Pacientes com Covid-19 grave e complicações tromboembólicas / Patients with severe Covid-19 and thromboembolic complications

Leonardo Costa Lopes, Fernando Oliveira Carvalho, Jaqueline Ferraz Souto, Carolina de Souza Araújo, Lucas Martins Ferreira Guimaraes, Laura Beatriz Gomes dos Santos, Camila Guimarães Reis, João Gabriel da Silva Lourenço, Sócrates Sousa Gomes, Victor Hugo Nunes de Oliveira

Abstract


INTRODUÇÃO: O coronavírus-2 associado à Síndrome da Angústia Respiratória Aguda Grave (SARS-CoV-2), agente etiológico da doença por coronavírus 2019 (COVID-19) foi documentado como uma pandemia pelo Organização Mundial da Saúde (OMS) no início de março de 2020, e no início de abril havia mais de 1,5 milhão de casos em todo o mundo, com mais de 90.000 mortes; OBJETIVOS: Dessa forma, em vista de elucidar a incidência do (1) perfil, (2) drogas de uso recreativo, (3) comorbidades, (4) achados laboratoriais, (5) evento tromboembólico, (6) terapia de anticoagulação, (7) desfecho e correlacionar essas evidências em pacientes com COVID-19 grave em UTI, foi realizado o presente estudo. METODOLOGIA: Trata-se de um estudo de caráter exploratório, ecológico, transversal e retrospectivo. Utilizou-se os descritores: “Embolism and Thrombosis OR Heart disease AND Covid-19” na primeira base de dados, pesquisados de acordo com o MeSH, e “doenças cardiovasculares AND covid-19” na segunda base de dados, pesquisados de acordo com o DeCS.; RESULTADOS: idade média de 58 anos; sexo mais prevalente foi o masculino (83%); a droga de uso recretivo mais usado foi tabaco (30%); comorbidade mais prevalente foi a HAS (43%); achado laboratorial mais presente foi o dímero-D; o evento tromboembólico mais frequente foi o TEP (37%); terapia de anticoagulação mais usada foi a heparina de baixo peso molecular; e a taxa de óbito foi de 23%; CONCLUSÃO: Portanto, percebe-se que os achados do presente estudo se assemelham bastante aos dados da literatura vigente, apesar de suas limitações.


Keywords


Covid-19, complicações, tromboembolismo, UTI.

References


Ahmed, I., Azhar, A., Eltaweel, N., & Tan, B. K. (2020). First COVID‐19 maternal mortality in the UK associated with thrombotic complications. British Journal of Haematology, 190(1). https://doi.org/10.1111/bjh.16849

Ali, S., Mathew, S., & Pappachan, J. M. (2020). Acute cor pulmonale from saddle pulmonary embolism in a patient with previous COVID-19: Should we prolong prophylactic anticoagulation? International Journal of Infectious Diseases, 97, 299–302. https://doi.org/10.1016/j.ijid.2020.06.039

Azevedo, R. B., Botelho, B. G., Hollanda, J. V. G. de, Ferreira, L. V. L., Junqueira de Andrade, L. Z., Oei, S. S. M. L., Mello, T. de S., & Muxfeldt, E. S. (2021). Covid-19 and the cardiovascular system: A comprehensive review. Journal of Human Hypertension, 35(1), 4–11. https://doi.org/10.1038/s41371-020-0387-4

Besutti, G., Bonacini, R., Iotti, V., Marini, G., Riva, N., Dolci, G., Maiorana, M., Spaggiari, L., Monelli, F., Ligabue, G., Guaraldi, G., Rossi, P. G., Pattacini, P., & Massari, M. (2020). Abdominal visceral infarction in 3 patients with covid-19. Emerging Infectious Diseases, 26(8), 1926–1928. https://doi.org/10.3201/eid2608.201161

Breakey, N., & Escher, R. (2020). D-dimer and mortality in COVID-19: A self-fulfilling prophecy or a pathophysiological clue? Swiss Medical Weekly. https://doi.org/10.4414/smw.2020.20293

Brüggemann, R., Gietema, H., Jallah, B., ten Cate, H., Stehouwer, C., & Spaetgens, B. (2020). Arterial and venous thromboembolic disease in a patient with COVID-19: A case report. Thrombosis Research, 191, 153–155. https://doi.org/10.1016/j.thromres.2020.04.046

Bruni, A., Garofalo, E., Zuccalà, V., Currò, G., Torti, C., Navarra, G., De Sarro, G., Navalesi, P., Longhini, F., & Ammendola, M. (2020). Histopathological findings in a COVID-19 patient affected by ischemic gangrenous cholecystitis. World Journal of Emergency Surgery, 15(1), 43. https://doi.org/10.1186/s13017-020-00320-5

Davoodi, L., Jafarpour, H., Taghavi, M., & Razavi, A. (2020). Covid-19 presented with deep vein thrombosis: An unusual presenting. Journal of Investigative Medicine High Impact Case Reports, 8, 232470962093123. https://doi.org/10.1177/2324709620931239

Dumitrascu, O. M., Volod, O., Bose, S., Wang, Y., Biousse, V., & Lyden, P. D. (2020). Acute ophthalmic artery occlusion in a COVID-19 patient on apixaban. Journal of Stroke and Cerebrovascular Diseases, 29(8), 104982. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104982

Emmanuel Villa, Matteo Saccocci, Antonio Messina, Diego Maffeo, Antonino Pitì, Federico Bianchetti, Claudio Cuccia, & Giovanni Troise. (2020). COVID-19 e coronaropatia: Uso selettivo e collaborativo delle risorse durante le crisi sanitarie. Giornale Italiano di Cardiologia, 2020Maggio. https://doi.org/10.1714/3343.33135

