Relação da pandemia de Covid-19 com o perfil epidemiológico em pacientes com miocardite
Tipo
TCC
Data de publicação
2024-06-20
Periódico
Citações (Scopus)
Autores
Martins, Leandro Cesar Tirelli
Fonseca, Rafaella Molleta
Fonseca, Rafaella Molleta
Orientador
Garcia, Amanda Carvalho
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Título de Volume
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Resumo
A pandemia de COVID-19, causada pelo SARS-CoV-2, trouxe desafios significativos para a saúde global, incluindo complicações cardiovasculares como a miocardite. Esta inflamação do miocárdio, frequentemente associada a infecções virais, ganhou destaque devido à sua relação com a COVID-19. Além dos sintomas respiratórios, a COVID-19 está ligada a lesões cardíacas, arritmias e insuficiência cardíaca, aumentando a morbidade e mortalidade, especialmente em pacientes com doenças cardiovasculares preexistentes. Essas complicações destacam a necessidade de atenção especial no manejo clínico de pacientes com COVID-19. OBJETIVO: Analisar as evidências da ocorrência de miocardite em pacientes vacinados contra a COVID-19 e identificar a possível relação entre o aumento no número de notificações de miocardite e a Pandemia. METODOLOGIA: O estudo epidemiológico analisou registros de eventos adversos relacionados ao uso de fármacos em nível nacional, dividindo os dados em dois grupos: o primeiro inclui todos os eventos adversos pós-vacinação contra a COVID-19 registrados na plataforma VigiMed da ANVISA; o segundo foca nos casos de miocardite após a vacinação contra a COVID-19. O período analisado foi de janeiro de 2020 a abril de 2023, abrangendo o início da pandemia até um momento em que todas as vacinas aprovadas estavam disponíveis e grande parte da população tinha sido vacinada. RESULTADOS: O estudo examinou 16.537 pacientes, dos quais 16.495 (99,75%) compreenderam o primeiro grupo e 42 (0,25%) compuseram o segundo. As mulheres representaram 62,38% e os homens 35,31% da amostra. A faixa etária mais afetada foi entre 18 e 44 anos (59,02%). A incidência de miocardite foi menor em relação aos registros gerais em 2021 (22,24%). No entanto, em 2022, houve um aumento significativo nos registros de miocardite, com uma incidência de 329,85%. As vacinas que mais causaram efeitos adversos foram, respectivamente, AstraZeneca (84,21%), Janssen (10,65%) e Pfizer (1,22%). A incidência de gravidade foi maior no segundo grupo em relação ao primeiro (78,57% - 41,05%). CONCLUSÃO: Os processos fisiopatológicos podem levar a maior morbidade e mortalidade devido à infecção viral em comparação com a resposta vacinal. A incidência de miocardite após a vacinação foi de apenas 0,2547%. Embora a miocardite possa ocorrer como reação adversa à vacinação, sua incidência e gravidade são geralmente baixas. Portanto, os benefícios da vacinação superam os riscos potenciais de inflamação e problemas cardíacos associados à infecção por COVID-19.
The COVID-19 pandemic, caused by SARS-CoV-2, has brought significant challenges to global health, including cardiovascular complications such as myocarditis. This inflammation of the myocardium, often associated with viral infections, gained prominence due to its relationship with COVID-19. In addition to respiratory symptoms, COVID-19 is linked to cardiac damage, arrhythmias and heart failure, increasing morbidity and mortality, especially in patients with pre-existing cardiovascular diseases. These complications highlight the need for special attention in the clinical management of patients with COVID-19. OBJECTIVE: To analyze evidence of myocarditis occurrence in patients vaccinated against COVID-19 and to identify the possible relationship between the increase in myocarditis notifications and the Pandemic. METHODOLOGY: The epidemiological study analyzed records of adverse events related to drug use at the national level, dividing the data into two groups: the first includes all adverse events post-COVID-19 vaccination registered on the ANVISA VigiMed platform; the second focuses on cases of myocarditis post-COVID-19 vaccination. The period analyzed was from January 2020 to April 2023, covering the onset of the pandemic until a moment when all approved vaccines were available, and a large portion of the population had been vaccinated. RESULTS: The study examined 16,537 patients, of which 16,495 (99.75%) comprised group 01 and 42 (0.25%) composed group 02. Women represented 62.38% and men 35.31% of the sample. The most affected age group was between 18 and 44 years (59.02%). The incidence of myocarditis was lower compared to general records in 2021 (22.24%). However, in 2022, there was a significant increase in myocarditis records, with an incidence of 329.85%. The vaccines that caused the most adverse effects were, respectively, AstraZeneca (84.21%), Janssen (10.65%), and Pfizer (1.22%). The severity incidence was higher in group 02 compared to group 01 (78.57% - 41.05%). CONCLUSION: Pathophysiological processes can lead to higher morbidity and mortality due to viral infection compared to the vaccine response. The incidence of myocarditis after vaccination was only 0.2547%. Although myocarditis may occur as an adverse reaction to vaccination, its incidence and severity are generally low. Therefore, the benefits of vaccination outweigh the potential risks of inflammation and heart problems associated with COVID-19 infection.
The COVID-19 pandemic, caused by SARS-CoV-2, has brought significant challenges to global health, including cardiovascular complications such as myocarditis. This inflammation of the myocardium, often associated with viral infections, gained prominence due to its relationship with COVID-19. In addition to respiratory symptoms, COVID-19 is linked to cardiac damage, arrhythmias and heart failure, increasing morbidity and mortality, especially in patients with pre-existing cardiovascular diseases. These complications highlight the need for special attention in the clinical management of patients with COVID-19. OBJECTIVE: To analyze evidence of myocarditis occurrence in patients vaccinated against COVID-19 and to identify the possible relationship between the increase in myocarditis notifications and the Pandemic. METHODOLOGY: The epidemiological study analyzed records of adverse events related to drug use at the national level, dividing the data into two groups: the first includes all adverse events post-COVID-19 vaccination registered on the ANVISA VigiMed platform; the second focuses on cases of myocarditis post-COVID-19 vaccination. The period analyzed was from January 2020 to April 2023, covering the onset of the pandemic until a moment when all approved vaccines were available, and a large portion of the population had been vaccinated. RESULTS: The study examined 16,537 patients, of which 16,495 (99.75%) comprised group 01 and 42 (0.25%) composed group 02. Women represented 62.38% and men 35.31% of the sample. The most affected age group was between 18 and 44 years (59.02%). The incidence of myocarditis was lower compared to general records in 2021 (22.24%). However, in 2022, there was a significant increase in myocarditis records, with an incidence of 329.85%. The vaccines that caused the most adverse effects were, respectively, AstraZeneca (84.21%), Janssen (10.65%), and Pfizer (1.22%). The severity incidence was higher in group 02 compared to group 01 (78.57% - 41.05%). CONCLUSION: Pathophysiological processes can lead to higher morbidity and mortality due to viral infection compared to the vaccine response. The incidence of myocarditis after vaccination was only 0.2547%. Although myocarditis may occur as an adverse reaction to vaccination, its incidence and severity are generally low. Therefore, the benefits of vaccination outweigh the potential risks of inflammation and heart problems associated with COVID-19 infection.
Descrição
Palavras-chave
miocardite , COVID-19 , vacina , myocarditis , COVID-19 , vaccine