Skip to main content Skip to main navigation menu Skip to site footer
Published: 2021-06-12

Major Actions of Preventive Measures on Sars-Cov-2: An Updated Vision for Emergency Physicians

Brazil University, Faculty of Medicine, Fernandopolis, Sao Paulo, Brazil
Mackenzie Evangelical College of Parana, Medicine, Curitiba, Parana, Brazil
Brazil University, Faculty of Medicine, Fernandopolis, Sao Paulo, Brazil
Brazil University, Faculty of Medicine, Fernandopolis, Sao Paulo, Brazil
Brazil University, Faculty of Medicine, Fernandopolis, Sao Paulo, Brazil
Pandemia COVID-19 SARS-CoV-2 SARS Prevention Emergency department


Introduction: The new coronavirus (SARS-CoV-2), has infected more than 23 million individuals to date and has resulted in more than 800,000 deaths worldwide. The rapid spread of SARS-CoV-2 and its variants requires the urgent development of accurate diagnostic methods, effective treatments, and vaccines. The recommendations are also related to the Expert Consensus for Clinical Management of Covid-19, at the headquarters of the Pan American Health Organization / World Health Organization (PAHO / WHO) in Brasilia (Brazil). Objective: To gather the main pathophysiological considerations of COVID-19, as well as the actions of investigation, management, and adoption of preventive measures against the complications caused by SARS-CoV-2 in the emergency of hospitals. Methods: This study followed an integrative review model based on the systematic review model. The search for the articles occurred in the databases WHO, PAHO, Ministry of Health, PubMed, Embase, Ovid, Cochrane Library, and Google Scholar. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 58 clinical studies were recruited and submitted to eligibility analysis and, after that, 26 studies were selected, including official public health guidelines and regulations. To the published articles, studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies. Based on the main literary findings, as well as the main public health guidelines published in the world, patients with COVID-19 may present respiratory syndromes very similar to the common influenza virus (influenza), being a challenge for early detection during screening. in emergency departments. According to the official health agencies of Brazil (Ministry of Health) and the world (WHO/PAHO) and their regulations, 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.


