Prevención del tromboembolismo venoso en pacientes afectados por COVID-19
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Oct 31, 2023
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Objetivo: Buscar en la literatura evidencia actual sobre la profilaxis del tromboembolismo venoso en pacientes adultos afectados por COVID-19. Métodos: Esta es una revisión integradora de la literatura. Las bases de datos utilizadas fueron la Biblioteca Virtual de Salud (BVS), el Índice Acumulativo de Literatura de Enfermería y Afines a la Salud (CINAHL), el Sistema de Recuperación y Análisis de Literatura Médica en Línea (MEDLINE) a través de la Biblioteca Nacional de Medicina y los Institutos Nacionales de Salud (PubMed) y SciVerse. Scopus (Elsevier). La elaboración de la pregunta de investigación se dio a través de la estrategia PICO. Surgió la pregunta: ¿cuáles son las medidas profilácticas de tromboembolismo venoso en pacientes adultos hospitalizados con COVID-19? La búsqueda bibliográfica se realizó entre agosto y noviembre de 2022. Inicialmente encontramos 501 artículos. La selección de estudios se realizó mediante el programa gestor de referencias Rayyan®. Resultados: Los artículos seleccionados se incluyeron en Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Y 23 artículos que conformaron la muestra final obedecieron a los criterios de inclusión y exclusión, fueron exportados y categorizados en Microsoft Excel® 2016. Consideraciones finales: La anticoagulación profiláctica o terapéutica se relacionó con mejores resultados clínicos y disminución de la tasa de mortalidad en esta población.
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Cómo citar
BritoT. V. C., SantosI. G. M. dos, & LopesF. J. (2023). Prevención del tromboembolismo venoso en pacientes afectados por COVID-19. Revista Eletrônica Acervo Saúde, 23(10), e13685. https://doi.org/10.25248/reas.e13685.2023
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1. ATALLAH B, et al. The impact of protocol-based high-intensity pharmacological thromboprophylaxis on thrombotic events in critically ill COVID-19 patients. Anaesthesia. 2021;76(3):327–35.
2. BARREIRO I, et al. Intrahospital Protocol for the Management of COVID-19 Disease in Adults. Acta Med Port. 2022;35(7–8):593–603.
3. BATISTA DR, et al. 2022 Uso de anticoagulantes em pacientes com COVID-19 : revisão sistemática “ viva ” e. J Bras Pneumol e Tisologia. 2022;48(4):1–10.
4. BRANDÃO SCS, et al. Severe COVID-19: Understanding the role of immunity, endothelium, and coagulation in clinical practice. J Vasc Bras. 2020;19:1–11.
5. BIKDELI V, et al. Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial. Thromb Haemost. 2021;122(1):131–41.
6. CASARIN ST, et al. Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. J. nurs. health. 2020; 10(n.esp.): e20104031.
7. CHINDAMO MC, et al. Avaliação do risco de sangramento na profilaxia do tromboembolismo venoso. J Vasc Bras., 2021; 20.
8. CUKER A, et al. American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19. Blood Adv., 2021; 5(3): 872–88.
9. CUNHA, et al. Incidence, diagnosis, treatment methods, and outcomes of clinically suspected venous thromboembolic disease in patients with COVID-19 in a quaternary hospital in Brazil. J Vasc Bras., 2021; 20: 1–7.
10. FARRAR JE, et al. Evaluation of a patient specific, targeted-intensity pharmacologic thromboprophylaxis protocol in hospitalized patients with COVID-19. J Thromb Thrombolysis, 2022; 53(2): 446–53.
11. FARIAS CP, et al. Trombose venosa profunda em pacientes com COVID-19: Rev Saúde. 2021;12(3):20–5.
12. FARHAT FCLG, et al. Avaliação da profilaxia da trombose venosa profunda em um hospital geral. J Vasc Bras., 2018;17(3):184–92.
13. HASAN SS, et al. Venous thromboembolism in critically ill COVID-19 patients receiving prophylactic or therapeutic anticoagulation: a systematic review and meta-analysis. J Thromb Thrombolysis, 2020; 50(4): 814–21.
14. IBA T, et al. Diagnosis and management of sepsis-induced coagulopathy and disseminated intravascular coagulation. J Thromb Haemost., 2019; 17(11): 1989–94.
15. KHALIL OAK e KHALIL SS. SARS-CoV-2: taxonomia, origem e constituição. Rev Med (São Paulo). 2020;99(5).
16. KYRIAKOULIS KG, et al. Thromboprophylaxis in Patients with COVID-19: Systematic Review of National and International Clinical Guidance Reports. Curr Vasc Pharmacol. 2021;20(1):96–110.
