Trombosis venosa profunda post-COVID-19 y su manejo farmacológico
DOI:
https://doi.org/10.33448/rsd-v11i1.24991Palabras clave:
SARS-CoV-2; COVID-19; Anticoagulantes; Tromboembolia venosa.Resumen
La infección causada por el coronavirus SARS-CoV-2 presenta casos clínicos que van desde asintomáticos hasta graves. Incluso en casos leves, se pueden observar secuelas relacionadas con un estado de hipercoagulabilidad asociado a COVID-19, con una mayor prevalencia de tromboembolismo venoso (TEV). La aparición de TEV es mayor en pacientes, principalmente pacientes hospitalizados en unidades de cuidados intensivos y requiere tratamiento anticoagulante, sin embargo, la trombogénesis post-COVID también puede ocurrir en una etapa posterior, en ausencia de carga viral. Los mecanismos protrombóticos relacionados con el SARS-CoV-2 difieren con respecto al uso de fármacos antiplaquetarios y anticoagulantes en pacientes con COVID-19 sospechado o confirmado. En este estudio se describirán la farmacología y la aplicabilidad clínica de los fármacos anticoagulantes como las heparinas y los anticoagulantes orales. Este estudio es un estudio exploratorio que tiene como objetivo abordar cuestiones relacionadas con el tratamiento hasta ahora recomendado para eventos trombóticos en pacientes afectados por COVID-19.
Citas
Abildgaard, U. (1968). Highly purified antithrombin III with heparin cofactor activity prepared by disc electrophoresis. Scand J Clin Lab Invest., 21(1), 89-91.
Ackermann, M., Verleden, S. E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F. et al. (2020). Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in COVID-19 . N Engl J Med, 383(2), 120-128.
Ahmed, S., Zimba, O., & Gasparyan, A. Y. (2020). Thrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow’s triad. Clin Rheumatol., 39(9), 2529-2543.
Albuquerque, H. P. C. & Vidal, C. P. (1996). Trombose Venosa Profunda: Revisão Dos Conceitos Atuais. Rev Bras Ortop, 31(10), 851-856.
Al Dieri, R., Wagenvoord R., Van Dedem, G.W.K., Béguin S., & Hemker, H. C. (2003). The inhibition of blood coagulation by heparins of different molecular weight is caused by a common functional motif-the C-domain. J Thromb Haemost., 1(5), 907-914.
Alves, C. P., Almeida, C. C. & Balhau, P. A. (2015). Tromboembolismo Venoso Diagnóstico e Tratamento. Sociedade Portuguesa de Cirurgia.
Bahia, L., Aguiar, L., Villela, N. R., Bottino, D., & Bouskela, E. (2004). Endotélio e aterosclerose. Revista da SOCERJ, 17(1), 26-36.
Barnes, G. D., Burnett, A., Allen, A., Blumenstein, M., Clark, N. P., Cuker, A., Dager, W. E., Deitelzweig, S, B., Ellsworth, S., Garcia, D., Kaatz, S., & Minichiello, T. (2020). Thromboembolism and anticoagulant therapy during the COVID-19 pandemic: interim clinical guidance from the anticoagulation forum. J Thromb Thrombolysis, 50(1), 72-81.
Baruzzi, A. C. do A., Nussbacher, A., Lagudis, S., & Souza, J. A. M. (1996). Trombose Venosa Profunda. Profilaxia. http://publicacoes.cardiol.br/abc/1996/6703/67030013.pdf
Berger, M., Silva, W. O. B. da, Santi, L., & Guimarães, J. A. (2014). Hemostasia: uma breve revisão. Rev Cad Pedagógico, 11(1), 140-148.
Bernardi, J. M., Silveira, G. C., Polese, J.F., Sant Ana, L., Lara, I. C., Turini, E. A. S. et al. (2021). Incidência de eventos tromboembólicos na COVID‐19. Brazilian J Infect Dis., 25(S1), 101078.
Best, C. H. (1959). Preparation of heparin and its use in the first clinical cases. Circulation, 19(1), 70-86.
