Recomendações em cirurgias bucomaxilofaciais de urgência e emergência em tempos de COVID-19

Abstract

Embora as rotas de transmissão da COVID-19 ainda não estejam totalmente identificadas, a transmissão homem-a-homem já é uma realidade em muitos países. Este trabalho tem por objetivo reunir recomendações dos órgãos de saúde e de estudos em artigos científicos relacionadas a condutas especiais do cirurgião bucomaxilofacial no período perioperatório de urgência e emergência. A justificativa é a possibilidade de infecção cruzada por meio da inalação de partículas produzidas durante os procedimentos cirúrgicos. A abordagem desse trabalho está relacionada à rota de transmissão e a possibilidade de contaminação cruzada da COVID-19 por meio de gotículas de salivas transformadas em aerossóis. Considera-se que a adoção de condutas especiais no período periorperatório por parte do cirurgião bucomaxilofacial pode representar auxílio quanto a prevenção de transmissão do vírus tanto em relação aos profissionais quanto aos pacientes.Descritores: Infecções por Coronavírus; Assistência Perioperatória; Aerossóis; Transmissão de Doença Infecciosa do Paciente para o Profissional.ReferênciasShoji H, Fonseca EKUN, Teles GBDS, et al. Structured thoracic computed tomography report for COVID-19 pandemic. Einstein (Sao Paulo). 2020;18:eED5720.Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42.Sabino-Silva R, Jardim ACG, Siqueira WL. Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis. Clin Oral Investig. 2020;24(4):1619-21.Rodrigues MFB, Rocha LLDA, Acioly RDF, Souza DDD, Carvalho DDC, Rocha RCLD, Rocha CCLD. Special precautions in oral and maxillofacial surgeries regarding COVID-19 transmission. Preprints 2020, 2020050135 (doi: 10.20944/preprints202005.0135.v1).To KKW, Tsang OTY, Leung WS, Tam AR, Wu TC, Lung DC et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020;20(5):565-74.Ather A, Patel B, Ruparel NB, Diogenes A, Hargreaves KM. Coronavirus Disease 19 (COVID-19): Implications for Clinical Dental Care. J Endod. 2020;46(5):584-95.Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. J Dent Res. 2020;99(5):481-87.Ge ZY, Yang LM, Xia JJ, Fu XH, Zhang YZ. Possible aerosol transmission of COVID-19 and special precautions in dentistry. J Zhejiang Univ Sci B. 2020;21(5):361-68. Wang WK, Chen SY, Liu IJ, Chen YC, Chen HL, Yang CF et al. Detection of SARS-associated coronavirus in throat wash and saliva in early diagnosis. Emerg Infect Dis. 2004;10(7):1213-19.Chang L, Yan Y, Wang L. Coronavirus Disease 2019: Coronaviruses and Blood Safety. Transfus Med Rev. 2020;34(2):75-80.Spagnuolo G, De Vito D, Rengo S, Tatullo M. COVID-19 Outbreak: An Overview on Dentistry. Int J Environ Res Public Health. 2020;17(6):2094.Zucco L, Levy N, Ketchandji D, Aziz M, Ramachandran SK. Considerações perioperatórias para o novo coronavírus 2019 (COVID-19). Rochester: ASPF; 2020.Abosadegh MM, Saddki N, Al-Tayar B, Rahman SA. Epidemiology of maxillofacial fractures at a tea- ching hospital in Malaysia: a retrospective study. BioMed Res Int. 2019: 9024763.Colégio Brasileiro de Cirurgia e Traumatologia Bucomaxilofacial (CTBMF). COVID-19 - Guia de Práticas em CTBMF. Disponível em: https://www.bucomaxilo.org.br/site/noticiasdetalhes.php?cod=344amp;q=COVID19%2B%20%2BGuia%2Bde%2BPr%C3%A1ticas%2Bem%2BCTBMFamp;bsc=ativar. Acesso em: 07 de abr. de 2020.American Association of Oral and Maxillofacial Surgeons (AAOMS). Member Alert: COVID-19 Guidance for OMS Practices. Disponível em: https://www.aaoms.org/news/member-alert-covid-19-guidance-for-oms-practices. Acesso em: 10 de fev. de 2020.AOCMF International Task Force Recommendations on Best Practices for Maxillofacial Procedures during COVID-19 Pandemic. Disponível em: https://aocmf3.aofoundation.org/-/media/project/aocmf/aocmf/files/covid-19/ao_cmf_covid-19_task_force_guidelines.pdf. Acesso em: 10 de fev. de 2020.

COVID‐19 outcomes among rheumatic disease patients in Kuwait: Data from the COVID‐19 Global Rheumatology Alliance (C19‐GRA) physician registry

“…Similar findings were reported in previous studies that assessed the impact of the COVID‐19 pandemic on IRD patients 18,19 . However, some literature reported a relative male predominance among IRD patients with severe SARS‐CoV‐2 infection 20,21 …”

“…18,19 However, some literature reported a relative male predominance among IRD patients with severe SARS-CoV-2 infection. 20,21 As reported by the Jaber Hospital electronic medical registry, the total number of hospitalized patients with COVID-19 in the same time period as our data collection was 13 825. A recent comparative study 22 revealed that, compared with matched comparators, IRD patients had a higher risk of hospitalization (relative risk [RR] = 1.…”

“… 18 , 19 However, some literature reported a relative male predominance among IRD patients with severe SARS‐CoV‐2 infection. 20 , 21 …”

COVID‐19 and reported mortality cases among rheumatic disease patients in Kuwait: Data from the Global Rheumatology Alliance registry

“…33,34 Due to the depletion of B cells and diminished viral clearance, long-term rituximab therapy may result in decreased antibody formation, which might interfere with the antibody responses to inhibit viral reproduction. 35,36 Depending on the type of biological agents they receive, IRD patients may have a variable risk of poor clinical outcomes, an in-…”

“…In conclusion, B cells play an essential role in the early antiviral response, even though the innate immune system and T cells are of utmost importance 33,34 . Due to the depletion of B cells and diminished viral clearance, long‐term rituximab therapy may result in decreased antibody formation, which might interfere with the antibody responses to inhibit viral reproduction 35,36 …”