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Abstract
Covid-19 is a disease caused by the SARS-CoV-2 virus that emerged in late 2019, where infected patients are observed, in addition to flu-like symptoms, thromboembolic events caused by the body's reaction in an attempt to fight the microorganism. Numerous therapies to try to reverse thrombotic events with anticoagulants are used in carriers of the disease. In this context, this study sought to analyze the reduction of negative outcomes in patients hospitalized with covid-19, comparing those who underwent high-dose anticoagulant therapy with those who used the standard dose. For this, the systematic review methodology was adopted, using articles already published in databases such as US National Library of Medicine National Institutes (PUBMED) e The Global Science Gateway (World Wide Science), with English language content between the years 2019 and 2022. The results indicated that in non-critical patients there was a small reduction in the need for mechanical ventilation, length of hospital stay, and deaths; in critical patients, however, the therapy was not successful. In addition, there were more cases of bleeding and severe thrombocytopenia in individuals who received high doses of anticoagulants. Thus, anticoagulant therapy for severe cases of covid-19 does not reduce the outcomes of hospitalized patients, increasing the cases of bleeding and thrombocytopenia.
References
ARRUDA, D. E. G.; MARTINS, D. D. S. ; SILVA, I. F. M. ; SOUSA, M. N. A. de . Prognóstico de pacientes com COVID-19 e doenças crônicas: uma revisão sistemática. Comunicação Em Ciências da Saúde (IMPRESSO), v. 31, p. 1-1, 2020.
ATTACC, ACTIV-4A, AND REMAP-CAP INVESTIGATORS. Therapeutic anticoagulation with heparin in noncritically ill patients with Covid-19. New England Journal of Medicine, v. 385, n. 9, p. 790-802, 2021.
BEZERRA, A. L. D.; RODRIGUES, E. J. F.; GOUVEIA, L. H. ; NOBREGA, A. R. O. ; SILVA, N. S. ; SOUSA, M. N. A. . Atuação de uma equipe multiprofissional em tempos de coronavírus. Revista Interdisciplinar em Saúde, v. 1, p. 1993-2008, 2020.
BIKDELI, Behnood. et al. COVID-19 e doença trombótica ou tromboembólica: implicações para prevenção, terapia antitrombótica e acompanhamento: revisão de última geração do JACC. Jornal do colégio Americano de Cardiologia, Estados Unidos, v.75, n.23, p. 2950-2973, 2020.
BIKDELI, Behnood et al. Intermediate-dose versus standard-dose prophylactic anticoagulation in patients with COVID-19 admitted to the intensive care unit: 90-day results from the INSPIRATION randomized trial. Thrombosis and haemostasis, v. 122, n. 01, p. 131-141, 2022.
CHARLOTTE, A. Bradbury et al. Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19. JAMA NETWORK, Estados Unidos, v.327, n.13, p. 1247-1259, o 2022.
CIOTTI, Marco. et al. A pandemia de COVID-19. Revisões clínicas em ciências de laboratório clínico. Roma, v. 57, n. 6, p. 365-388, 2020.
DEVREESE, Katrien M. J. Achados laboratoriais de coagulação relacionados ao COVID-19. Sociedade Internacional de Hematologia Laboratorial, Gante, v.43, n.1, p. 36-42, 2021.
CONNORS, Jean M. et al. Effect of antithrombotic therapy on clinical outcomes in outpatients with clinically stable symptomatic COVID-19: the ACTIV-4B randomized clinical trial. Jama, v. 326, n. 17, p. 1703-1712, 2021.
COOLS, Frank et al. Thromboprophylactic low-molecular-weight heparin versus standard of care in unvaccinated, at-risk outpatients with COVID-19 (ETHIC): an open-label, multicentre, randomised, controlled, phase 3b trial. The Lancet Haematology, v. 9, n. 8, p. e594-e604, 2022.
DONATO, H.; DONATO, M. Etapas na Condução de uma Revisão Sistemática. Acta Médica Portuguesa, v.32, n.3, p. 227-235, 2019.
FERNANDEZ-CAPITAN, Carmen et al. Presenting characteristics, treatment patterns, and outcomes among patients with venous thromboembolism during hospitalization for COVID-19. In: Seminars in Thrombosis and Hemostasis. Thieme Medical Publishers, Inc., 2021. p. 351-361.