17. LAVÍNIO A, et al. Safety profile of enhanced thromboprophylaxis strategies for critically ill COVID-19 patients during the first wave of the pandemic: observational report from 28 European intensive care units. Crit Care. 2021; 25(1): 1–10.
18. LAZARIDIS D, et al. The Impact of Anticoagulation on COVID-19 (SARS CoV-2) Patient Outcomes: A Systematic Review. J PharmPract. 2022;35(6):1000-1006.
19. MAATMAN TK, et al. Routine Venous Thromboembolism Prophylaxis May Be Inadequate in the Hypercoagulable State of Severe Coronavirus Disease 2019. Crit Care Med. 2020;48(9):E783–90.
20. MELNYK BM e FINEOUT-OVERHOLT E. Evidence-based practice in nursing & healthcare: a guide to best practice [Internet]. Vol. 19, The Joanna Briggs Institute. 2013. p. 2013. Available from: https://books.google.com.br/books?id=EPaBEAAAQBAJ&printsec=frontcover&hl=pt-BR&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false. Acessado em: 10 de outubro de 2022.
21. OMS. 2022. Organização Mundial da Saúde (OMS). Painel da OMS sobre o Coronavírus. Disponível em: https://covid19.who.int/. Acessado em: 12 de abril de 2022.
22. OPAS. 2020. ORGANIZAÇÃO PAN-AMERICANA DE SAÚDE (OPAS). Histórico da Pandemia de Covid-19. Disponível em: https://www.paho.org/pt/covid19/historico-da-pandemia-covid-19. Acessado em: 6 de março de 2022.
23. ORSI FA, et al. Diretrizes sobre diagnóstico, prevenção e tratamento de complicações tromboembólicas na Covid-19. Assoc Médica Bras.2020;1–22.
24. PARKS AL, et al. Venous thromboembolism (VTE) prevention and diagnosis in COVID-19: Practice patternsand outcome sat 33 hospitals. PLoS ONE 2022. 17(5): e0266944.
25. RAMACCIOTTI E, et al. Higher Intensity Thromboprophylaxis Regimens and Pulmonary Embolism in Critically Ill Coronavirus Disease 2019 Patients. Crit Care Med. 2020;48(11):E1087–9.
26. RIYAHI S, et al. Predictors of acute deep venous thrombosis in patients hospitalized for COVID-19. Med (United States). 2021;100(38).
27. SADEGHIPOR P, et al. Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality among Patients with COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinic. JAMA - J Am Med Assoc. 2021;325(16):1620–30.
28. SAMPAIO SML, et al. 2020 Atuação de enfermagem frente ao atendimento ao paciente hipertenso: uma revisão integrativa. Revista Eletrônica Acervo Saúde, n. 50, p. e3526, 18 jun. 2020.
29. SANT’ANNA LP, 2020. Anticoagulação na Covid-19, orientações da Sociedade Brasileira de Trombose e Hemostasia. Portal PEBMED. Disponível em: https://pebmed.com.br/anticoagulacao-na-covid-19-orientacoes-da-sociedade-brasileira-de-trombose-e-hemostasia/. Acessado em: 6 de março de 2022.
30. SIMPSON G e ROGERS M. A coleta em tempo real de dados sobre pacientes com COVID-19 e trombose e / ou hemorragia ajudou no desenvolvimento de diretrizes de profilaxia para tromboembolismo no Royal Surrey County Hospital durante a pandemia de COVID-19. R Coll Physicians. 2021;51–2.
31. SMS. 2020. SECRETARIA MUNICIPAL DE SAÚDE (SMS). Plano de ação para enfretamento da Covid-19. Brasil. Disponível em: https://www.prefeitura.sp.gov.br/cidade/secretarias/saude/acesso_a_informacao/index.php?p=295844. Acessado em: 6 de março de 2022.
32. SOBREIRA ML, et al. Anticoagulants as panacea in COVID-19 infection. J Vasc Bras. 2020;19:1–2.
33. SPYROPOULOS AC, et al. Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients with COVID-19: The HEP-COVID Randomized Clinical Trial. JAMA Intern Med. 2021;181(12):1612–20.
34. STAWIARSKI K. D-dimer driven deep vein thrombosis prophylaxis strategy for hospitalized patients with COVID-19. Thromb Res. 2021;201:151–3.
35. TACCONE FS, et al. Higher Intensity Thromboprophylaxis Regimens and Pulmonary Embolism in Critically Ill Coronavirus Disease 2019 Patients. Crit Care Med. 2020;48(11):E1087–90.
