Biomarcadores laboratoriais como preditores de gravidade em pacientes COVID-19: uma revisão de literatura

Abstract

COVID-19 is a pathogenic and highly transmissible viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), which can progress to serious cases and promote acute respiratory distress syndrome (ARDS). SARS-CoV-2 virus gets into the hostage cell by angiotensin-converting enzyme 2 (ACE-2), which is present in various tissues and acts as a receptor. The primary infection occurs by airways, where cells possess ACE-2, which allows virus entry into the cells and its proliferation. COVID-19’s physiopathology is not well founded yet; however, it is believed that it evolves into severe cases by cytokine storm, which promotes a dysregulation on immune response, being able to generate severe infection on the lower respiratory tract, as well as ARDS and extrapulmonary manifestations, like diarrhea, lymphopenia, liver and kidney damage, besides dysfunction syndrome of multiple organs. Laboratory tests are of a major importance for monitoring patient’s clinical conditions, once it gives information about case evolution, and that enlightening is valuable to guide health care workers and, that way, they are able to optimize clinical management of each case. COVID-19 quickly evolves into sever cases, and the mechanisms which initiate this aggravation are not totally elucidated. Thereby, it is of a major importance to evaluate biomarkers which are effective to predict severe cases evolution, with the goal to optimize clinical management and therapeutics to avoid a high number of deceased. After analyzing a large number of articles related to alterations of laboratory markers during COVID-19, it was possible to highlight hematological, inflammatory, coagulation and biochemical biomarkers, which have the capacity to predict the possibility of an evolution into a serious case. It was observed that a raise in WBC, neutrophils, PT, PTT, LDH, ferritin, NRL, CRP, IL-6 and d-dimer, as well as a decrease in lymphocyte count, are markers capable of predicting the severity of this disease, being theNRL, CRP, IL-6 and D-dimer independent predictors.