F., Wei, X., & Fang, Y. (2021). Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin. European heart journal, 42(2), 206. https://doi.org/10.1093/eurheartj/ehaa190
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England), 395(10223), 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5
Inciardi, R. M., Lupi, L., Zaccone, G., Italia, L., Raffo, M., Tomasoni, D., Cani, D. S., Cerini, M., Farina, D., Gavazzi, E., Maroldi, R., Adamo, M., Ammirati, E., Sinagra, G., Lombardi, C. M., & Metra, M. (2020). Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19). JAMA cardiology, 5(7), 819–824. https://doi.org/10.1001/jamacardio.2020.1096
Irabien-Ortiz, Á., Carreras-Mora, J., Sionis, A., Pàmies, J., Montiel, J., & Tauron, M. (2020). Fulminant myocarditis due to COVID-19. Revista espanola de cardiologia (English ed.), 73(6), 503–504. https://doi.org/10.1016/j.rec.2020.04.005
Jabri, A., Kalra, A., Kumar, A., Alameh, A., Adroja, S., Bashir, H., Nowacki, A. S., Shah, R., Khubber, S., Kanaa'N, A., Hedrick, D. P., Sleik, K. M., Mehta, N., Chung, M. K., Khot, U. N., Kapadia, S. R., Puri, R., & Reed, G. W. (2020). Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic. JAMA network open, 3(7), e2014780. https://doi.org/10.1001/jamanetworkopen.2020.14780
Kawakami, R., Sakamoto, A., Kawai, K., Gianatti, A., Pellegrini, D., Nasr, A., Kutys, B., Guo, L., Cornelissen, A., Mori, M., Sato, Y., Pescetelli, I., Brivio, M., Romero, M., Guagliumi, G., Virmani, R., & Finn, A. V. (2021). Pathological Evidence for SARS-CoV-2 as a Cause of Myocarditis: JACC Review Topic of the Week. Journal of the American College of Cardiology, 77(3), 314–325. https://doi.org/10.1016/j.jacc.2020.11.031
Kim, I. C., Kim, J. Y., Kim, H. A., & Han, S. (2020). COVID-19-related myocarditis in a 21-year-old female patient. European heart journal, 41(19), 1859. https://doi.org/10.1093/eurheartj/ehaa288
Klok, F. A., Kruip, M. J. H. A., van der Meer, N. J. M., Arbous, M. S., Gommers, D. A. M. P. J., Kant, K. M., Kaptein, F. H. J., van Paassen, J., Stals, M. A. M., Huisman, M. V., & Endeman, H. (2020). Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thrombosis research, 191, 145–147. https://doi.org/10.1016/j.thromres.2020.04.013
Koche JC. Fundamentals of scientific methodology. Petro ́polis: voices. Sa ̃o Paulo, Brazil (2011).
Lala, A., Johnson, K. W., Januzzi, J. L., Russak, A. J., Paranjpe, I., Richter, F., Zhao, S., Somani, S., Van Vleck, T., Vaid, A., Chaudhry, F., De Freitas, J. K., Fayad, Z. A., Pinney, S. P., Levin, M., Charney, A., Bagiella, E., Narula, J., Glicksberg, B. S., Nadkarni, G., … Mount Sinai COVID Informatics Center (2020). Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection. Journal of the American College of Cardiology, 76(5), 533–546. https://doi.org/10.1016/j.jacc.2020.06.007
Li, B., Yang, J., Zhao, F., Zhi, L., Wang, X., Liu, L., Bi, Z., & Zhao, Y. (2020). Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clinical research in cardiology : official journal of the German Cardiac Society, 109(5), 531–538. https://doi.org/10.1007/s00392-020-01626-9
Libby, P., & Lüscher, T. (2020). COVID-19 is, in the end, an endothelial disease. European heart journal, 41(32), 3038–3044. https://doi.org/10.1093/eurheartj/ehaa623
Madjid, M., Safavi-Naeini, P., Solomon, S. D., & Vardeny, O. (2020). Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA cardiology, 5(7), 831–840. https://doi.org/10.1001/jamacardio.2020.1286
Meyer, P., Degrauwe, S., Van Delden, C., Ghadri, J. R., & Templin, C. (2020). Typical takotsubo syndrome triggered by SARS-CoV-2 infection. European heart journal, 41(19), 1860. https://doi.org/10.1093/eurheartj/ehaa306
