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Hematology, Transfusion and Cell Therapy
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Hematology, Transfusion and Cell Therapy
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PubMed Central
Other literature type . 2020
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ANTICOAGULANTES NO TRATAMENTO DO SARS-COV-2

Authors: Silber, J.M.; Rezende, A.C.M.M.; Campos, G.O.; Spina, A.M.B.; Bernardes, F.P.; Sentillo, I.; Magri, L.D.; +3 Authors

ANTICOAGULANTES NO TRATAMENTO DO SARS-COV-2

Abstract

Objetivos: Revisao integrativa da literatura sobre a utilizacao de anticoagulantes em pacientes com SARS-Cov-2. Material e metodos: Trata-se de um estudo realizado por meio de levantamento bibliografico nas bases de dados Pubmed Elsevier, Lilacs e MedLine com a combinacao dos termos Mesh: Coronavirus;COVID-19;SARS-CoV-2;AND ou OR Anticoagulants;Blood Coagulation Disorders;Thromboembolism;Venous Thromboembolism;Pulmonar Embolism. Foram utilizados como criterios de inclusao: artigos completos, em lingua inglesa, disponiveis em acesso aberto, realizados em humanos, e publicados no periodo da pandemia por COVID-19 (janeiro a junho de 2020). Como criterios de exclusao os artigos que nao apresentaram analise estatistica e relato de casos. Foram selecionados 651 artigos, excluidos 416 duplicados. Desses, 195 artigos preencheram os criterios de inclusao e 153 artigos foram excluidos pelos criterios de exclusao. Resultados: Os estudos sugerem a substituicao das terapias anticoagulantes orais, em tratamentos previos, por heparina parenteral de baixo peso molecular (HBPM) ou heparina nao fracionada (UH). O uso de profilaxia antitrombotica esta recomendado em pacientes hospitalizados com COVID-19, tendo maior beneficio quando iniciada na fase pre trombotica (na admissao hospitalar). A dose recomendada pelos estudos sao: HBPM 1 mg/kg de 12/12 horas, subcutânea para pacientes com clearance de creatinina > 30 mL/min;e HNF 18 UI/kg/h, intravenosa para pacientes com clearance de creatinina 30 mL/min deve utilizar HBPM 1 mg/kg de 12/12 horas, e em pacientes com clearance de creatinina < 30 mL/min deve utilizar HNF 18 UI/kg/h, segundo alguns estudos. Esses pacientes devem ser monitorizados por meio do tempo de protrombina D-dimero, fibrinogenio, contagem de plaquetas, lactato desidrogenase, alanina aminotransferase e creatinina de 2-3 vezes na semana. Com isso, ha um melhor prognostico diante das complicacoes tromboticas e hemorragicas em pacientes graves com SARS-CoV-2. Conclusao: Os pacientes em estado critico, apresentam uma desregulacao da coagulacao levando a um risco aumentado de complicacoes tromboticas. Desse modo, e recomendado o uso de HBPM (1 mg/kg de 12/12 horas) ou HNF (18 UI/kg/h), via parenteral em pacientes ventilados ou intubados, com excecao de pacientes com proteses valvares cardiacas.

Related Organizations
Keywords

801, Immunology and Allergy, Diseases of the blood and blood-forming organs, Hematology, RC633-647.5

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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