Desordens clínicas e olfatórias na COVID-19 e o impacto da pandemia nas tentativas de suicídio
Data
2023
Autores
David, Andrea Goldwasser 
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Em janeiro de 2021, a cidade de Manaus apresentou um rápido aumento de internações por COVID-19, doença decorrente do novo coronavírus (SARS-CoV-2), devido ao surgimento da variante Gama. Mesmo com o índice de soropositividade de 76%, ou seja, "imunidade de rebanho", não foi suficiente para conter a infecção por essa nova variante, que se disseminou rapidamente para várias regiões do Brasil e continentes. As medidas visando conter a pandemia prolongaram-se além do previsto, com o surgimento de novas variantes, aumentando o número de casos, internações e óbitos. O distanciamento e isolamento social forçados são entendidos como fatores de risco para suicídio, uma vez que a solidão possui grande impacto na saúde mental. A interação social e o lazer são primordiais para o bem-estar e sua carência pode piorar os distúrbios psicológicos e a depressão. Objetivo: Avaliar as repercussões clínicas causadas pelo SARS-CoV-2 e sua variante Gama e a relação do distúrbio do olfato com sintomas de acometimento pulmonar, além de analisar o impacto na saúde mental decorrente da pandemia de COVID-19 e suas medidas de isolamento social no Estado de São Paulo. Métodos: Estudo observacional comparativo entre indivíduos acometidos pela COVID-19 em surtos ocorridos em períodos distintos da pandemia. O grupo 1 foi formado 45 adultos acometidos pela COVID-19 no período de fevereiro a março de 2021 e o grupo 2, por 46 indivíduos entre março e julho de 2020. O sequenciamento genético foi realizado para caracterizar a predominância da variante do SARS-CoV-2 nos indivíduos do presente estudo. Além dessa avaliação, foi realizado um segundo estudo comparativo de prevalência de suicídios e tentativas de suicídio registrados pelo Corpo de Bombeiros da Polícia Militar do Estado de São Paulo (SP-FRS), de janeiro de 2018 a dezembro de 2021, a partir de 9.806 ocorrências. Resultados: Os grupos foram homogêneos, compostos por adultos jovens e de meia-idade, não havendo diferença etária estatística entre os grupos. Para avaliação da cepa viral predominante no grupo 1, foram analisadas nove amostras representativas. Após o sequenciamento genético, oito apresentaram mutações compatíveis com a variante Gama. Portanto, o grupo 1 teve a variante Gama como cepa predominante no surto. Não houve diferença estatística na prevalência dos sintomas da COVID-19 nos grupos (p>0,05) e a anosmia não está relacionada ao sintoma dispneia, que indicaria acometimento pulmonar (Grupo 1: p=0,62; Grupo 2: p=0,88). Considerando as tentativas de suicídio, o biênio de 2020-2021 durante a pandemia não apresentou aumento dos suicídios em relação aos anos anteriores pré-pandemia. No ano de 2021, houve aumento significativo, em comparação aos anos pré-pandemia de 2018 e 2019, tanto para suicídios (p<0,02), quanto para tentativas (p<0,01). Porém, esse resultado está dentro da projeção de crescimento esperada para o estado de São Paulo. Conclusão: Não houve diferença entre os sintomas da COVID-19 em adultos infectados pela variante Gama e as cepas ancestrais. Anosmia não é fator preditivo para o desenvolvimento ou proteção de sintomas pulmonares. A incidência e tentativas de suicídio em São Paulo foram semelhantes à projeção de crescimento de casos pré-pandemia.