Bikdeli, B., Madhavan, M. V., Jimenez, D., Chuich, T., Dreyfus, I., Driggin, E. et al. (2020). COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. J Am Coll Cardiol. 75(23), 2950-2973.
Boccia, M., Aronne, L., Celia, B., Mazzeo, G. Ceparano, M., D’Agnano, V. et al. (2020). COVID-19 and coagulative axis: review of emerging aspects in a novel disease. Monaldi Arch Chest Dis., 90(2), 271-276.
Brandão, G. M. S, Cândido, R. C. F, Rollo, H. de A., Sobreira, M. L., & Junqueira, D. R. (2018). Direct oral anticoagulants for treatment of deep vein thrombosis: Overview of systematic reviews. J Vasc Bras. 17(4),310-317.
Bray, M. A., Sartain, S. E., Gollamudi, J., & Rumbaut, R. E. (2020). Microvascular thrombosis: experimental and clinical implications. Transl Res., 225, 105-130.
Brinkhous, K. M., Smith, H. P., Warner, E. D., & Seegers, W. H. (1939). The inhibition of blood clotting: an unidentified substance which acts in conjunction with heparin to prevent the conversion of prothrombin into thrombin. Am J Physiol Content, 125(4), 683-687.
Boneu, B., Necciari, J., Cariou, R., Sié, P., Gabaig, A. M., Kieffer, G. et al.(1995). Pharmacokinetics and tolerance of the natural pentasaccharide (SR90107/ORG31540) with high affinity to antithrombin III in man. Thromb Haemost., 74(6), 1468-1473.
Bussey, H., Francis, J. L. (2004). Heparin Overview and Issues. Pharmacotherapy, 24(8 Part 2):103S-107S.
Cunha, M. V. S.; Pinto, C. A. V.; Guerra, J. C. de C.; Tachibana, A.; Cassino, M. F. (2020). Incidência, diagnóstico, tratamento e desfechos de tromboembolia venosa em pacientes com COVID-19 em um hospital. https://sbacvsp.com.br/incidencia-diagnostico-tratamento-e-desfechos-de-tromboembolia-venosa-em-pacientes-com-COVID-19 -em-um-hospital-quaternario-no-brasil/.
Engelhorn, A. L. V., Garcia, A. C. F., Cassou, M. F., Birckholz, L., & Engelhorn, C. A. (2002). Profilaxia da trombose venosa profunda-estudo epidemiológico em um hospital escola. J Vasc Bras, 1(2), 97-102.
Estevão, A. (2020). COVID-19. Acta Radiológica Portuguesa, 32(1), 5-6.
Fareed, J., Hoppensteadt, D., Walenga, J., Iqbal, O., Ma, Q., Jeske, W., & Taqdees, S. (2003). Pharmacodynamic and pharmacokinetic properties of enoxaparin: Implications for clinical practice. Clin Pharmacokinet., 42(12), 1043-1057.
Farhat, F. C. L. G; Gregório, H. C. T.; Carvalho, R. D. P. de (2018). Evaluation of deep vein thrombosis prophylaxis in a general hospital. J. Vasc. Bras., 17(3), 184-192.
Ferreira, C. N., Sousa, M. de O., Dusse L. M. S., & Carvalho, M. das G. (2010). O novo modelo da cascata de coagulação baseado nas superfícies celulares e suas implicações. Rev Bras Hematol Hemoter., 32(5), 416-421.
Flato, U. A. P., Buhatem, T., Merluzzi, T., & Bianco, A. C. M. (2011). Novos anticoagulantes em cuidados intensivos. Rev Bras Ter Intensiva, 23(1),68-77.
Fraga-Silva, R. A., Sorg, B. S., Wankhede, M., de Deugd, C., Jun, J. Y., Baker, M. B. et al. (2010). ACE2 activation promotes antithrombotic activity. Mol Med. 16(5-6), 210-215.
Gerotziafas, G. T., Depasse, F., Chakroun T., Samama, M. M., & Elalamy, I. (2004). Recombinant factor VIIa partially reverses the inhibitor effect of fondaparinux on thrombin generation after tissue factor activation in platelet rich plasma and whole blood. Thromb Haemost., 91(3), 531-537.
