Post-COVID-19 acquired hemostatic sequelae
DOI:
https://doi.org/10.33448/rsd-v12i5.41544Keywords:
SARS-CoV-2; COVID-19; Hemostasis; Síndrome Pós-COVID-19 Aguda; Blood coagulation.Abstract
The exacerbated systemic inflammatory picture generated by COVID-19 is associated with disorders in hemostasis. The objective of this study was to carry out a search, synthesis and discussion about studies related to the consequences of COVID-19 and the hemostatic sequelae generated after SARS-CoV-2 infection. Is a descriptive observational study, of the integrative literature review type. Six studies were included in this research. The COVID-19 causes an inflammatory process associated with hypercoagulability, platelet activation and endothelial dysfunction. The increase in D-Dimer seems to reflect the formation of clots due to viremia and excess cytokines resulting from the inflammatory process. In contrast, persistently elevated D-dimer values even after hospitalization for COVID-19 may not be associated with a risk of VTE (in individuals without risk of thrombosis). Routine treatment of all patients with post-discharge thromboprophylaxis may not be necessary, while targeting high-risk patients may be sufficient. The alteration in the VWF(Ag)/ADAMTS13 axis is related to a prothrombotic state and is very present in patients with COVID-19. There is sustained involvement of endothelial cells, clotting activity, and chronic inflammation over the course of the disease, in addition to potential microvascular damage. The elderly are more susceptible to complications in the course of COVID-19. The majority of the pediatric population has mild and/or asymptomatic cases. However, all age groups are influenced by the presence or absence of comorbidities added with other individual and environmental factors. Care for patients affected by COVID-19 should go beyond hospital discharge, requiring continuous monitoring, evaluation and rehabilitation.
References
Ackermann, M., Verleden, S .E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F., Vanstapel, A., Werlein, C., Stark, H., Tzankov, A., Li, W. W., Li, V. W., Mentzer, S. J. & Jonigk, D. (2020). Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in covid-19. N Engl J Med, 383(2), 120-128. Doi.org/10.1056/NEJMoa2015432.
Aguiar, B. F., Lind, J., Pasquini-Netto, H., Böger, B., Abatti, R. T. B., Ramos, M. P., & Rocha, J. L. L. (2022). Uma revisão integrativa das sequelas da COVID-19. Revista Brasileira em Promoção da Saúde, 35, 1–1. Doi.org/10.5020/18061230.2022.12606
Ahmed, O. F., Kakamad, F. H., Amin, B. J. H., Abdullah, B. A., Hassan, M. N., Salih, R. Q., Mohammed, S. H., Othman, S., Ahmed, G. S. & Salih, A.M. (2021). Post COVID-19 pulmonary complications; a single center experience. Annals of Medicine and Surgery, 72(1), 1-4. Doi.org/10.1016/j.amsu.2021.103052.
Almeida, M. J., Guillaumon, A. T., Miquelin, D., Joviliano, E. E., Hafner, L., Sobreira, M. L., Geiger, M. A., Moura, R., Raymundo, S. & Yoshida, W. B. (2019). Diretrizes de conceito, diagnóstico e tratamento da trombose venosa superficial. Jornal Vascular Brasileiro, 18, e20180105. Doi.org/10.1590/1677-5449.180105.
Amorim, D. S., Lima, F. L. O. & Costa, E. A. S. (2020). Tromboembolismo pulmonar em COVID-19. Hematology, Transfusion and Cell Therapy, 42, 562–563. Doi.org/10.1016/j.htct.2020.10.951.
Azevedo, M. C. A., Pereira, D. A., Júnior, C. W. L. C., Fernandes, L. J. N., Silva, M. E. G., Soares, M. M. B., Sousa, B. M., Souza, D. M., Gomes, A. M. & Carvalho, J. P. (2022). Relação fisiopatológica entre COVID-19 e diabetes mellitus tipo 2: uma revisão narrativa. Revista Eletrônica Acervo Saúde, 15(4), e10154. Doi.org/10.25248/reas.e10154.2022.