36. TAVARES LS e ORTIZ JV. Desenvolvimento da trombose em pacientes com e sem infecção pelo SARS-Cov-2 - revisão de literatura. Res Soc Dev. 2021;10(15):e410101522959.
37. VALLEJO OG, et al. Knowledge of thromboprophylaxis-COVID-19 in healthcare professionals in Spain. Med Fam Semer. 2021;47:361–8.
38. VAUGHN VN, et al. Trends in Venous Thromboembolism Anticoagulation in Patients Hospitalized with COVID-19. JAMA Netw Open, 2021; 4(6): 1–13.
39. VOICU S, et al. Increased anticoagulation reduces proximal deep vein thrombosis in mechanically ventilated COVID-19 patients: Venous thrombosis prevention & COVID-19. J Infect., 2021; 82(5): 186-230.
40. XAVIER AR, et al. COVID-19: manifestações clínicas e laboratoriais na infecção pelo novo coronavírus. J Bras Patol e Med Lab., 2020; 56(5): 1–9.
2. BARREIRO I, et al. Intrahospital Protocol for the Management of COVID-19 Disease in Adults. Acta Med Port. 2022;35(7–8):593–603.
3. BATISTA DR, et al. 2022 Uso de anticoagulantes em pacientes com COVID-19 : revisão sistemática “ viva ” e. J Bras Pneumol e Tisologia. 2022;48(4):1–10.
4. BRANDÃO SCS, et al. Severe COVID-19: Understanding the role of immunity, endothelium, and coagulation in clinical practice. J Vasc Bras. 2020;19:1–11.
5. BIKDELI V, et al. Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial. Thromb Haemost. 2021;122(1):131–41.
6. CASARIN ST, et al. Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. J. nurs. health. 2020; 10(n.esp.): e20104031.
7. CHINDAMO MC, et al. Avaliação do risco de sangramento na profilaxia do tromboembolismo venoso. J Vasc Bras., 2021; 20.
8. CUKER A, et al. American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19. Blood Adv., 2021; 5(3): 872–88.
9. CUNHA, et al. Incidence, diagnosis, treatment methods, and outcomes of clinically suspected venous thromboembolic disease in patients with COVID-19 in a quaternary hospital in Brazil. J Vasc Bras., 2021; 20: 1–7.
10. FARRAR JE, et al. Evaluation of a patient specific, targeted-intensity pharmacologic thromboprophylaxis protocol in hospitalized patients with COVID-19. J Thromb Thrombolysis, 2022; 53(2): 446–53.
11. FARIAS CP, et al. Trombose venosa profunda em pacientes com COVID-19: Rev Saúde. 2021;12(3):20–5.
12. FARHAT FCLG, et al. Avaliação da profilaxia da trombose venosa profunda em um hospital geral. J Vasc Bras., 2018;17(3):184–92.
13. HASAN SS, et al. Venous thromboembolism in critically ill COVID-19 patients receiving prophylactic or therapeutic anticoagulation: a systematic review and meta-analysis. J Thromb Thrombolysis, 2020; 50(4): 814–21.
14. IBA T, et al. Diagnosis and management of sepsis-induced coagulopathy and disseminated intravascular coagulation. J Thromb Haemost., 2019; 17(11): 1989–94.
15. KHALIL OAK e KHALIL SS. SARS-CoV-2: taxonomia, origem e constituição. Rev Med (São Paulo). 2020;99(5).
16. KYRIAKOULIS KG, et al. Thromboprophylaxis in Patients with COVID-19: Systematic Review of National and International Clinical Guidance Reports. Curr Vasc Pharmacol. 2021;20(1):96–110.
17. LAVÍNIO A, et al. Safety profile of enhanced thromboprophylaxis strategies for critically ill COVID-19 patients during the first wave of the pandemic: observational report from 28 European intensive care units. Crit Care. 2021; 25(1): 1–10.
18. LAZARIDIS D, et al. The Impact of Anticoagulation on COVID-19 (SARS CoV-2) Patient Outcomes: A Systematic Review. J PharmPract. 2022;35(6):1000-1006.
19. MAATMAN TK, et al. Routine Venous Thromboembolism Prophylaxis May Be Inadequate in the Hypercoagulable State of Severe Coronavirus Disease 2019. Crit Care Med. 2020;48(9):E783–90.
20. MELNYK BM e FINEOUT-OVERHOLT E. Evidence-based practice in nursing & healthcare: a guide to best practice [Internet]. Vol. 19, The Joanna Briggs Institute. 2013. p. 2013. Available from: https://books.google.com.br/books?id=EPaBEAAAQBAJ&printsec=frontcover&hl=pt-BR&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false. Acessado em: 10 de outubro de 2022.
