MAJOR ACTIONS FOR RESEARCH, MANAGEMENT, AND ADOPTION OF
PREVENTIVE MEASURES ON SARS-COV-2 IN SEVERE ACUTE RESPIRATORY SYNDROME:
A SYSTEMATIC REVIEW
Introduction: In March 2020, the new coronavirus (COVID-19) spread throughout the world, causing respiratory disease and deaths, especially in risk groups such as the elderly, pregnant women, immunocompromised people, and others. The World Health Organization (WHO; WHO, English) declared, on January 30, 2020, that the outbreak of the disease caused by COVID-19 constitutes a Public Health Emergency of international importance. 6,287,771 cases of COVID-19 (93,246 new compared to the previous day) and 379,941 deaths (3,621 new compared to the previous day) were confirmed worldwide by June 3, 2020. In the Region of the Americas, 1,036,155 people who were infected with the new coronavirus recovered, according to data from June 3, 2020. In Brazil, on January 22, 2020, the Center for Emergency Operations in Public Health for COVID-19 has activated, a strategy provided for in the National Response Plan to Public Health Emergencies of the Ministry of Health (MH). Objective: To present, using a systematic review, the main considerations about the existing actions for notification, registration, investigation, management, and adoption of preventive measures on SARS-CoV-2 in Severe Acute Respiratory Syndrome (SARS). Methods: The present study followed a systematic review model. After literary search criteria using the MeSH terms, a total of 58 clinical studies were compared and submitted to eligibility analysis and, after that, 26 studies were selected, following the rules of PRISMA. The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), OneFile. Main findings and Conclusion: It is recommended that patients diagnosed with SARS be hospitalized and that the cases identified with the symptoms of severity are admitted to an intensive care bed. These symptoms are persistent hemodynamic instability (blood pressure that did not respond to volume replacement (30 mL/kg in the first 3 hours), indicating the use of vasoactive amine, signs, and symptoms of respiratory failure, including hypoxemia (PaO2 below 60 mmHg) in need supplementation of oxygen to maintain arterial oxygen saturation above 90%, evolution to other organic disorders, such as acute renal failure and neurological dysfunction. It was defined that the clinical criteria for hospital discharge should take into account the improvement of the clinical picture, the absence of tachydyspnea and hypoxia, the absence of O2 supplementation for at least 24 hours, hemodynamic stability, good oral acceptance and absence of fever. Prophylactic use of antibiotics has not recommended, but use should be considered suspect of associated bacterial infection.
Keywords: COVID-19. SARS-CoV-2. Severe Acute Respiratory Syndrome. Acute Respiratory Distress Syndrome. Prevention.