Podemos atuar preventivamente para evitar que os pacientes portadores de COVID-19 evoluam de forma mais grave?

Abstract

Resumo Muitos pacientes com COVID-19 apresentam complicações tromboembólicas que acabam piorando seu prognóstico. Os autores propõem uma modificação no escore CHA2DS2-VASc, incluindo 1 ponto para COVID-19, para, desse modo, indicar profilaxia de eventos tromboembólicos antes do agravamento do quadro. As vantagens dessa modificação seriam evitar a piora do paciente por problemas tromboembólicos, bem como a necessidade de internação em unidade de tratamento intensivo e de ventilação mecânica, e diminuir a mortalidade.

Neurological complications of Covid-19:

“…20 As described, the imbalance of coagulation factors present in phase 2 may enable the formation of platelet thrombi in small vessels and this is a risk factor not only for the respiratory condition but also for neurological manifestations. 20,27 In this sense, it is necessary to predict or reverse the prothrombotic state of some patients using anticoagulants. Ddimer, a fibrin degradation product, is also used to assess the risk of venous thromboembolism.…”

“…In addition, relevant articles or data, which might be found in the references of the texts read, were added to this work. 2,3,5,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]…”

“…Ddimer, a fibrin degradation product, is also used to assess the risk of venous thromboembolism. 20,27 These degradation products are usually elevated in a serious SARS-CoV-2 infection, a mechanism that can lead to cerebrovascular disorders, such as ischemic stroke. 27 Such an inflammatory state can leave patients even more vulnerable to central nervous system complications, as lesions in the vessels also favor the attraction of coagulation factors, which in turn, favor the state of hypercoagulability.…”