A SÍNDROME INFLAMATÓRIA MULTISSISTÊMICA PEDIÁTRICA (SIM-P) RELACIONADA À COVID-19: UM ALERTA NECESSÁRIO
DOI:
https://doi.org/10.47820/recima21.v4i3.2918Palavras-chave:
citocinas, inflamação, coronavírus, SIM-PResumo
O severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), responsável pela coronavírus disease 2019 (COVID-19), causa uma doença com apresentação clínica variável desde pacientes assintomáticos até quadros infecciosos respiratórios graves. Estudos recentes demonstraram que uma parcela de pacientes pediátricos apresenta semanas após o contato com o vírus uma resposta imunológica exacerbada, conhecida como Síndrome Inflamatória Multissistêmica Pediátrica (SIM-P). Objetivo: Conhecer as características da SIM-P no contexto da pandemia do COVID-19 em crianças. Metodologia: Revisão integrativa da literatura realizada nas bases de dados: PUBMED/Medline, Periódicos/CAPES e SciELO, utilizando-se os termos “Síndrome Inflamatória Multissistêmica Pediátrica” e “COVID-19”. Critérios de inclusão: estudos publicados entre março de 2020 e outubro de 2021, sem restrição de idioma, excluindo-se notícias, notificações, comentários ou cartas de apresentação. Resultados: Os pacientes costumam ser mais velhos predominando em hispânicos, latinos e afrodescendentes. Entre os sintomas destacam-se: febre, lesões cutâneo-mucosas, fadiga, mialgia, sintomas gastrointestinais, respiratórios, cardiovasculares e neurológicos e clinicamente possui similaridades com a doença de Kawasaki. Acredita-se que a doença é desencadeada por processo mediado por anticorpos e/ou imunocomplexos em resposta à infecção prévia, resultando em uma resposta inflamatória sistêmica intensa com aumento de citocinas pró-inflamatórias tais como: IL-1, IL-6, TNF-α. Os pacientes foram tratatos com imunomoduladores e esteróides e a maioria apresentou melhora dos sintomas em poucos dias. Conclusão: o SARS-CoV-2 possui papel central no desenvolvimento da SIM-P e, portanto, sendo importante identificação e diagnóstico precoce da SIM-P para tratar os pacientes e previnir complicações de maneira efetiva.
Downloads
Referências
BRASIL. Ministério da Saúde. Coronavírus Brasil. Painel coronavírus. Brasília, 2023. Disponível em: https://covid.saude.gov.br/. Acesso em 04/03/2023.
BEREZIN, E. N. Síndrome inflamatória multissistêmica pediátrica (síndrome associada temporalmente ao COVID-19). Sociedade de Pediatria de São Paulo, 2020. Disponível em: https://www.spsp.org.br/2020/05/19/sindrome-inflamatoria-multissistemica-pediatrica/. Acesso em: 10/09/2020.
CAMPOS, Leonardo et al. Pediatric inflammatory multisystem syndrome (PIMS) temporally related to SARS-CoV-2. Residência Pediátrica, [S.L.], v. 10, n. 2, p. 148-153, 2020.
CARDUCCI, Francesca I. Calò et al. Hyperinflammation in Two Severe Acute Respiratory Syndrome Coronavirus 2-Infected Adolescents Successfully Treated With the Interleukin-1 Inhibitor Anakinra and Glucocorticoids. Frontiers In Pediatrics, [S.L.], v. 8, p. 1-6, 30 nov. 2020.
CATTALINI, Marco et al. Defining Kawasaki disease and pediatric inflammatory multisystem syndrome-temporally associated to SARS-CoV-2 infection during SARS-CoV-2 epidemic in Italy: results from a national, multicenter survey. Pediatric Rheumatology, [S.L.], v. 19, n. 1, p. 1-11, 16 mar. 2021.
CDC, Multisystem Inflammatory Syndrome (MIS-C). Centers for Disease Control and Prevention, 2020. Disponível em: https://www.cdc.gov/mis-c/. Acesso em: 04/09/2020.
CONSIGLIO, Camila Rosat et al. The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19. Cell, [S.L.], v. 183, n. 4, p. 968-981, nov. 2020.
EL-CHAAR, Gladys. Pharmacotherapy of Acute COVID-19 Infection and Multisystem Inflammatory Syndrome in Children: current state of knowledge. Pediatric Allergy, Immunology, And Pulmonology, [S.L.], v. 33, n. 4, p. 177-189, 1 dez. 2020.
ESTEVE-SOLE, Ana et al. Similarities and differences between the immunopathogenesis of COVID-19–related pediatric multisystem inflammatory syndrome and Kawasaki disease. Journal Of Clinical Investigation, [S.L.], v. 131, n. 6, p. 1-10, 15 mar. 2021.
FABI, Marianna et al. Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection in Children: one year after the onset of the pandemic in a high-incidence area. Viruses, [S.L.], v. 13, n. 10, p. 1-15, 7 out. 2021.
FARIAS, Luís Arthur Brasil Gadelha et al. Systemic inflammatory syndrome in children during COVID-19 pandemic in Ceará state, northeastern Brazil: an observational study. Revista da Sociedade Brasileira de Medicina Tropical, [S.L.], v. 54, p. 1-6, 2021.