Gralinski, L. E, Sheahan, T. P., Morrison, T. E., Menachery, V. D., Jensen, K. et al. (2018). Complement activation contributes to severe acute respiratory syndrome coronavirus pathogenesis. MBio., 9(5), 1753-1771.
Gray, E., Mulloy, B., & Barrowcliffe, T. W. (2008). Heparin and low-molecular-weight heparin. Thromb Haemost. 99(5), 807-818.
Grossman, S & Porth, C. M. (2015). Porth Fisiopatologia. Guanabara Koogan.
Guerra, C. C. (1968). Fisiologia da coagulação. Matern Infanc, 27(4), 291-295.
Hao, C., Sun, M., Wang, H., Zhang, L. & Wang, W. (2019). Low molecular weight heparins and their clinical applications. Progress in Molecular Biology and Translational Science., 163, 21-39.
Helms, J., Tacquard, C.; Severac, F., Leonard-Lorant, I., Ohana, M., Delabranche, X. et al. (2020). High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med., 46(6),1089-1098.
Hirsh, J., Warkentin, T. E., Shaughnessy, S. G., Anand, S. S., Halperin, J. L., Raschke, R., Granger, C., Ohman, E. M & Dalen, J. E. (2001). Heparin and low-molecular-weight heparin: Mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety. Chest., 119(1 Suppl.), 64S-94S.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y. et al. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2395(10223),497-506.
Hull, R. D., Raskob, G. E., Hirsh, J., Jay, R. M., Leclerc, J. R., Geerts, W. H. et al. (1986). Continuous Intravenous Heparin Compared with Intermittent Subcutaneous Heparin in the Initial Treatment of Proximal-Vein Thrombosis. N Engl J Med., 315(18), 1109-1114.
Hull, R. D., Raskob, G. E., Hirsh, J. et al. (1986). Continuous Intravenous Heparin Compared with Intermittent Subcutaneous Heparin in the Initial Treatment of Proximal-Vein Thrombosis. N Engl J Med., 315(18), 1109-1114.
Hull, R. D., Garcia, D. A., Burnett, A. E. et al. (2021). Heparin and LMW heparin: Dosing and adverse effects. https://www.uptodate.com/contents/heparin-and-lmw-heparin-dosing-and-adverse-effects.
Imai, Y., Kuba, K., Rao, S., Huan, Y. Guo, F., Guan, B. et al. (2005). Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature, 436(7047), 112-116.
Izcovich, A.; Cuker, A.; Kunkle, R.; Neumann, J.; Panepinto, J., Menaka, P. et al. (2020). A user guide to the American Society of Hematology clinical practice guidelines. Blood Adv, 4(9), 2095-2110.
Kumar, V., Abbas, A. K. & Aster, J. C. (2016). Robbins Patologia Básica. Guanabara Koogan.
Kumar, V., Abbas, A. K. & Aster, J. C. (2016). Robbins & Cotran Patologia: bases patológicas das doenças. Elsevier.
Kruger, P. C., Eikelboom, J. W.; Douketis, J. D. & Hankey, G. J. (2019). Deep vein thrombosis: update on diagnosis and management. Med J Aust. 210(11), 516-524.
Kucher, N., Connolly, S., Beckman, J. A., Cheng, L. H., Tsilimingras, K. V.; Fanikos, J., & Goldhaber, S. Z. (2004). International normalized ratio increase before warfarin-associated hemorrhage: Brief and subtle. Arch Intern Med. 164(19), 2176-2179.
Levine, M. N.; Raskob G., Beyth, R. J., Kearon, C. & Schulman, S. (2004). Hemorrhagic complications of anticoagulant treatment: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest., 126, 287S-310S.
Marques, M. A., Sá, F. P. A. de, Lupi, O. Brasil, P., & Ristow, A. (2017). Trombose venosa profunda e vírus chicungunha. J Vasc Bras., 16(1), 60-62.
