O papel do gerenciamento clínico e as perspectivas de vacinação para pacientes com doença inflamatória intestinal durante pandemia de COVID-19
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Data
2021-12-17
Autores
Oliveira, Alice Crispim de
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Universidade Estadual Paulista (Unesp)
Resumo
A doença de Crohn e retocolite ulcerativa são as principais doenças inflamatórias intestinais (DII) e seu gerenciamento clínico é realizado com atuação de equipe multidisciplinar, sendo que as terapias para DII visam modular a resposta imunológica ou efeitos anti-inflamatórios locais. Pensando na pandemia causada pelo vírus SARS-Cov-2, seria a população com DII vulnerável a infecção, com potencial piora devido ao tratamento imunossupressor utilizado usualmente? Dessa forma, este trabalho analisa o papel do gerencimaneto clínico dessa população durante a pandemia. Como metodologia, foram analisados artigos publicados no período entre julho de 2020 e setembro de 2021. O gerenciamento clínico dos indivíduos com DII durante a pandemia foi evoluindo e novas diretrizes foram publicadas para auxiliar os profissionais de saúde atuantes no manejo de DII, visando à minimização de risco e a melhor tomada de decisão para cada caso. Embora muito ainda seja necessário para compreender as consequências da associação entre DII e COVID-19, um consenso existe, pacientes com DII devem ser vacinados, embora ainda sejam necessários novos estudos e monitoramentos para avaliar quanto à resposta imunológica desses indivíduos e a frequência em que a vacina deverá ser reforçada. Por outro lado, as medidas de distanciamento social, o uso de máscara e higienização devem permanecer para todos, visto que a pandemia ainda permanece ativa.
Crohn's Disease and Ulcerative colitis are the main inflammatory bowel diseases and their clinical management is performed by a multidisciplinary team, with the therapies for IBD aim to improve the immune response or present local anti-inflammatory effects. Thinking about the pandemic scenario of COVID-19 and the hypothesis of the infection mechanism associated, which acts in different digestive cells, this review is a reflection on the role of clinical management of patients with inflammatory bowel disease, thinking about potential risks to COVID-19, and about the vaccination perspectives for this population. As methodology, some articles published between July 2020 and September 2021 was analyzed. The clinical management of individuals with IBD during the pandemic was evolving and new guidelines were published to assist healthcare professionals acting in the management of IBD, aiming at risk minimization and the best decision making for each case. Much remains to be done to understand the inflammatory potential of IBD and its association, especially in the long term, with COVID-19. IBD patients should be vaccinated, although further studies and monitoring are still needed to assess how well the immune response of these individuals and the frequency at which the vaccine will be applied. Thus, social distancing measures, mask wearing and sanitizing should remain for all, as the pandemic still remains ongoing.
Crohn's Disease and Ulcerative colitis are the main inflammatory bowel diseases and their clinical management is performed by a multidisciplinary team, with the therapies for IBD aim to improve the immune response or present local anti-inflammatory effects. Thinking about the pandemic scenario of COVID-19 and the hypothesis of the infection mechanism associated, which acts in different digestive cells, this review is a reflection on the role of clinical management of patients with inflammatory bowel disease, thinking about potential risks to COVID-19, and about the vaccination perspectives for this population. As methodology, some articles published between July 2020 and September 2021 was analyzed. The clinical management of individuals with IBD during the pandemic was evolving and new guidelines were published to assist healthcare professionals acting in the management of IBD, aiming at risk minimization and the best decision making for each case. Much remains to be done to understand the inflammatory potential of IBD and its association, especially in the long term, with COVID-19. IBD patients should be vaccinated, although further studies and monitoring are still needed to assess how well the immune response of these individuals and the frequency at which the vaccine will be applied. Thus, social distancing measures, mask wearing and sanitizing should remain for all, as the pandemic still remains ongoing.
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Palavras-chave
Inflammatory bowel disease, clinical management, vaccination, covid-19, Doença inflamatória intestinal, gerenciamento, vacinação