Title : Approach to covid-19 in immunosuppressed patients: A systematic review
Abstract:
Covid-19 is an acute respiratory disease that can range from a mild infection to a serious, potentially fatal condition. Immunosuppressed people are those whose immune systems are compromised, either due to underlying medical conditions or due to the use of immunosuppressant medications. As a result, these individuals have a reduced ability to mount an effective immune response against infections. This research proposes to review the approaches to Covid-19 in immunosuppressed patients to highlight the most efficient procedures. This work also seeks to understand factors that influence patients' morbidity and mortality rates.
Objective: The objective of the research is to analyze and synthesize the available evidence on the approach to Covid-19 in immunosuppressed patients, aiming to improve understanding of how to effectively manage this vulnerable population.
Methodology: This is a Systematic Review carried out through searches in the PubMed database. The descriptors were used: “Disease Management”, “COVID-19” and “Immunocompromised Host”. This search resulted in 19 articles, submitted to the selection criteria. The inclusion criteria were articles in English and Portuguese, published between 2019 and 2023 that addressed the themes for this research. The exclusion criteria were: duplicate articles and not associated with the proposed topic. After the selection criteria, no article was discarded.
Results: Analysis of the articles revealed that immunosuppressed patients affected by Covid-19 represent an extremely vulnerable population, facing a significantly increased risk of serious infection and mortality. This finding reinforces the importance of careful and personalized management to ensure favorable outcomes in this population. Early diagnosis has emerged as a crucial element in the care of these patients. Quickly identifying the infection allows for immediate therapeutic intervention, favoring the reduction of mortality. Early administration of treatment slows the uncontrolled spread of the pathogen, preventing overload of the already compromised immune system and mitigating serious complications. Furthermore, it was observed that the hospitalization of these patients became a necessary measure to guarantee full monitoring of the clinical evolution, as hospitalization facilitates closer monitoring of signs and symptoms, allowing immediate intervention in the face of any complications that may arise. It is noteworthy that the therapeutic approach for immunosuppressed patients with Covid-19 must be carefully adapted to the individual needs of each patient, considering factors such as the type and degree of immunosuppression, pre-existing comorbidities and potential drug interactions. A multidisciplinary approach, involving different healthcare professionals, is essential to ensure effective and comprehensive management of these complex cases.
Conclusion: It is concluded that the personalized and multidisciplinary approach is the main method to guarantee a good prognosis of the clinical condition in immunosuppressed patients. This is because collective work enables strategies that allow early diagnosis and immediate initiation of treatment, which are the main factors associated with reducing morbidity and mortality. Furthermore, hospitalization stands out as an essential tool in the care of these people as it provides full monitoring of the patients' health status, ensuring comprehensive care for them.