Introduction: In January 2021, the city of Manaus showed a rapid increase in hospitalizations for COVID-19, a disease caused by the new coronavirus (SARS-CoV-2), due to the emergence of the Gamma variant. Even with a seropositivity rate of 76%, "herd immunity", was not enough to contain the infection by this new variant, which spread rapidly to several regions of Brazil and continents. The emergence of a new strain of the new coronavirus, the Gamma variant, has spread to several locations in Brazil. The measures aimed at containing the pandemic lasted longer than expected, given the emergence of new strains increasing the number of cases, hospitalizations, and deaths. Distancing and forced social isolation are understood as risk factors for suicide, considering that loneliness has a significant impact on mental health. Social interaction and leisure are essential for well-being, and their lack can worsen psychological disorders and depression. Objective: To evaluate the clinical repercussions caused by SARS-CoV-2 and its Gamma variant and the relationship of olfaction disturbance with symptoms of lung involvement, as well as to analyze the mental health impact arising from the COVID-19 pandemic and its measures of social isolation in the State of São Paulo. Methods: Comparative observational study was carried out between individuals affected by COVID-19 in outbreaks that occurred during different periods of the pandemic. Group 1 consisted of 45 adults affected by COVID-19 from February to March 2021, and group 2, 46 from March to July 2020. The genetic sequencing of the virus was performed to characterize the predominance of the COVID-19 variant in the individuals of the present study. In addition to this assessment, a second comparative study of the prevalence of suicides and suicide attempts recorded by the Fire Brigade of Sao Paulo state (SP-FRS) was carried out from January 2018 to December 2021 from 9806 occurrences. Results: The groups were homogeneous, composed of young and middle-aged adults, with no statistical age difference between groups. Nine representative samples were analyzed to evaluate the predominant viral strain in group 1. After genetic sequencing, eight showed mutations compatible with the gamma variant. Therefore, group 1 had the Gamma variant as the predominant strain in the outbreak. There was no statistical difference in the prevalence of COVID-19 symptoms in the groups (p>0,05), and anosmia is not related to the dyspnea symptom that would indicate pulmonary involvement (group 1, p=0,62, group 2, p=0,88). Considering suicide attempts, the 2020-2021 biennium, during the pandemic, showed no increase in suicides compared to previous pre-pandemic years. The year 2021 alone had a significant increase compared to the pre-pandemic years 2018 and 2019 for both suicides (p<0.02) and attempts (p<0.01). However, this result is within the expected growth projection for the state of São Paulo. Conclusion: There was no difference between COVID-19 symptoms in adults infected with the Gamma variant and the ancestral strains. Anosmia is not a predictive factor for developing or protecting pulmonary symptoms. The incidence and suicide attempts in São Paulo were similar to the growth forecast before the pandemic.
Introduction: In January 2021, the city of Manaus showed a rapid increase in hospitalizations for COVID-19, a disease caused by the new coronavirus (SARS-CoV-2), due to the emergence of the Gamma variant. Even with a seropositivity rate of 76%, "herd immunity", was not enough to contain the infection by this new variant, which spread rapidly to several regions of Brazil and continents. The emergence of a new strain of the new coronavirus, the Gamma variant, has spread to several locations in Brazil. The measures aimed at containing the pandemic lasted longer than expected, given the emergence of new strains increasing the number of cases, hospitalizations, and deaths. Distancing and forced social isolation are understood as risk factors for suicide, considering that loneliness has a significant impact on mental health. Social interaction and leisure are essential for well-being, and their lack can worsen psychological disorders and depression. Objective: To evaluate the clinical repercussions caused by SARS-CoV-2 and its Gamma variant and the relationship of olfaction disturbance with symptoms of lung involvement, as well as to analyze the mental health impact arising from the COVID-19 pandemic and its measures of social isolation in the State of São Paulo. Methods: Comparative observational study was carried out between individuals affected by COVID-19 in outbreaks that occurred during different periods of the pandemic. Group 1 consisted of 45 adults affected by COVID-19 from February to March 2021, and group 2, 46 from March to July 2020. The genetic sequencing of the virus was performed to characterize the predominance of the COVID-19 variant in the individuals of the present study. In addition to this assessment, a second comparative study of the prevalence of suicides and suicide attempts recorded by the Fire Brigade of Sao Paulo state (SP-FRS) was carried out from January 2018 to December 2021 from 9806 occurrences. Results: The groups were homogeneous, composed of young and middle-aged adults, with no statistical age difference between groups. Nine representative samples were analyzed to evaluate the predominant viral strain in group 1. After genetic sequencing, eight showed mutations compatible with the gamma variant. Therefore, group 1 had the Gamma variant as the predominant strain in the outbreak. There was no statistical difference in the prevalence of COVID-19 symptoms in the groups (p>0,05), and anosmia is not related to the dyspnea symptom that would indicate pulmonary involvement (group 1, p=0,62, group 2, p=0,88). Considering suicide attempts, the 2020-2021 biennium, during the pandemic, showed no increase in suicides compared to previous pre-pandemic years. The year 2021 alone had a significant increase compared to the pre-pandemic years 2018 and 2019 for both suicides (p<0.02) and attempts (p<0.01). However, this result is within the expected growth projection for the state of São Paulo. Conclusion: There was no difference between COVID-19 symptoms in adults infected with the Gamma variant and the ancestral strains. Anosmia is not a predictive factor for developing or protecting pulmonary symptoms. The incidence and suicide attempts in São Paulo were similar to the growth forecast before the pandemic.
Descrição
Citação
DAVID, Andrea Goldwasser. Desordens clínicas e olfatórias na COVID-19 e o impacto da pandemia nas tentativas de suicídio. 2023. 103 f. Dissertação (Mestrado em Otorrinolaringologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2023.