Fenton, M., Siddavaram, S., Sugihara, C., & Husain, S. (2020). Lessons of the month 3: ST-elevation myocardial infarction and left ventricular thrombus formation: an arterial thrombotic complication of severe COVID-19 infection. Clinical Medicine, 20(4), 437–439. https://doi.org/10.7861/clinmed.2020-0266

Ferguson, K., Quail, N., Kewin, P., & Blyth, K. G. (2020). COVID-19 associated with extensive pulmonary arterial, intracardiac and peripheral arterial thrombosis. BMJ Case Reports, 13(8), e237460. https://doi.org/10.1136/bcr-2020-237460

Gómez-Mesa, J. E., Galindo-Coral, S., Montes, M. C., & Muñoz Martin, A. J. (2021). Thrombosis and coagulopathy in covid-19. Current Problems in Cardiology, 46(3), 100742. https://doi.org/10.1016/j.cpcardiol.2020.100742

High thrombus burden despite thrombolytic therapy in ST-elevation myocardial infarction in a patient with COVID-19. (2020). Reviews in Cardiovascular Medicine, 21(2), 289. https://doi.org/10.31083/j.rcm.2020.02.92

Lorenzo, C., Francesca, B., Francesco, P., Elena, C., Luca, S., & Paolo, S. (2020). Acute pulmonary embolism in COVID-19 related hypercoagulability. Journal of Thrombosis and Thrombolysis, 50(1), 223–226. https://doi.org/10.1007/s11239-020-02160-1

Ma, W., Li, C., Zhang, W., Ji, Z., & Li, Y. (2020). Anterior wall myocardial infarction in a 16-year-old man caused by coronary artery aneurysm during the outbreak of COVID-19. BMC Cardiovascular Disorders, 20(1), 314. https://doi.org/10.1186/s12872-020-01593-z

Magro, C., Mulvey, J. J., Berlin, D., Nuovo, G., Salvatore, S., Harp, J., Baxter-Stoltzfus, A., & Laurence, J. (2020). Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases. Translational Research, 220, 1–13. https://doi.org/10.1016/j.trsl.2020.04.007

Martin, A. I., & Rao, G. (2020). Covid-19: A potential risk factor for acute pulmonary embolism. Methodist DeBakey Cardiovascular Journal, 16(2), 155. https://doi.org/10.14797/mdcj-16-2-155

Moreira, B. L., Santana, P. R. P., Zanetti, G., & Marchiori, E. (2020). COVID-19 and acute pulmonary embolism: What should be considered to indicate a computed tomography pulmonary angiography scan? Revista da Sociedade Brasileira de Medicina Tropical, 53, e20200267. https://doi.org/10.1590/0037-8682-0267-2020

Nauka, P. C., Oran, E., & Chekuri, S. (2020). Deep venous thrombosis in a non-critically ill patient with novel COVID-19 infection. Thrombosis Research, 192, 27–28. https://doi.org/10.1016/j.thromres.2020.05.015

Pericàs, J. M., Hernandez-Meneses, M., Sheahan, T. P., Quintana, E., Ambrosioni, J., Sandoval, E., Falces, C., Marcos, M. A., Tuset, M., Vilella, A., Moreno, A., Miro, J. M., Hospital Clínic Cardiovascular Infections Study Group, Miró, J. M., Ambrosioni, J., Pericàs, J. M., Téllez, A., Hernandez-Meneses, M., Garcia-Pares, D., … Llopis, J. (2020). COVID-19: From epidemiology to treatment. European Heart Journal, 41(22), 2092–2112. https://doi.org/10.1093/eurheartj/ehaa462

Polat, V., & Bostancı, G. İ. (2020). Sudden death due to acute pulmonary embolism in a young woman with COVID-19. Journal of Thrombosis and Thrombolysis, 50(1), 239–241. https://doi.org/10.1007/s11239-020-02132-5

Puzzitiello, R. N., Pagani, N. R., Moverman, M. A., Moon, A. S., Menendez, M. E., & Ryan, S. P. (2020). Inflammatory and coagulative considerations for the management of orthopaedic trauma patients with covid-19: A review of the current evidence and our surgical experience. Journal of Orthopaedic Trauma, 34(8), 389–394. https://doi.org/10.1097/BOT.0000000000001842

Stevenson, A., Davis, S., & Murch, N. (2020). Pulmonary embolism in acute medicine: A case-based review incorporating latest guidelines in the COVID-19 era. British Journal of Hospital Medicine, 81(6), 1–12. https://doi.org/10.12968/hmed.2020.0300

Vacirca, A., Faggioli, G., Pini, R., Teutonico, P., Pilato, A., & Gargiulo, M. (2020). Unheralded Lower limb threatening ischemia in a COVID-19 patient. International Journal of Infectious Diseases, 96, 590–592. https://doi.org/10.1016/j.ijid.2020.05.060

Valderrama, E. V., Humbert, K., Lord, A., Frontera, J., & Yaghi, S. (2020). Severe acute respiratory syndrome coronavirus 2 infection and ischemic stroke. Stroke, 51(7). https://doi.org/10.1161/STROKEAHA.120.030153

Wool, G. D., & Miller, J. L. (2021). The impact of covid-19 disease on platelets and coagulation. Pathobiology, 88(1), 15–27. https://doi.org/10.1159/000512007

Zhou, B., She, J., Wang, Y., & Ma, X. (2020). Venous thrombosis and arteriosclerosis obliterans of lower extremities in a very severe patient with 2019 novel coronavirus disease: A case report. Journal of Thrombosis and Thrombolysis, 50(1), 229–232. https://doi.org/10.1007/s11239-020-02084-w




DOI: https://doi.org/10.34119/bjhrv5n3-188

Refbacks

  • There are currently no refbacks.