  1. World Health Organization, Report of the WHO-China joint mission on Coronavirus Disease 2019 (COVID-19) 2020.
  2. World Health Organization, Advice on the use of masks the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak Interim guidance, 29 Jan. 2020. WHO/nCov/IPC_Masks/2020.1. Disponível em: Acesso em: mar. 2020.
  3. H-I. Shih, C.J. Wu, Y.F. Tu, C.Y. Chi, Fighting COVID-19: A quick review of diagnoses, therapies, and vaccines, Biomedical Journal, 43(2020) 341-354.
  4. Agência Nacional De Vigilância Sanitária (Brasil), Nota Técnica nº 04/2020. Orientações para serviços de saúde: medidas de prevenção e controle que devem ser adotadas durante a assistência aos casos suspeitos ou confirmados de infecção pelo novo coronavírus (SARS-CoV-2). Atualizada em 31 mar. 2020. Disponível em: http:// br/documents/33852/271858/Nota+T%C3%A9cnica+n+04-2020+GVIMS-GGTES-ANVISA/ ab598660-3de4-4f14-8e6f-b9341c196b28. Acesso em: mar. 2020.
  5. Associação De Medicina Intensiva Brasileira. Orientações sobre o manuseio do paciente com pneumonia e insuficiência respiratória devido a infecção pelo Coronavírus (SARS-CoV-2). Versão n. 3, 2020. Disponível em: Versao_n.032020.pdf. Acesso em: mar. 2020.
  6. Brasil, Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento do Complexo Industrial e Inovação em Saúde. Classificação de risco dos agentes biológicos. 3. ed. Brasília, DF: MS, 2017.
  7. Brasil, Ministério da Saúde. Secretaria de Vigilância em Saúde. Boletim Epidemiológico, n. 1, Brasília, DF: Secretaria de Vigilância em Saúde SVS/MS-COE, Jan. 2020. Disponível em: http:// pdf. Acesso em: mar. 2020.
  8. Brasil, Ministério da Saúde, Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Protocolo de tratamento de Influenza: 2017. Brasília, DF: MS, 2018. Disponível em: influenza_2017.pdf. Acesso em: mar. 2020.
  9. Centers For Disease Control and Prevention, Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (2019-nCoV) in a Healthcare Setting, 2020. Disponível em: Acesso em: mar. 2020.
  10. W. Guan, Z. Ni, Yu Hu, W. Liang, C. Ou, J. He, L. Liu, H. Shan, C. Lei, D.S.C. Hui, B. Du, L. Li, G. Zeng, K.-Y. Yuen, R. Chen, C. Tang, T. Wang, P. Chen, J. Xiang, S. Li, Jin-lin Wang, Z. Liang, Y. Peng, L. Wei, Y. Liu, Ya-hua Hu, P. Peng, Jian-ming Wang, J. Liu, Z. Chen, G. Li, Z. Zheng, S. Qiu, J. Luo, C. Ye, S. Zhu, and N. Zhong, for the China Medical Treatment Expert Group for Covid-19, Clinical Characteristics of Coronavirus Disease 2019 in China, New england Journal of Medicine, 382(2020) 1708-1720.
  11. C. Huang, Y. Wang, X. Li, L. Ren, J. Zhao, Yi Hu, L. Zhang, G. Fan, J. Xu, X. Gu, Z. Cheng, T. Yu, J. Xia, Y. Wei, W. Wu, X. Xie, W.Yin, H. Li, M. Liu, Y. Xiao, H.Gao, L. Guo, J. Xie, G. Wang, R. Jiang, Z. Gao, Q. Jin, J. Wang, B. Cao, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, The Lancet, 395(2020 ) 497-506.
  12. I.O. Ayenigbara, O.R. Adeleke, G.O.Ayenigbara, J.S. Adegboro, O.O. Olofintuyi, COVID-19 (SARS-CoV-2) pandemic: fears, facts and preventive measures, Germs, 10(2020) 218-228.
  13. D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, The PRISMA Group, Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLOS Medicine 6(2009): e1000097.
  14. H. Balshem, M. Helfand, H.J. Schünemann, A.D. Oxman, R. Kunz, J. Brozek, G.E. Vist, Y. Falck-Ytter, J. Meerpohl, S. Norris, G.H. Guyat, GRADE guidelines: 3. Rating the quality of evidence. Journal of Clinical Epidemiology, 64(2011) 401-406.
  15. J. Higgins, S. Green, Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration; 2011.
  16. L.E. Wee, T.P. Fua, Y.Y. Chua, A.F.W. Ho, X.Y.J. Sim, E.P. Conceicao, I. Venkatachalam, K.B. Tan, B.H. Tan, Containing COVID-19 in the Emergency Department: The Role of Improved Case Detection and Segregation of Suspect Cases, Academic Emergency Medicine, 27(2020) 379-387.
  17. S. Raoof, S. Nava, C. Carpati, N.S. Hill, High-Flow, Noninvasive Ventilation and Awake (Nonintubation) Proning in Patients With Coronavirus Disease 2019 With Respiratory Failure, Chest, 158(2020) 1992-2002.
  18. Instituto Latino Americano De Sepse. Implementação de protocolo gerenciado de Sepse: Protocolo Clínico. 2018. Disponivel em: ferramentas/protocolo-de-tratamento.pdf. Acesso em: mar. 2020.