Minhas, A. S., Scheel, P., Garibaldi, B., Liu, G., Horton, M., Jennings, M., Jones, S. R., Michos, E. D., & Hays, A. G. (2020). Takotsubo Syndrome in the Setting of COVID-19. JACC. Case reports, 2(9), 1321–1325. https://doi.org/10.1016/j.jaccas.2020.04.023
Modin, D., Claggett, B., Sindet-Pedersen, C., Lassen, M. C. H., Skaarup, K. G., Jensen, J. U. S., Fralick, M., Schou, M., Lamberts, M., Gerds, T., Fosbøl, E. L., Phelps, M., Kragholm, K. H., Andersen, M. P., Køber, L., Torp-Pedersen, C., Solomon, S. D., Gislason, G., & Biering-Sørensen, T. (2020). Acute COVID-19 and the Incidence of Ischemic Stroke and Acute Myocardial Infarction. Circulation, 142(21), 2080–2082. https://doi.org/10.1161/CIRCULATIONAHA.120.050809
Nguyen, D., Nguyen, T., De Bels, D., & Castro Rodriguez, J. (2020). A case of Takotsubo cardiomyopathy with COVID 19. European heart journal. Cardiovascular Imaging, 21(9), 1052. https://doi.org/10.1093/ehjci/jeaa152
Nicol, M., Cacoub, L., Baudet, M., Nahmani, Y., Cacoub, P., Cohen-Solal, A., Henry, P., Adle-Biassette, H., & Logeart, D. (2020). Delayed acute myocarditis and COVID-19-related multisystem inflammatory syndrome. ESC heart failure, 7(6), 4371–4376. https://doi.org/10.1002/ehf2.13047
Palmieri, V., Di Pietro, L., Perini, G., Barba, M., Parolini, O., De Spirito, M., Lattanzi, W., & Papi, M. (2020). Graphene Oxide Nano-Concentrators Selectively Modulate RNA Trapping According to Metal Cations in Solution. Frontiers in bioengineering and biotechnology, 8, 421. https://doi.org/10.3389/fbioe.2020.00421
Park, J. H., Moon, J. Y., Sohn, K. M., & Kim, Y. S. (2020). Two Fatal Cases of Stress-induced Cardiomyopathy in COVID-19 Patients. Journal of cardiovascular imaging, 28(4), 300–303. https://doi.org/10.4250/jcvi.2020.0125
Poissy, J., Goutay, J., Caplan, M., Parmentier, E., Duburcq, T., Lassalle, F., Jeanpierre, E., Rauch, A., Labreuche, J., Susen, S., & Lille ICU Haemostasis COVID-19 Group (2020). Pulmonary Embolism in Patients With COVID-19: Awareness of an Increased Prevalence. Circulation, 142(2), 184–186. https://doi.org/10.1161/CIRCULATIONAHA.120.047430
Qin, J. J., Cheng, X., Zhou, F., Lei, F., Akolkar, G., Cai, J., Zhang, X. J., Blet, A., Xie, J., Zhang, P., Liu, Y. M., Huang, Z., Zhao, L. P., Lin, L., Xia, M., Chen, M. M., Song, X., Bai, L., Chen, Z., Zhang, X., … Li, H. (2020). Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19. Hypertension (Dallas, Tex. : 1979), 76(4), 1104–1112. https://doi.org/10.1161/HYPERTENSIONAHA.120.15528
Richard, I., Robinson, B., Dawson, A., Aya, A., & Ali, R. (2020). An Atypical Presentation of Fulminant Myocarditis Secondary to COVID-19 Infection. Cureus, 12(7), e9179. https://doi.org/10.7759/cureus.9179
Roca, E., Lombardi, C., Campana, M., Vivaldi, O., Bigni, B., Bertozzi, B., & Passalacqua, G. (2020). Takotsubo Syndrome Associated with COVID-19. European journal of case reports in internal medicine, 7(5), 001665. https://doi.org/10.12890/2020_001665
Salah, H. M., & Mehta, J. L. (2020). Takotsubo cardiomyopathy and COVID-19 infection. European heart journal. Cardiovascular Imaging, 21(11), 1299–1300. https://doi.org/10.1093/ehjci/jeaa236
Sandoval, Y., Januzzi, J. L., Jr, & Jaffe, A. S. (2020). Cardiac Troponin for Assessment of Myocardial Injury in COVID-19: JACC Review Topic of the Week. Journal of the American College of Cardiology, 76(10), 1244–1258. https://doi.org/10.1016/j.jacc.2020.06.068
Sang, C. J., 3rd, Heindl, B., Von Mering, G., Brott, B., Kopf, R. S., Benson, P. V., & Rajapreyar, I. (2020). Stress-Induced Cardiomyopathy Precipitated by COVID-19 and Influenza A Coinfection. JACC. Case reports, 2(9), 1356–1358. https://doi.org/10.1016/j.jaccas.2020.05.068
Shi, S., Qin, M., Shen, B., Cai, Y., Liu, T., Yang, F., Gong, W., Liu, X., Liang, J., Zhao, Q., Huang, H., Yang, B., & Huang, C. (2020). Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA cardiology, 5(7), 802–810. https://doi.org/10.1001/jamacardio.2020.0950
