A vacina protege das mutações da Covid-19?

Sequelas pós- Covid-19 também são um alerta dos médicos à população

Por Daniele Haller
daniele.haller@mulheresjornalistas.com

Reino Unido, África do Sul e Brasil são os países onde foram identificadas as novas variantes do Sars-CoV-2. À medida que vai se espalhando, o vírus sofre mutações, mas o que isso significa?

Após um ano do início da pandemia, ainda há muito o que descobrir a respeito do Sars-CoV-2, em especial com relação as mutações que o vírus vem sofrendo. Mesmo as sequelas ainda são uma dúvida no meio científico, até onde e por quanto tempo elas podem prejudicar a vida das pessoas que foram infectadas? As vacinas já estão sendo aplicadas desde o final de 2020, mas a eficácia contra as novas variantes, continua a mesma?

Até o momento, três variantes foram identificadas e estão sendo estudadas, são elas: a variante do Reino Unido (B.1.1.7), da África do Sul (B.1.351) e a variante do Brasil (P.1). O que sabemos a respeito delas? A repórter Daniele Haller, do Instituto Mulheres Jornalistas, entrevistou a médica Otília Lupi, infectologista da Fiocruz. No ano passado, Otília atuou como médica visitante no Hospital Pitié Salpetrière, em Paris, e acompanhou de perto o início da pandemia na Europa.

Médica Infectologista Otília Lupi, coronavirus, covid-19, sintomas, sequelas, instituto mulheres jornalistas
Médica Infectologista Otília Lupi

Sobre as variantes da Covid-19 que têm surgido até agora, ela explica que essas mutações são comuns com todos os vírus, como uma forma de se tornar mais resistente: “Na medida que vai surgindo em diferentes regiões, vão surgir as mutações. A variante britânica permitiu que o vírus seja mais transmissível, a carga excretada é maior e por isso domina o número de casos e internações. Ele é mais
frequente, incide mais, no entanto, não se pode afirmar que é o mais letal”, afirma a médica.

Apesar de incidirem com mais frequência, ainda não há certeza sobre a letalidade das mutações. Segundo Otília Lupi, das cepas identificadas, a da África do Sul está em maior evidência, mas ainda há dúvidas sobre sua letalidade. “Aparentemente, a cepa brasileira é uma variante da mutação encontrada na África do Sul”, segundo a médica, mas afirma estar sendo analisada, ainda não há confirmações.

A eficácia das vacinas tem sido uma dúvida diante das variantes da Covid-19, a respeito do tema, a infectologista diz: “Dentro do cenário brasileiro, a vacina com vírus inativado, a Coranavac, tem maior potencial de eficácia”. Segundo Otília Lupi, com o tempo, as vacinas de método RNA possivelmente precisarão passar por algumas alterações e serem adaptadas. As vacinas de RNA, como a da Pfizer e a Moderna, é um novo imunizante que faz com que as células sintetizem uma proteína que vai estimular uma resposta imunológica. Já as vacinas de vírus inativado, como a Coronavac, utilizam o vírus atenuado ou inativado para provocar a defesa do
sistema imunológico do corpo.

Questionada sobre se as vacinas podem ser aplicadas em pessoas que já foram infectadas, Otilia Lupi comenta: “Todas as pessoas devem ser vacinadas, mas o ideal seria investigar quem já foi infectado. No entanto, não é uma realidade possível, porque muitas pessoas infectadas foram assintomáticas, então não podemos ter certeza de quem já foi ou não infectado. Também não temos
conhecimento do quanto a doença garante de proteção, ainda é cedo para dizer, sem tempo suficiente para saber por quanto tempo o vírus vai proteger a pessoa que já foi infectada. O mais sensato é que se vacine de forma máxima”, conclui.

Sobre se existe alguma recomendação para quem já testou positivo e irá se vacinar, a infectologista explica: “O indicado é que quem foi recentemente infectado, deve evitar se vacinar logo em seguida, porque pode perder a eficácia da vacina. O ideal é que essa pessoa se vacine numa distância de 4 semanas após a recuperação da Covid-19”. Otília Lupi reforça que, antes de se vacinar, a pessoa não deve apresentar mais nenhum sintoma da doença.

Mesmo após a recuperação, pessoas infectadas ainda se queixam de sequelas deixadas pelo vírus

Núbia Voss Reis, entrevista, mulheres jornalistas, coroavirus, sintomas, sequelas
Núbia Voss Reis, psicóloga, relata seus sintomas durante e pós covid-19

A psicológa Núbia Voss Reis foi diagnosticada com Covid-19 em dezembro de 2020, os primeiros sintomas foram apenas espirros e coriza, logo após, iniciaram outros sintomas como pressão no peito. Durante o período de isolamento, apresentou tosse, dor de cabeça, falta de ar, perda do olfato e paladar. Após a recuperação, ela comenta: “Depois de cerca de 12 dias, meu olfato e paladar voltaram, também tive cansaço, mas nada exagerado, consegui desempenhar minhas atividades normalmente. E agora, há duas semanas eu comecei com uma tontura que parece com uma labirintite. É uma tontura que vem de repente, dependendo do movimento brusco que faço, não tenho controle sobre ela , eu tenho que esperar passar, não demora muito, mas existe”, comenta.

Assim como Núbia, inúmeras pessoas relatam sintomas como estes durante e após a infecção, mas as complicações podem ir além. Segundo o relatório divulgado pela Organização Pan-americana de Saúde, em agosto de 2020, a principal sequela nos pacientes que desenvolveram quadro clínico grave é a fibrose pulmonar. No relatório consta: “Na fase seguinte da infecção, que geralmente ocorre entre a segunda e a quinta semana, os pulmões apresentam sinais de fibrose (…) Durante o estágio final, entre a sexta e a oitava semana, o tecido pulmonar torna-se fibrótico”. Além das consequências no aparelho respiratório, o sistema cardiovascular também pode ser afetado. Pacientes em estado grave da infecção também apresentaram lesões miocárdicas e arritmias. Além destas, o relatório também cita sequelas neuropsiquiátricas e psicológicas após a recuperação da doença.

fisioterapeuta Lilian Ramine Ramos
Fisioterapeuta Lilian Ramine Ramos

Diante das complicações pós-Covid, a reabilitação tem um papel fundamental na recuperação desses pacientes. A respeito deste tema, conversamos com uma Especialista em Reabilitação Neurofuncional, a fisioterapeuta Lilian Ramine Ramos, ela comenta: “A reabilitação deve ser baseada em uma avaliação criteriosa de todas as funções comprometidas, visto que é uma doença que pode acometer de forma sistêmica o corpo. No geral, pacientes que adquirem a forma grave e necessitam ficar internados na UTI, necessitarão de uma reabilitação com ênfase na função cardiorrespiratória e motora também. A reabilitação deve ser aplicada por um
fisioterapeuta em conjunto com uma equipe multiprofissional especializada para direcionar e nortear o tratamento”, conclui a especialista, que também é doutoranda em Reabilitação e Desempenho Funcional.

É importante lembrar que especialistas aconselham que as medidas de higiene e proteção contra infecções devem continuar mesmo após a vacinação. Hábitos como lavar as mãos frequentemente, usar máscaras e o uso de produtos com ação antiviral devem continuar, pois uma pessoa vacinada ainda pode ser uma portadora assintomática do vírus

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