FAROOQ, Ayesha et al. Multisystem Inflammatory Syndrome in Children and Adolescents (MIS-C) under the Setting of COVID-19: a review of clinical presentation, workup and management. Infectious Diseases: Research and Treatment, [S.L.], v. 14, p. 1-12, jan. 2021.
FEKETEA, Gavriela et al. Vitamin D in Corona Virus Disease 2019 (COVID-19) Related Multisystem Inflammatory Syndrome in Children (MIS-C). Frontiers In Immunology, [S.L.], v. 12, p. 1-7, 8 mar. 2021.
GRIMAUD, Marion et al. Acute myocarditis and multisystem inflammatory emerging disease following SARS-CoV-2 infection in critically ill children. Annals Of Intensive Care, [S.L.], v. 10, n. 1, p. 1-5, 1 jun. 2020.
Guidance - Paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS). Royal College of Paediatrics and Child Health, 2020. Disponível em: https://www.rcpch.ac.uk/resources/guidance-paediatric-multisystem-inflammatory-syndrome-temporally-associated-covid-19-pims. Acesso em: 08/09/2020.
KORNITZER, Jeffrey et al. A Systematic Review of Characteristics Associated with COVID-19 in Children with Typical Presentation and with Multisystem Inflammatory Syndrome. International Journal Of Environmental Research And Public Health, [S.L.], v. 18, n. 16, p. 8269, 4 ago. 2021.
LEE, Pui Y. et al. Distinct clinical and immunological features of SARS–CoV-2–induced multisystem inflammatory syndrome in children. Journal Of Clinical Investigation, [S.L.], v. 130, n. 11, p. 5942-5950, 5 out. 2020.
LIMA-SETTA, Fernanda et al. Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study. Jornal de Pediatria, [S.L.], v. 97, n. 3, p. 354-361, maio 2021.
LO, Tzu-Chen; CHEN, Yu-Yen. Ocular and Systemic Manifestations in Paediatric Multisystem Inflammatory Syndrome Associated with COVID-19. Journal Of Clinical Medicine, [S.L.], v. 10, n. 13, p. 1-18, 30 jun. 2021.
NAKRA, Natasha et al. Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: review of clinical presentation, hypothetical pathogenesis, and proposed management. Children, [S.L.], v. 7, n. 7, p. 69, 1 jul. 2020.
PANARO, Salvatore et al. The Spectrum of Manifestations of Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV2) Infection in Children: what we can learn from multisystem inflammatory syndrome in children (mis-c). Frontiers In Medicine, [S.L.], v. 8, n. 747190, p. 1-10, 28 ot. 2021.
PEREZ-TOLEDO, M.et al. Serology confirms SARS-CoV-2 infection in PCR-negative children presenting with Paediatric Inflammatory Multi-System Syndrome. MedRxiv [Preprint]. 2020.
RADIA, Trisha et al. Multi-system inflammatory syndrome in children & adolescents (MIS-C): a systematic review of clinical features and presentation. Paediatric Respiratory Reviews, [S.L.], v. 38, p. 51-57, jun. 2021.
ROWLEY, A. H. Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children. Nature Reviews Immunology, v. 20, n. 8, p. 453-454, 16 jun. 2020.
SANTOS, Bruna Silva dos; SANTOS, Fernanda Silva dos; RIBEIRO, Elaine Rossi. CLINICAL-EPIDEMIOLOGICAL RELATION BETWEEN SARS-COV-2 AND KAWASAKI DISEASE: an integrative literature. Revista Paulista de Pediatria, [S.L.], v. 39, p. 1-8, 2021.
SCHLAPBACH, Luregn J. et al. Best Practice Recommendations for the Diagnosis and Management of Children With Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS; Multisystem Inflammatory Syndrome in Children, MIS-C) in Switzerland. Frontiers In Pediatrics, [S.L.], v. 9, p. 1-14, 26 maio 2021.
SHARMA, Chetan et al. Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison. Nature Reviews Rheumatology, [S.L.], v. 17, n. 12, p. 731-748, 29 out. 2021.
SIMPSON, John M.; NEWBURGER, Jane W.. Multisystem Inflammatory Syndrome in Children in Association With COVID-19. Circulation, [S.L.], v. 142, n. 5, p. 437-440, 4 ago. 2020.
TOUBIANA, J. et al. Outbreak of Kawasaki disease in children during COVID-19 pandemic: a prospective observational study in Paris, France. MedRxiv [Preprint]. 2020.
VINER, Russell M; WHITTAKER, Elizabeth. Kawasaki-like disease: emerging complication during the covid-19 pandemic. The Lancet, [S.L.], v. 395, n. 10239, p. 1741-1743, jun. 2020.
WHO, Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19. World Health Organization, 2020. Disponívelem: https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19. Acesso em: 05/09/2020.
ZHU, Yanfang P. et al. Immune response to intravenous immunoglobulin in patients with Kawasaki disease and MIS-C. Journal Of Clinical Investigation, [S.L.], v. 131, n. 20, p. 1-15, 15 out. 2021.
Downloads
Publicado
Como Citar
Edição
Seção
Categorias
Licença
Copyright (c) 2023 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
Clique para ver detalhes 