Connors, J. M. & Levy, J. H. (2020). Thromboinflammation and the hypercoagulability of COVID-19. J Thromb Haemost, 18(7) 1559-1561. Doi.org/10.1111/jth.14849.
Elshazli, R. M., Toraih, E. A., Elgaml, A., El-Mowafy, M., El-Mesery, M., Amin, M. N., Hussein, M. H., Killackey, M. T., Fawzy, M. S. & Kandil, E. (2020). Diagnostic and prognostic value of hematological and immunological markers in COVID-19 infection: A meta-analysis of 6320 patients. PLoS One, 15(8), e0238160. Doi.org/10.1371/journal.pone.0238160.
Engelen, M. M., Vandenbriele, G., Balthazar, T., Claeys, E., Gunst, J., Guler, I., Jacquemin, M., Janssens, S., Lorent, E., Liesenborghs, L., Peerlinck, K., Pieters, G., Rex, S., Sinonquel, P., Linden, L. V., Laer, C. V., Vos, R., Wauters, J., Wilmer, A., Verhamme, P. & Vanassche, T. (2021). Venous Thromboembolism in Patients Discharged after COVID-19 Hospitalization. Semin Thromb Hemost, 47(4), 362-371. Doi.org/10.1055/s-0041-1727284.
Fink, T. T., Marques, H. H. S., Gualano, B., Lindoso, L., Bain, V., Astley, C., Martins, F., Matheus, D., Matsuo, O. M., Suguita, P., Trindade, V., Paula, C. S. Y., Farhat, S. C. L., Palmeira, P., Leal, G. N., Suzuki, L., Odone, V., Carneiro-Sampaio, M., Duarte, A. J. S. & Antonangelo, L. (2021). Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital. Clinics, 76, e3511. Doi.org/10.6061/clinics/2021/e3511.
Fraissé, M., Logre, E., Pajot, O., Mentec, H., Plantefève, G. & Contou, D. (2020). Thrombotic and hemorrhagic events in critically ill COVID-19 patients: a French monocenter retrospective study. Critic Care, 24(1), 275. Doi.org/10.1186/s13054-020-03025-y
Hamad, A. M. M., Elmahrouk, A. F. & Abdulatty, O. A. (2020). Alveolar air leakage in COVID-19 patients: Pneumomediastinum and/or pneumopericardium. Heart Lung, 49(6), 881-882. Doi.org/10.1016/j.hrtlng.2020.09.006.
Helms, J., Tacquard, C., Severac, F., Leonard-Lorant, I., Ohana, M., Delabranche, X., Merdji, H., Clere-Jehl, R., Schenck, M., Gandet, F. F., Fafi-Kremer, S., Castelain, V., Schneider, F., Grunebaum, L., Anglés-Cano, E., Sattler, L., Mertes, P. M., Meziani, F. & CRICS TRIGGERSEP Group (2020). High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Medicine, 46, 1089-1098. Doi.org/10.1007/s00134-020-06062-x.
Henry, B. M., Benoit, S. W., de Oliveira, M. H. S., Hsieh, W. C., Benoit, J., Ballout, R. A., Plebani, M. & Lippi, G. (2020). Laboratory abnormalities in children with mild and severe coronavirus disease 2019 (COVID-19): A pooled analysis and review. Clinical Biochemistry, 81, 1–8. Doi.org/10.1016/j.clinbiochem.2020.05.012.
Hoang, A., Chorath, K., Moreira, A., Evans, M., Burmeister-Morton, F., Burmeister, F., Naqvi, R., Petershack, M. & Moreira, A. (2020). COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine, 24, 100433. Doi.org/10.1016/j.eclinm.2020.100433.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M. & Xiao, Y. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497–506. Doi.org/10.1016/s0140-6736(20)30183-5.
Klok, F.A., Kruip, M.J.H.A., van der Meer, N.J.M., Arbous, M.S., Gommers, D.A.M.P.J., Kant, K.M., Kaptein, F.H.J., van Paassen, J., Stals, M.A.M., Huisman, M.V. & Endeman, H. (2020). Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thrombosis Research, 191. 145-147. Doi.org/10.1016/j.thromres.2020.04.013.
