Banca de DEFESA: BEATRIZ REGINA LIMA DE AGUIAR

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : BEATRIZ REGINA LIMA DE AGUIAR
DATE: 05/11/2024
TIME: 14:00
LOCAL: Fiocruz Brasília - sala 07 – 1º Andar - Bloco Educacional
TITLE:

PREVALENCE OF CUTANEOUS MANIFESTATIONS OF COVID-19 IN CHILDREN, ADOLESCENTS AND ADULTS

KEY WORDS:

COVID-19; Skin Manifestations; Systematic review; Meta-analysis.

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

INTRODUCTION: Skin manifestations have been reported in patients with COVID-19. Studies suggest that these manifestations may arise from the direct action of the SARS-CoV-2 virus on epithelial cell receptors, inflammatory reactions, or immune responses. Identifying these manifestations can serve as an important criterion in the clinical evaluation of patients with a confirmed COVID-19 diagnosis and may aid in the diagnosis itself. OBJECTIVE: To present the characteristics of SARS-CoV-2 infection and how COVID-19 manifests, as well as to review the literature on skin manifestations observed in patients with a positive laboratory test for COVID-19, characterize these manifestations, and investigate possible associated factors. METHOD: This doctoral thesis consist of two systematic prevalence reviews (one focusing on children and adolescents and the other on adults and the elderly) with metanalysis, a narrative review, an opinion article on the topic. The main work. The systematic reviews were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A single search was conducted for both reviews, retrieving studies from seven databases and two sources of gray literature. A prevalence meta-analysis was performed using MetaXL® 5.3, while an association meta-analysis was conducted using Cochrane Collaboration’s Review Manager® 5.4 (RevMan 5.4). In the systematic review of children and adolescents, meta-regression by age and subgroup analysis of skin manifestations related or not related to multisystem inflammatory syndrome were performed. In the review of adults and the elderly, the certainty of evidence was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) tool for association outcomes. RESULTS: Review 1: Thirty-four studies were included in the systematic review of children and adolescents. The prevalence of skin manifestations was 27% (95% CI: 20-35; I²: 99%) with no difference in prevalence by age (p=0.62). Maculopapular rash on the extremities and trunk was the most common manifestation. Among patients with Multisystem Inflammatory Syndrome in Children (MIS-C), 49% presented with rash, with urticarial being the most frequent. There were insufficient data for association analysis. Review 2: Thirty-one studies were included in the systematic review of adult and elderly patients. The prevalence of skin manifestations was 29% (95% CI: 17-43; I²: 99%). Patients with mild to moderate COVID-19 exhibited more lesions resembling chilblains (97%), and inflammatory lesions (86%) than those with severe forms. Vascular manifestations occurred only in the elderly and were significantly associated with disease severity (p = 0). CONCLUSION: Recognizing the skin manifestations of COVID-19 may facilitate early diagnosis of the disease and its prompt management. The overall prevalence of skin manifestations was like that of other extrapulmonary symptoms and should be considered as a criterion for recommending diagnostic testing for COVID-19.

COMMITTEE MEMBERS:
Externa à Instituição - ANA GABRIELA COSTA NORMANDO - MS
Interna - 3102127 - ELAINE BARROS FERREIRA
Interna - 1278451 - ELIETE NEVES DA SILVA GUERRA
Presidente - 2528668 - PAULA ELAINE DINIZ DOS REIS
Externa à Instituição - RENATA CRISTINA DE CAMPOS PEREIRA SILVEIRA - EERP/USP