  19. S.L. Weiss, M.J. Peters, W. Alhazzani, M.S.D. Agus, H.R. Flori, D.P. Inwald, S. Nadel, L.J. Schlapbach, R.C. Tasker, A.C. Argent, J. Brierley, J. Carcillo, E.D. Carrol, C.L. Carroll, I.M. Cheifetz, K. Choong, J.J. Cies, A.T. Cruz, D. De Luca, A. Deep, S.N. Faust, C.F. De Oliveira, M.W. Hall, P. Ishimine, E. Javouhey, K.F.M. Joosten, P. Joshi, O. Karam, M.C.J. Kneyber, J. Lemson, G. MacLaren, N.M. Mehta, M.H. Møller, C.J.L. Newth, T.C. Nguyen, A. Nishisaki, M.E. Nunnally, M.M. Parker, R.M. Paul, A.G. Randolph, S. Ranjit, L.H. Romer, H.F. Scott, L.N. Tume, J.T. Verger, E.A. Williams, J. Wolf, H.R. Wong, J.J. Zimmerman, N. Kissoon, P. Tissieres, Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children, Pediatric Critical Care Medicine, 21(2020) e52-e106.
  20. Z Wu, J.M. McGoogan, Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of72 314 Cases From the Chinese Center for Disease Control and Prevention, JAMA, 323(2020) 1239-1242
  21. S. Tian, N. Hu, J. Lou, K. Chen, X. Kang, Z. Xiang, H. Chen, D. Wang, N. Liu, D. Liu, G. Chen, Y. Zhang, D. Li, J. Li, H. Lian, S. Niu, L. Zhang, J. Zhang, Characteristics of COVID-19 infection in Beijing, Journal of Infection, 80(2020) 401-406.
  22. D. Wang, B. Hu, C. Hu, F. Zhu, X. Liu, J. Zhang, B. Wang, H. Xiang, Z. Cheng, Y. Xiong, Y. Zhao, Y. Li, X. Wang, Z. Peng, Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China, JAMA, 323(2020) 1061-1069
  23. J-J. Zhang, X. Dong, Y-Y. Cao, Y-D. Yuan, Y-B. Yang, Y-Q. Yan, C.A. Akdis, Y-D. Gao, Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China, European journal of allergy and clinical immunology, 75(2020) 1730-1741.
  24. J. Wu, J. Liu, X. Zhao, C. Liu, W. Wang, D. Wang, W. Xu, C. Zhang, J. Yu, B. Jiang, H. Cao, L. Li, Clinical Characteristics of Imported Cases of Coronavirus Disease 2019 (COVID-19) in Jiangsu Province: A Multicenter Descriptive Study, Clinical Infectious Diseases, 71(2020) 706-712.
  25. X. Yang, Y. Yu, J. Xu, H. Shu, J. Xia, H. Liu, Y. Wu, L. Zhang, Z. Yu, M. Fang, T. Yu, Y. Wang, S. Pan, X. Zou, S. Yuan, Y. Shang, Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study, The Lancet Respiratory Medicine, 8(2020) 475-481.
  26. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, Li C. The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020 Jun;55(6):327-331.
  27. Liu W, Wang F, Li G, Wei Y, Li X, He L, Analysis of 2019-nCoV Infection and Clinical Manifestations of Outpatients: An Epidemiological Study from the Fever Clinic in Wuhan, China. The Lancet, Social Science Research Network, Rochester, NY.
  28. G. Grasselli, A. Zangrillo, A. Zanella, M. Antonelli, L. Cabrini, A. Castelli, D. Cereda, A. Coluccello, G. Foti, R. Fumagalli, G. Iotti, N. Latronico, L. Lorini, S. Merler, G. Natalini, A. Piatti, M.V. Ranieri, A.M. Scandroglio, E. Storti, M. Cecconi, A. Pesenti, COVID-19 Lombardy ICU Network. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA, 323(2020) 1574-1581.
  29. A. Simonnet, M. Chetboun, J. Poissy, V. Raverdy, J. Noulette, A. Duhamel, J. Labreuche, D. Mathieu, F. Pattou, M. Jourdain, LICORN and the Lille COVID-19 and Obesity study group. High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation, Obesity (Silver Spring), 28(2020) 1195-1199.
  30. A.L. Giwa, A. Desai, A. Duca, Novel 2019 coronavirus SARS-CoV-2 (COVID-19): An updated overview for emergency clinicians, Emergency Medicine Practice, 22(2020) 1‐28.
  31. E. Mahmud, H.L. Dauerman, F.G.P. Welt, J.C. Messenger, S.V. Rao, C. Grines, A. Mattu, A.J. Kirtane, R. Jauhar, P. Meraj, I.C. Rokos, J.S. Rumsfeld, T.D. Henry, Management of Acute Myocardial Infarction During the COVID-19 Pandemic: A Position Statement From the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP), Journal of the American College of Cardiology, 76(2020) 1375-1384.
  32. Z. Zhai, C. Li, Y. Chen, G. Gerotziafas, Z. Zhang, J. Wan, P. Liu, I. Elalamy, C. Wang, Prevention Treatment of VTE Associated with COVID-19 Infection Consensus Statement Group. Prevention and Treatment of Venous Thromboembolism Associated with Coronavirus Disease 2019 Infection: A Consensus Statement before Guidelines. Thromb Haemost. 2020 Jun;120(6):937-948.

How to Cite

Almeida Lima, M. de, Almeida Lima, M. de, Silva, V. B. da, Scantamburlo Júnior, D., & Gaggini, M. C. R. (2021). Major Actions of Preventive Measures on Sars-Cov-2: An Updated Vision for Emergency Physicians. MedNEXT Journal of Medical and Health Sciences, 2(3), 56–62.