Mazilu, L., Katsiki, N., Nikolouzakis, T. K., Aslanidis, G. L., Kouretas, D., Tsatsakis, A. et al. (2021). Thrombosis and Haemostasis challenges in COVID-19 – Therapeutic perspectives of heparin and tissue-type plasminogen activator and potential toxicological reactions-a mini review. Food Chem Toxicol., 148, 111974.
Mesquita Junior, N., Kingerski F. N. M., Marioto, G. L., Viegas, F. A. F., Mesquita, S. F. da S., & Perreto, S. (2013). Prevalência de trombose venosa profunda em paraplégicos de causa traumática. J Vasc Bras., 12(4), 271-277. doi:10.1590/jvb.2013.051.
McGonagle D, Sharif K, O’Regan A, & Bridgewood C. (2020). The Role of Cytokines Including Interleukin-6 in COVID-19 Induced Pneumonia and Macrophage Activation Syndrome-Like Disease. Autoimmun Rev Actions, 19(6), 102537.
McRae, H. L., Militello, L. & Refaai, M. A. (2021). Updates in Anticoagulation Therapy Monitoring. Biomedicines, 9(3), 262.
Miranda, F. (2015). Projeto Diretrizes SBACV: trombose venosa profunda diagnóstico e tratamento. https://sbacvsp.com.br/wp-content/uploads/2016/05/trombose-venosa-profunda.pdf.
Moores, L. K., Tritschler, T., Brosnahan, S., Carrier, M., Collen, J. F., Doerschug, K., Holley, A. B., Jimenez, D., Gal, G. L., Rali, P. & Wells, P. (2020). Prevention, Diagnosis, and Treatment of VTE in Patients with Coronavirus Disease 2019: CHEST Guideline and Expert Panel Report. Chest., 158(3), 1143-1163.
Mulloy, B., Gray, E., & Barrowcliffe, T. W. (2000). Characterization of unfractionated heparin: Comparison of materials from the last 50 years. Thromb Haemost, 84(6), 1052-1056.
Nagler, M., Haslauer, M., & Wuillemin, W. A. (2012). Fondaparinux - Data on efficacy and safety in special situations. Thromb Res. 129(4), 407-417.
Noschang, J., Guimarães, M. D., Teixeira, D. F. D., Braga, J. C. D., Hochhegger, B., Santana, P. R. P., Marchiori, E. (2018). Novas técnicas no diagnóstico por imagem do tromboembolismo pulmonar. Radiol Bras. 51(3), 178-186.
Nutescu E. A., Burnett A., Fanikos, J., Spinler, S., & Wittkowsky, A. (2016). Pharmacology of anticoagulants used in the treatment of venous thromboembolism. J Thromb Thrombolysis, 41(1), 15-31.
Ramacciotti E., Agati, L. B., Aguiar, V. C. R., Wolosker, N., Guerra, João C., & Almeida, R. P. de (2019). Zika and Chikungunya Virus and Risk for Venous Thromboembolism. Clin Appl Thromb., 25, 107602961882118.
Reno, L. da C., Silva Junior, V. L. da, & Trevisan, A. M. (2015). Trombose venosa profunda grave associada ao Sars-Cov-2 (COVID-19). http://sbacvrj.com.br/novo/artigo/trombose-venosa-profunda-grave-associada-ao-sars-cov-2-COVID-19 /.
Rocha, C. (2020). Quais as possíveis sequelas causadas pelo novo coronavírus. https://www.nexojornal.com.br/expresso/2020/07/22/Quais-as-possíveis-sequelas-causadas-pelo-novo-coronavírus.
Rodrigues, E. S.; Castilho-Fernandes, A.; Fontes, A. M. (2012). Novos conceitos sobre a fisiologia da hemostasia. Rev da Univ Val do Rio Verde. 10(1), 218-233.
Simões, M. S. M. B. & Pinto De Oliveira, R. P. de (2014). Principais fatores de risco para trombose venosa profunda. https://atualizarevista.com.br/wp-content/uploads/2014/10/SIMOES-Myriam-Solange-Martins-Bohana-OLIVEIRA-Rubia-Pinto-de.pdf.