Singh, S., Desai, R., Gandhi, Z., Fong, H. K., Doreswamy, S., Desai, V., Chockalingam, A., Mehta, P. K., Sachdeva, R., & Kumar, G. (2020). Takotsubo Syndrome in Patients with COVID-19: a Systematic Review of Published Cases. SN comprehensive clinical medicine, 2(11), 2102–2108. https://doi.org/10.1007/s42399-020-00557-w
Tavazzi, G., Pellegrini, C., Maurelli, M., Belliato, M., Sciutti, F., Bottazzi, A., Sepe, P. A., Resasco, T., Camporotondo, R., Bruno, R., Baldanti, F., Paolucci, S., Pelenghi, S., Iotti, G. A., Mojoli, F., & Arbustini, E. (2020). Myocardial localization of coronavirus in COVID-19 cardiogenic shock. European journal of heart failure, 22(5), 911–915. https://doi.org/10.1002/ejhf.1828
Tersalvi, G., Vicenzi, M., Calabretta, D., Biasco, L., Pedrazzini, G., & Winterton, D. (2020). Elevated Troponin in Patients With Coronavirus Disease 2019: Possible Mechanisms. Journal of cardiac failure, 26(6), 470–475. https://doi.org/10.1016/j.cardfail.2020.04.009
Thygesen, K., Alpert, J. S., Jaffe, A. S., Chaitman, B. R., Bax, J. J., Morrow, D. A., White, H. D., & Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction (2018). Fourth Universal Definition of Myocardial Infarction (2018). Journal of the American College of Cardiology, 72(18), 2231–2264. https://doi.org/10.1016/j.jacc.2018.08.1038
Tomasoni, D., Italia, L., Adamo, M., Inciardi, R. M., Lombardi, C. M., Solomon, S. D., & Metra, M. (2020). COVID-19 and heart failure: from infection to inflammation and angiotensin II stimulation. Searching for evidence from a new disease. European journal of heart failure, 22(6), 957–966. https://doi.org/10.1002/ejhf.1871
Tsao, C. W., Strom, J. B., Chang, J. D., & Manning, W. J. (2020). COVID-19-Associated Stress (Takotsubo) Cardiomyopathy. Circulation. Cardiovascular imaging, 13(7), e011222. https://doi.org/10.1161/CIRCIMAGING.120.011222
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X., & Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 323(11), 1061–1069. https://doi.org/10.1001/jama.2020.1585
Wichmann, D., Sperhake, J. P., Lütgehetmann, M., Steurer, S., Edler, C., Heinemann, A., Heinrich, F., Mushumba, H., Kniep, I., Schröder, A. S., Burdelski, C., de Heer, G., Nierhaus, A., Frings, D., Pfefferle, S., Becker, H., Bredereke-Wiedling, H., de Weerth, A., Paschen, H. R., Sheikhzadeh-Eggers, S., … Kluge, S. (2020). Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Annals of internal medicine, 173(4), 268–277. https://doi.org/10.7326/M20-2003
Zeng, J. H., Liu, Y. X., Yuan, J., Wang, F. X., Wu, W. B., Li, J. X., Wang, L. F., Gao, H., Wang, Y., Dong, C. F., Li, Y. J., Xie, X. J., Feng, C., & Liu, L. (2020). First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection, 48(5), 773–777. https://doi.org/10.1007/s15010-020-01424-5
Zhu N, Zhang D, Wang W et al (2020) Um novo coronavírus de pacientes com pneumonia na China, 2019.N Engl J Med 382: 727-733. https://doi.org/10.1056/NEJMoa2001017
Zheng, Y. Y., Ma, Y. T., Zhang, J. Y., & Xie, X. (2020). COVID-19 and the cardiovascular system. Nature reviews. Cardiology, 17(5), 259–260. https://doi.org/10.1038/s41569-020-0360-5
Zhong J, Tang J, Ye C, Dong L (2020) A imunologia do COVID-19: a modulação imunológica é uma opção de tratamento? Lancet Rheumatol 2: e428 – e436. https://doi.org/10.1016/S2665-9913(20)30120-X
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Leonildo Aparecido Perez Junior; Delcio Gonçalves da Silva Junior
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Autores que publicam nesta revista concordam com os seguintes termos:
1) Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
2) Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
3) Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado.
