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Anticoagulación sostenible en COVID-19: Revisión de predicción de gravedad y razonamiento clínico
Sustainable anticoagulation in COVID-19: Review of severity prediction and clinical reasoning
DOI:
https://doi.org/10.15446/rsap.v22n3.87321Palabras clave:
Anticoagulación, COVID-19, dímero D, heparina de bajo peso molecular, heparina no fraccionada, trombocitopenia, tromboembolismo pulmonar (es)Trombose, Anticoagulante, COVID19, Quimioprevenção (pt)
Anticoagulation, COVID-19, D-dimer, low-molecular-weight heparin, unfractionated heparin, thrombocytopenia, pulmonary thromboembolism (en)
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Objetivo Identificar el fenómeno procoagulante en pacientes SARS-CoV- 2 y proponer orientación terapéutica sostenible para países de bajos ingresos.
Método Se realizó una revisión sistemática que identificó cinco estudios observacionales de un escrutinio a partir de 78 resultados. Se examinaron 712 pacientes y los resultados fueron agrupados según mortalidad y severidad. La comparación de los grupos se interpretó mediante estadística descriptiva.
Resultado Los valores del dímero D se asociaron significativamente en todas las observaciones a mayor severidad y mortalidad. La protrombina se asoció, en algunas observaciones, a mayor mortalidad; en cuanto a severidad, los resultados fueron inconclusos.
Conclusión El COVID-19 tiene importante actividad procoagulante y su tratamiento oportuno puede alterar el pronóstico. La evidencia explorada avala métodos sostenibles. Se necesita más evidencia para mejorar el manejo. Se recomienda un abordaje sistemático temprano de los pacientes con medidas terapéuticas sostenibles a la medida del sistema de salud.
Objective To identify the procoagulant phenomenon in SARS-CoV-2 patients and propose sustainable therapeutic guidance for low-income countries.
Methods A systematic review was conducted. It identified 5 observational studies from a scrutiny from 78 results. 712 patients were examined and the results were grouped according to mortality and severity. The comparison of the groups was interpreted using descriptive statistics.
Results D-dimer values were significantly associated with greater severity and mortality. Prothrombin was associated in some observations with higher mortality, but in terms of severity it was inconclusive.
Conclusion COVID-19 disease has significant procoagulant activity and its timely treatment can alter the prognosis. The explored evidence supports sustainable methods. More evidence is needed to improve management. An early systematic approach to patients with sustainable therapeutic measures tailored to the health system is recommended.
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Derechos de autor 2020 Revista de Salud Pública
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
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