Smith, Y. (2021). Types of Thrombosis. https://www.news-medical.net/health/Types-of-Thrombosis.aspx.
Souto, X. M. (2020). COVID-19: Aspectos gerais e implicações globais. Recital: Revista de Educação e Tecnologia de Almenara, 2(1).
Spyropoulos, A. C., Levy, J. H.; Walter, A., Connors, J. M., Hunt, B., Iba, T. et al. (2020). Scientific and standardization committee communication: clinical guide on the diagnosis, prevention,and treatment of venous thromboembolism in hospitalized patients with COVID-19 . J Thromb Haemost., 18(8),1859-1865.
Tang, N., Li, D. Wang, X., & Sun, Z. (2020). Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost., 18(4), 844-847.
Thachil, J., Tang, N., Gando, S., Falanga, A., Cattaneo, M., Levi, M., Clark, C. & Iba, T. (2020). ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 18(5); 1023-1026. doi:10.1111/jth.14810.
Theilen, E. O., Carr, T. L.& Fowler, W. M. (1950). The effects of intravenous administration of commercial beef heparin on the thrombocyte count and heparin sensitivity in man. J Lab Clin Med. 35(5), 699-702.
Piccinato, C. E. (2008). Postoperative venous thrombosis. Medicina, 41(4), 477-86.
Vaduganathan, M., Vardeny, O., Michel, T., McMurray, J. J. V., Pfeffer, M. A., & Solomon, S. D. (2020). Renin–angiotensin–aldosterone system inhibitors in patients with COVID-19. N Engl J Med, 382, 1653–1659.
Van Leeuwen, R. T., Kol, A., Andreotti, F., Kluft, C., Maseri, A., & Sperti, G. (1994). Angiotensin II increases plasminogen activator inhibitor type 1 and tissue-type plasminogen activator messenger RNA in cultured rat aortic smooth muscle cells. Circulation. 90(1), 362-368.
Verdecchia, P., Cavallini, C., Spanevello, A., & Angeli, F. (2020). The pivotal link between ACE2 deficiency and SARS-CoV-2 infection. Eur J of Intern Med, 76, 14-20.
Weitz, D. S. & Weitz, J. I. (2010). Update on heparin: What do we need to know? Journal of Thrombosis and Thrombolysis. 29, 199-207.
Whitlock, R. P., Sun, J. C., Fremes, S. E., Rubens, F. D., & Teoh, K. H. (2012). Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest., 141(2 SUPPL.), e576S-e600S.
World Health Organization (2020). Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected. https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf.
Zhang, Q., Lenardo, M. J., & Baltimore D. (2017). 30 Years of NF-κB: A Blossoming of Relevance to Human Pathobiology. Cell., 168(1-2), 37-57.
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z. et al. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 395(10229), 1054-1062.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2022 Clara Maria Muguet; Karoline Guimarães; Lilian Bastos; Marcela Baroni; Marcela Curty; Marcos Marzano; Mariana Costa; Mirela Tardelli; Rafael Risi ; Renata Lustosa ; Vanessa Estato
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Los autores que publican en esta revista concuerdan con los siguientes términos:
1) Los autores mantienen los derechos de autor y conceden a la revista el derecho de primera publicación, con el trabajo simultáneamente licenciado bajo la Licencia Creative Commons Attribution que permite el compartir el trabajo con reconocimiento de la autoría y publicación inicial en esta revista.
2) Los autores tienen autorización para asumir contratos adicionales por separado, para distribución no exclusiva de la versión del trabajo publicada en esta revista (por ejemplo, publicar en repositorio institucional o como capítulo de libro), con reconocimiento de autoría y publicación inicial en esta revista.
3) Los autores tienen permiso y son estimulados a publicar y distribuir su trabajo en línea (por ejemplo, en repositorios institucionales o en su página personal) a cualquier punto antes o durante el proceso editorial, ya que esto puede generar cambios productivos, así como aumentar el impacto y la cita del trabajo publicado.