Kolivras, A., Dehavay, F., Delplace, D., Feoli, F., Meiers, I., Milone, L., Olemans, C., Sass, U., Theunis, A., Thompson, C. T., Van De Borne, L. & Richert, B. (2020). Coronavirus (COVID-19) infection–induced chilblains: A case report with histopathologic findings. JAAD Case Reports, 6(6), 489-492. Doi.org/10.1016/j.jdcr.2020.04.011.
Lemos, F. A. & Almeida, M. C. (2022). Principais complicações cardíacas em idosos infectados pelo SARS-CoV-2: uma revisão sistemática. R Pesq Cuid Fundam, 14(1). Doi.org/10.9789/2175-5361.rpcfo.v14.10517.
Levi, M., Thachil, J., Iba, T. & Levy, J. H. (2020). Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol, 7(6), 438-440. Doi.org/10.1016/S2352-3026(20)30145-9.
Levy, J. H., Iba, T., Olson, L. B., Corey, K. M., Ghadimi, K. & Connors, J. M. (2021). COVID-19: Thrombosis, thromboinflammation, and anticoagulation considerations. International journal of laboratory hematology, 43(Suppl 1), 29–35. Doi.org/10.1111/ijlh.13500.
Libby, P. & Lüscher, T. (2020). COVID-19 is, in the end, an endothelial disease. Eur Heart J., 41(32), 3038-3044. Doi.org/10.1093/eurheartj/ehaa623.
Lippi, G. & Favaloro, E.J. (2020). D-dimer is Associated with Severity of Coronavirus Disease 2019: A Pooled Analysis. Thromb Haemost, 120(5), 876-878. Doi.org/10.1055/s-0040-1709650.
Mancini, I., Baronciani, L., Artoni, A., Colpani, P., Biganzoli, M., Cozzi, G., Novembrino, C., Anzoletti, M. B., Zan, V. D., Pagliari, M. T., Gualtierotti, R., Aliberti, S., Panigada, M., Grasselli, G., Blasi, F. & Peyvandi, F. (2021). The ADAMTS13-von Willebrand factor axis in COVID-19 patients. J Thromb Haemost, 19(2), 513-521. Doi.org/10.1111/jth.15191.
Mathew, A., Balaji V. E., Pai, S. R. K., Kishore, A., Pai, V. & Chandrashekar, K.S. (2021). ABO phenotype and SARS-CoV-2 infection: Is there any correlation? Infection, Genetics and Evolution, 90, 104751. Doi.org/10.1016/j.meegid.2021.104751.
Mendes, K. D. S., Silveira, R. C. C. P. & Galvão, C. M. (2019). Uso de gerenciador de referências bibliográficas na seleção dos estudos primários em revisão integrativa. Texto & Contexto - Enfermagem, 28. Doi.org/10.1590/1980-265X-TCE-2017-0204.
Mostardeiro, L. R., Antoniolli, E. C. A. & Xavier, J. W. (2020). Coronavirus in pediatrics: report of two cases and review of the literature. Jornal Brasileiro de Patologia e Medicina Laboratorial, e3552020. Doi.org/10.5935/1676-2444.20200058.
Obukhov, A. G., Stevens, B. R., Prasad, R., Calzi, S. L., Boulton, M. E., Raizada, M. K., Oudit, G.Y. & Grant, M. B. (2020). SARS-CoV-2 Infections and ACE2: Clinical Outcomes Linked With Increased Morbidity and Mortality in Individuals With Diabetes. Diabetes, 69(9), 1875–1886. Doi.org/10.2337/dbi20-0019.
Oliveira, P. A., Santos, R. M. G., Monteiro, F. F. C., Walraven, M. D. S. M., Diógenes, R. S., Capistrano, S. F. S. & Morais, A. C. L. N. (2022). Disfonia pós-infecção por COVID-19: uma revisão integrativa de literatura. Revista de Casos e Consultoria, 13(1), e131X.
Paz, G. M., Puty, M. C. & Fonseca, F. M. N. S. (2022). Análise de uma abordagem da pediatria no contexto da pandemia por Covid-19. Research, Society and Development, 11(3), e1211326060. Doi.org/10.33448/rsd-v11i3.26060.
