Palabras clave
Infecciones por coronavirus
SARS-CoV
Coagulación sanguínea
Coagulación intravascular diseminada
Disfunción orgánica múltiple
Sepsis
Síndrome de respuesta inflamatoria sistémica
Lesión renal aguda
SARS-CoV
Coagulación sanguínea
Coagulación intravascular diseminada
Disfunción orgánica múltiple
Sepsis
Síndrome de respuesta inflamatoria sistémica
Lesión renal aguda
Cómo citar
Pájaro-Galvis, N., Abuabara-Franco, E., Leal-Martínez, V., Serpa-Díaz, D., Rico-Fontalvo, J., Daza-Arnedo, R., Bohorquez-Rivero, J., Correa-Guerrero, J., López-Fontalvo, J., Pomares-Lara, A., Raad-Sarabia, M., & Porto-Corbacho, D. (2020). Anticoagulación en pacientes con infección por COVID-19. Salud UIS, 52(4), 422–430. https://doi.org/10.18273/revsal.v52n4-2020009
Resumen
Introducción: El COVID-19 es una neumonía por el nuevo Coronavirus SARS-CoV-2, con presentación clínica muy heterogénea, que en casos graves puede asociarse con un alto riesgo de coagulación intravascular diseminada, similar a lo observada en la coagulopatía inducida por sepsis, pero con un fenotipo predominantemente trombótico. Por esto, La anticoagulación debe ser considerado como una estrategia terapéutica en este tipo de pacientes. Objetivos: Mostrar toda la literatura disponible sobre los beneficios de la anticoagulación en COVID-19 grave. Metodología: Se realizó una búsqueda avanzada con los términos DeSC y MeSH: Infecciones por Coronavirus; SARS-CoV; Coagulación Sanguínea; Coagulación Intravascular Diseminada; Disfunción orgánica múltiple; Sepsis; Síndrome de respuesta inflamatoria sistémica; Lesión renal aguda. Se utilizaron los motores de búsqueda Clinical Key, Embase, PubMed y Ovid, obteniendo un total de 143 resultados, entre artículos originales, reportes de casos, series de casos y revisiones de la literatura, se seleccionaron un total de 56 artículos que fueron utilizados para la elaboración de la presente revisión de la literatura. Conclusiones: Los pacientes con COVID-19 grave poseen alto riesgo trombótico y podrían beneficiarse de la anticoagulación con heparinas de bajo peso molecular; no obstante, hace falta más estudios sobre la utilidad del tratamiento anticoagulante en pacientes con COVID-19 grave y riesgo de coagulación intravascular diseminada.
Referencias
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2. Zhong J, Tang J, Ye C, Dong L. The immunology of COVID-19: is immune modulation an option for treatment? Lancet Rheumat. 2020; S266599132030120X.
3. Ministerio de Salud y Protección Social. Colombia confirma su primer caso de COVID-19. 6 de marzo de 2020; https://www.minsalud.gov.co/Paginas/ Colombia-confirma-su-primer-caso-de-COVID-19. aspx.
4. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 51. 11 de marzo de 2020.
5. World Health Organization. Coronavirus disease (COVID-19) outbreak situation. 3 de junio de 2020.
6. González C, Yama E, Yomayusa M, VargasJ, Rico J, Ariza A, et al. Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, diagnóstico y manejo de la lesión renal aguda por SARS-CoV-2/COVID-19. Rev Colomb Nefrol. 2020; 7(Supl 2). doi: https:// doi.org/10.22265/acnef.7.Supl.2.473
7. Daza Arnedo R, Aroca Martínez G, Rico Fontalvo JE, Rey Vela E, Pájaro Galvis NE, Salgado Montiel LG, et al. Terapias de purificación sanguínea en COVID-19. Rev Colomb Nefrol. 2020; 7(Supl.2). doi: https://doi.org/10.22265/acnef.7.Supl.2.476
8. Ministerio de Salud y Protección social, Instituto nacional de salud. Situación actual de Nuevo Coronarivus (COVID-19). 3 de junio de 2020; https://d2jsqrio60m94k.cloudfront.net/.
9. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. 2020; 323(20): 2052- 2059. doi: 10.1001/jama.2020.6775
10. Shang J, Ye G, Shi K, Wan Y, Luo C, Aihara H, et al. Structural basis of receptor recognition by SARS-CoV-2. 2020; 581(7807): 221-224. doi: 10.1038/ s41586-020-2179-y
11. Moore JB, June CH. Cytokine release syndrome in severe COVID-19. Science. 2020; 368(6490): 473-474. doi: 10.1126/science.abb8925
12. Leisman DE, Deutschman CS, Legrand M. Facing COVID-19 in the ICU: vascular dysfunction, thrombosis, and dysregulated inflammation. Intensive Care Med. 2020;46(6): 1105-1108. doi: 10.1007/s00134-020-06059-6
13. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. COVID-19 and Cardiovascular Disease. Circulation. 2020; 141(20): 1648-1655. doi: https://doi.org/10.1161/ CIRCULATIONAHA.120.046941
14. Ciceri F, Beretta L, Scandroglio AM, Colombo S, Landoni G, Ruggeri A, et al. Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis. Crit Care Resusc. 2020; 22(2): 95-97.