FILHO, Carlos Rodrigues et al. Avaliação da qualidade de estudos clínicos e seu impacto nas metanálises. Revista Saúde Pública, Brasil, v.9, n.6, p.865-873, 2005.
HELMS, Julie et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care MED, Estraburgo, v. 46, p. 1089-1098, 2020.
JADAD, Alejandro et al. Assessing the Quality os Reports of Randomized Clinical Trials: Is Blinding Necessary? Elsevier Science, Nova Iorque, v.17, p. 1-12, 1996.
LEMOS, Anna Cristina Bertoldi et al. Therapeutic versus prophylactic anticoagulation for severe COVID-19: A randomized phase II clinical trial (HESACOVID). Thrombosis research, v. 196, p. 359-366, 2020.
LOPES, Renato D. et al. Randomized clinical trial to evaluate a routine full anticoagulation strategy in patients with coronavirus infection (SARS-CoV2) admitted to hospital: rationale and design of the action (AntiCoagulaTlon cOroNavirus)–coalition IV trial. American Heart Journal, v. 238, p. 1-11, 2021.
LOPES, Renato D. et al. Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial. The Lancet, v. 397, n. 10291, p. 2253-2263, 2021.
MARCOS-JUBILAR, María et al. Therapeutic versus prophylactic bemiparin in hospitalized patients with nonsevere COVID-19 pneumonia (BEMICOP study): an open-label, multicenter, randomized, controlled trial. Thrombosis and haemostasis, v. 122, n. 02, p. 295-299, 2022.
MARIETTA, Marco et al. Randomised controlled trial comparing efficacy and safety of high versus low Low-Molecular Weight Heparin dosages in hospitalized patients with severe COVID-19 pneumonia and coagulopathy not requiring invasive mechanical ventilation (COVID-19 HD): a structured summary of a study protocol. Trials, v. 21, n. 1, p. 1-5, 2020.
MAZLOOMZADEH, Saeideh et al. Effect of intermediate-dose vs standard-dose prophylactic anticoagulation on thrombotic events, extracorporeal membrane oxygenation treatment, or mortality among patients with COVID-19 admitted to the intensive care unit: the INSPIRATION randomized clinical trial. Jama, v. 325, n. 16, p. 1620-1630, 2021.
MORICI, Nuccia et al. Enoxaparin for thromboprophylaxis in hospitalized COVID‐19 patients: The X‐COVID‐19 Randomized Trial. European journal of clinical investigation, v. 52, n. 5, p. e13735, 2022.
RAMACCIOTTI, Eduardo et al. Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. The Lancet, v. 399, n. 10319, p. 50-59, 2022.
RIBES, Agnes et al. Thomboembolic events and covid-19. Advances in biological regulation, França, v.77, p. 100735, 2020.
SHOLZBERG, Michelle et al. Coagulopathy of hospitalised COVID-19: A Pragmatic Randomised Controlled Trial of Therapeutic Anticoagulation versus Standard Care as a Rapid Response to the COVID-19 Pandemic (RAPID COVID COAG–RAPID Trial): A structured summary of a study protocol for a randomised controlled trial. Trials, v. 22, n. 1, p. 1-4, 2021.
SHOLZBERG, Michelle et al. Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial. bmj, v. 375, 2021.
SPYROPOULOS, Alex C. et al. Efficacy and safety of therapeutic-dose heparin vs standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19: the HEP-COVID randomized clinical trial. JAMA internal medicine, v. 181, n. 12, p. 1612-1620, 2021.
TOSHIAKI, Iba. et al. Coagulopatia da doença de coronavírus 2019. Medicina de Cuidados Intensivos, v.48, n.9, p. 1358-1364, 2020.
VANASSCHE, Thomas et al. A randomized, open-label, adaptive, proof-of-concept clinical trial of modulation of host thromboinflammatory response in patients with COVID-19: the DAWn-Antico study. Trials, v. 21, n. 1, p. 1-14, 2020.
VARGA, Zsuzsanna. et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet, Estados Unidos, v.395, n. 10234, p. 1417-1418, 2020.
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Copyright (c) 2024 Matheus Gomes Balduino , Andréia Emily Silva de Azevêdo , Milena Nunes Alves de Sousa, Tiago Bruno Carneiro de Faria , Rita de Cássia Jales de Oliveira