Pons, S., Fodil, S., Azoulay, E. & Zafrani, N. (2020). The vascular endothelium: the cornerstone of organ dysfunction in severe SARS-CoV-2 infection. Crit Care, 24(1), 353. Doi.org/10.1186/s13054-020-03062-7.
Prasannan, N., Heightman, M., Hillman, T., Wall, E., Bell, R., Kessler, A., Neave, L., Doyle, A., Devaraj, A., Singh, D., Dehbi, H. M. & Scully, M. (2022). Impaired exercise capacity in post–COVID-19 syndrome: the role of VWF-ADAMTS13 axis. Blood Advances, 6(13), 4041–4048. Doi.org/10.1182/bloodadvances.2021006944.
Rossi, F.H. (2020). Tromboembolismo venoso em pacientes COVID-19. Jornal Vascular Brasileiro, 19, e20200107. Doi.org/10.1590/1677-5449.200107.
Shi, H., Han, X., Jiang, N., Cao, Y., Alwalid, O., Gu, J., Fan, Y. & Zheng, C. (2020). Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. The Lancet Infectious Diseases, 20(4), 425–434. Doi.org/10.1016/s1473-3099(20)30086-4.
Soeiro, A. M. & Pêgo-Fernandes, P. M. (2021). Post-COVID-19 cardiological alterations (Editorial). Sao Paulo Medical Journal, 139(6), 543-544. Doi.org/10.1590/1516-3180.2021.139628062021
Terpos, E., Ntanasis‐Stathopoulos, I., Elalamy, I., Kastritis, E., Sergentanis, T.N., Politou, M., Psaltopoulou, T., Gerotziafas, G. & Dimopoulos, M.A. (2020). Hematological findings and complications of COVID‐19. American Journal of Hematology, 95(7), 834-847. Doi.org/10.1002/ajh.25829.
Ulhaq, Z. S. & Soraya, G. V. (2020). Interleukin-6 as a potential biomarker of COVID-19 progression. Med Mal Infect, 50(4), 382-383. Doi.org/10.1016/j.medmal.2020.04.002.
Wang, W., Wang, C. Y., Wang, S. I. & Wei, J. C. C. (2022). Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks. EClinicalMedicine, 53, 101619. Doi.org/10.1016/j.eclinm.2022.101619.
Willems, L. H., Nagy, M., ten Cate, H., Spronk, H. M. H., Groh, L. A., Leentjens, J., Janssen, N. A. F., Netea, M. G., Thijssen, D. H. J., Hannink, G., van Petersen, A. S. & Warlé, M. C. (2022). Sustained inflammation, coagulation activation and elevated endothelin-1 levels without macrovascular dysfunction at 3 months after COVID-19. Thrombosis Research, 209, 106–114. Doi.org/10.1016/j.thromres.2021.11.027.
Witt, D. M., Nieuwlaat, R., Clark, N. P., Ansell, J., Holbrook, A., Skov, J., Shehab, N., Mock, J., Myers, T., Dentali, F., Crowther, M. A., Agarwal, A., Bhatt, M., Khatib, R., Riva, J.J., Zhang, Y. & Guyatt, G. (2018). American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy. Blood Advances, 2(22), 3257–3291. Doi.org/10.1182/bloodadvances.2018024893.
Wool, G. D. & Miller, J. L. (2020). The impact of COVID-19 disease on platelets and coagulation. Pathobiology, 88(1), 1–13. Doi.org/10.1159/000512007.
Zhang, H., Penninger, J. M., Li, Y., Zhong, N. & Slutsky, A. S. (2020). Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Medicine, 46(4), 586–590. Doi.org/10.1007/s00134-020-05985-9.
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Copyright (c) 2023 Mercia Mendes de Lima; Guilherme Agostinho Rodrigues ; Francinaldo Filho Castro Monteiro; Rannyella Saldanha Diógenes ; Maria Angelina Silva Medeiros; Daisy Maria Meireles Arruda Loureiro
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