15. Williamson DR, Albert M, Heels-Ansdell D, Arnold DM, Lauzier F, Zarychanski R, et al. Thrombocytopenia in critically ill patients receiving thromboprophylaxis: Frequency, risk factors, and outcomes. Chest. 2013; 144(4): 1207-1215. doi: 10.1378/chest.13-0121
16. Selvin E, Lazo M, Chen Y, Shen L, Rubin J, McEvoy JW, et al. Diabetes mellitus, prediabetes, and incidence of subclinical myocardial damage. Circulation. 2014; 130(16): 1374-1382. doi: 10.1161/CIRCULATIONAHA.114.010815
17. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020; 323(11): 1061-1069. doi: 10.1001/jama.2020.1585
18. Iba T, Di Nisio M, Levy JH, Kitamura N, Thachil J. New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: A retrospective analysis of a nationwide survey. BMJ Open. 2017; 7(9): 1-8. doi: 10.1136/ bmjopen-2017-017046
19. Sarup BM. Diagnosis and treatment of disseminated intravascular coagulation (DIC). J Assoc Physicians India. 1973; 21(10): 861-866.
20. Levi M, Scully M. How I treat disseminated intravascular coagulation. Blood. 2018; 131(8): 845-854. doi: 10.1182/blood-2017-10-804096
21. Hasegawa N, Husari AW, Hart WT, Kandra TG, Raffin TA. Role of the coagulation system in ARDS. Chest. 1994; 105(1): 268-277. doi: 10.1378/ chest.105.1.268
22. van Gorp ECM, Suharti C, ten Cate H, Dolmans WMV, van der Meer JWM, ten Cate JW, et al. Review: Infectious diseases and coagulation disorders. J Infect Dis. 1999; 180(1): 176-186. doi: 10.1086/314829
23. Yang Y, Tang H. Aberrant coagulation causes a hyper-inflammatory response in severe influenza pneumonia. Cell Mol Immunol. 2016; 13(4): 432-442. doi: 10.1038/cmi.2016.1
24. Cao W, Li T. COVID-19: towards understanding of pathogenesis. Cell Res. 2020; 30(5): 367-369. doi: 10.1038/s41422-020-0327-4
25. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020; 180(7): 1-11. doi: 10.1001/jamainternmed.2020.0994
26. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020; 18(4): 844-847. doi: 10.1111/jth.14768
27. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. abril de 2020; 8(4):420-422. doi: 10.1016/S2213-2600(20)30076-X
28. Iba T, Levi M, Levy JH. Sepsis-Induced coagulopathy and disseminated intravascular coagulation. Semin Thromb Hemost. 2020; 46(1): 89-95. doi: 10.1055/s-0039-1694995
29. Najem MY, Couturaud F, Lemarié CA. Cytokine and chemokine regulation of venous thromboembolism. J Thromb Haemost. 2020; 18(5): 1009-1019. doi: https://doi.org/10.1111/jth.14759
30. Lillicrap D. Disseminated intravascular coagulation in patients with 2019‐nCoV pneumonia. J Thromb Haemost. 2020; 18(4): 786-787. doi: 10.1111/ jth.14781
31. Gralinski LE, Iii AB, Jeng S. Mechanisms of severe acute respiratory syndrome coronavirus-. MBio. 2013; 4(4): 1-12. doi: 10.1128/mBio.00271-13
32. Yao XH, Li TY, He ZC, Ping YF, Liu HW, Yu SC, et al. A pathological report of three COVID-19 cases by minimally invasive autopsies. Zhonghua Bing Li Xue Za Zhi. 2020; 49(5): 411-417. doi: 10.3760/ cma.j.cn112151-20200312-00193
33. Connors J, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020; 135(23): 2033-2040. doi: 10.1182/ blood.2020006000
34. Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID‐19. J Thromb Haemost. 2020; 18(7): 1559-1561. doi: 10.1111/ jth.14849
35. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020; 191: 145-147. doi: https://doi.org/10.1016/j. thromres.2020.04.013
36. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, et al. Hematologic parameters in patients with COVID‐19 infection. Am J Hematol. 2020; 95(6). E131-E134. doi: 10.1002/ajh.25774
37. Yan SF, Mackman N, Kisiel W, Stern DM, Pinsky DJ. Hypoxia/hypoxemia-induced activation of the procoagulant pathways and the pathogenesis of ischemia-associated thrombosis. Arterioscler Thromb Vasc Biol. 1999; 19(9): 2029-2035. doi: 10.1161/01.atv.19.9.2029
38. Chauhan AJ, Wiffen LJ, Brown TP. COVID‐19: a collision of complement, coagulation and inflammatory pathways. J Thromb Haemost. 2020; published ahead of print. doi: https://doi. org/10.1111/jth.14981
39. Magro CM, Momtahen S, Mulvey JJ, PhD, Yassin AH, Kaplan RB, Laurence JC. Role of the skin biopsy in the diagnosis of atypical hemolytic uremic syndrome. Am J Dermatopathol 2015; 37(5): 349-359. doi: 10.1097/DAD.0000000000000234
40. Campbell CM, Kahwash R. Will complement inhibition be the new target in treating COVID-19– related systemic thrombosis? Circulation. 2020; 141(22): 1739-1741. doi: 10.1161/ CIRCULATIONAHA.120.047419
41. Magro C, Mulvey JJ, Berlin D, Nuovo G, Salvatore S, Harp J, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases. Transl Res. 2020; 220: 1-13. doi: 10.1016/j.trsl.2020.04.007
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Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Derechos de autor 2020 Nehomar Pájaro Galvis, Emilio Abuabara Franco, Victor Leal Martínez, Dagoberto Serpa Díaz, Jorge Rico Fontalvo, Rodrigo Daza Arnedo, José Bohorquez Rivero, José Correa Guerrero, Jonatan López Fontalvo, Alonso Pomares Lara, María Raad Sarabia, Daniel Porto Corbacho
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