21. OMS. 2022. Organização Mundial da Saúde (OMS). Painel da OMS sobre o Coronavírus. Disponível em: https://covid19.who.int/. Acessado em: 12 de abril de 2022.
22. OPAS. 2020. ORGANIZAÇÃO PAN-AMERICANA DE SAÚDE (OPAS). Histórico da Pandemia de Covid-19. Disponível em: https://www.paho.org/pt/covid19/historico-da-pandemia-covid-19. Acessado em: 6 de março de 2022.
23. ORSI FA, et al. Diretrizes sobre diagnóstico, prevenção e tratamento de complicações tromboembólicas na Covid-19. Assoc Médica Bras.2020;1–22.
24. PARKS AL, et al. Venous thromboembolism (VTE) prevention and diagnosis in COVID-19: Practice patternsand outcome sat 33 hospitals. PLoS ONE 2022. 17(5): e0266944.
25. RAMACCIOTTI E, et al. Higher Intensity Thromboprophylaxis Regimens and Pulmonary Embolism in Critically Ill Coronavirus Disease 2019 Patients. Crit Care Med. 2020;48(11):E1087–9.
26. RIYAHI S, et al. Predictors of acute deep venous thrombosis in patients hospitalized for COVID-19. Med (United States). 2021;100(38).
27. SADEGHIPOR P, et al. Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality among Patients with COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinic. JAMA - J Am Med Assoc. 2021;325(16):1620–30.
28. SAMPAIO SML, et al. 2020 Atuação de enfermagem frente ao atendimento ao paciente hipertenso: uma revisão integrativa. Revista Eletrônica Acervo Saúde, n. 50, p. e3526, 18 jun. 2020.
29. SANT’ANNA LP, 2020. Anticoagulação na Covid-19, orientações da Sociedade Brasileira de Trombose e Hemostasia. Portal PEBMED. Disponível em: https://pebmed.com.br/anticoagulacao-na-covid-19-orientacoes-da-sociedade-brasileira-de-trombose-e-hemostasia/. Acessado em: 6 de março de 2022.
30. SIMPSON G e ROGERS M. A coleta em tempo real de dados sobre pacientes com COVID-19 e trombose e / ou hemorragia ajudou no desenvolvimento de diretrizes de profilaxia para tromboembolismo no Royal Surrey County Hospital durante a pandemia de COVID-19. R Coll Physicians. 2021;51–2.
31. SMS. 2020. SECRETARIA MUNICIPAL DE SAÚDE (SMS). Plano de ação para enfretamento da Covid-19. Brasil. Disponível em: https://www.prefeitura.sp.gov.br/cidade/secretarias/saude/acesso_a_informacao/index.php?p=295844. Acessado em: 6 de março de 2022.
32. SOBREIRA ML, et al. Anticoagulants as panacea in COVID-19 infection. J Vasc Bras. 2020;19:1–2.
33. SPYROPOULOS AC, et al. Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients with COVID-19: The HEP-COVID Randomized Clinical Trial. JAMA Intern Med. 2021;181(12):1612–20.
34. STAWIARSKI K. D-dimer driven deep vein thrombosis prophylaxis strategy for hospitalized patients with COVID-19. Thromb Res. 2021;201:151–3.
35. TACCONE FS, et al. Higher Intensity Thromboprophylaxis Regimens and Pulmonary Embolism in Critically Ill Coronavirus Disease 2019 Patients. Crit Care Med. 2020;48(11):E1087–90.
36. TAVARES LS e ORTIZ JV. Desenvolvimento da trombose em pacientes com e sem infecção pelo SARS-Cov-2 - revisão de literatura. Res Soc Dev. 2021;10(15):e410101522959.
37. VALLEJO OG, et al. Knowledge of thromboprophylaxis-COVID-19 in healthcare professionals in Spain. Med Fam Semer. 2021;47:361–8.
38. VAUGHN VN, et al. Trends in Venous Thromboembolism Anticoagulation in Patients Hospitalized with COVID-19. JAMA Netw Open, 2021; 4(6): 1–13.
39. VOICU S, et al. Increased anticoagulation reduces proximal deep vein thrombosis in mechanically ventilated COVID-19 patients: Venous thrombosis prevention & COVID-19. J Infect., 2021; 82(5): 186-230.
40. XAVIER AR, et al. COVID-19: manifestações clínicas e laboratoriais na infecção pelo novo coronavírus. J Bras Patol e Med Lab., 2020; 56(5): 1–9.