{"id":15565,"date":"2020-05-12T20:26:46","date_gmt":"2020-05-12T20:26:46","guid":{"rendered":"https:\/\/sbpt.org.br\/portal\/?p=15565"},"modified":"2020-05-12T20:26:46","modified_gmt":"2020-05-12T20:26:46","slug":"resumo-cientifico-covid-12","status":"publish","type":"post","link":"https:\/\/sbpt.org.br\/portal\/resumo-cientifico-covid-12\/","title":{"rendered":"COVID-19: resumos de artigos selecionados &#8211; parte 12"},"content":{"rendered":"<p><em>12 de maio de 2020.<\/em><\/p>\n<p style=\"text-align: justify\">Os artigos escolhidos para resenha tratam da alta incid\u00eancia de tromboembolismo venoso (TEV) em pacientes com COVID-19 e dos eventos cardiovasculares nos infectados pelo novo coronav\u00edrus.<\/p>\n<p><strong>High Incidence of Venous Thromboembolic Events In Anticoagulated Severe Covid-19 Patients<\/strong><\/p>\n<p><strong>Resumo<\/strong><\/p>\n<p>O artigo tem por objetivo avaliar, de forma sistem\u00e1tica e por meio de ultrassom doppler completo, a incid\u00eancia de tromboembolismo venoso (TEV) em pacientes com COVID-19 (<em>coronavirus disease 2019)<\/em> grave, internados em UTI.<\/p>\n<p><strong>M\u00e9todos:<\/strong><\/p>\n<ul>\n<li>Estudo retrospectivo em duas UTIs francesas.<\/li>\n<li>Entre os dias 1 e 3 ap\u00f3s admiss\u00e3o na UTI, os pacientes foram submetidos a ultrassom doppler venoso de membros inferiores.<\/li>\n<li>Em pacientes sem TEV no primeiro ultrassom, um novo US foi realizado no 7\u00ba dia de interna\u00e7\u00e3o.<\/li>\n<li>Angiotomografia de t\u00f3rax ou ecocardiografia transesof\u00e1gica para pesquisa de TEP foram realizadas nos pacientes com insufici\u00eancia respirat\u00f3ria persistente ou secund\u00e1ria.<\/li>\n<li>Anticoagula\u00e7\u00e3o foi deixada a crit\u00e9rio do m\u00e9dico assistente, com base no risco individual de trombose. Os pacientes foram classificados como tratados com anticoagula\u00e7\u00e3o profil\u00e1tica ou com anticoagula\u00e7\u00e3o terap\u00eautica.<\/li>\n<\/ul>\n<p><strong>Resultados:<\/strong><\/p>\n<ul>\n<li>Foram avaliados 26 pacientes com mediana de 68 anos de idade, 77% do sexo masculino, mediana de IMC de 30,2Kg\/m<sup>2<\/sup>, 85% de hipertensos, 27% j\u00e1 usavam anticoagula\u00e7\u00e3o antes da interna\u00e7\u00e3o. Todos os pacientes foram submetidos a ventila\u00e7\u00e3o mec\u00e2nica, com posicionamento prono em 62%.<\/li>\n<li>Medianas de D-d\u00edmero 1.750 ng\/mL e fibrinog\u00eanio 7 g\/L.<\/li>\n<li>Tratamento com anticoagula\u00e7\u00e3o:\n<ul>\n<li>Profil\u00e1tica: 31% dos pacientes (n = 8)<\/li>\n<li>Terap\u00eautica: 69% dos pacientes (n = 18)<\/li>\n<\/ul>\n<\/li>\n<li>Incid\u00eancia geral de TEV perif\u00e9rico: 69% (n= 18)\n<ul>\n<li>Grupo anticoagula\u00e7\u00e3o profil\u00e1tica: 100% (n= 8)<\/li>\n<li>Grupo anticoagula\u00e7\u00e3o terap\u00eautica: 56% (n= 10)<\/li>\n<\/ul>\n<\/li>\n<li>Incid\u00eancia de embolia pulmonar: 23% (n= 6), sendo que todos ocorreram nos pacientes com anticoagula\u00e7\u00e3o terap\u00eautica.<\/li>\n<li>A mortalidade geral foi de 12%.\n<p><strong>Interpreta\u00e7\u00f5es:<\/strong><\/li>\n<\/ul>\n<ul>\n<li style=\"text-align: justify\">H\u00e1 alta incid\u00eancia de TEV e TEP em pacientes com COVID-19 graves e internados em UTI. Mesmo em pacientes com anticoagula\u00e7\u00e3o terap\u00eautica, essa incid\u00eancia segue elevada.<\/li>\n<li style=\"text-align: justify\">Esses achados refor\u00e7am o alto risco de fen\u00f4menos tromboemb\u00f3licos em pacientes com COVID-19 e a necessidade de triagem e monitoriza\u00e7\u00e3o de rotina para TEV em pacientes internados em UTI.<\/li>\n<\/ul>\n<p>Refer\u00eancia:<\/p>\n<ol>\n<li style=\"text-align: justify\">LLITJOS, JF. et al. High Incidence of Venous Thromboembolic Events in Anticoagulated Severe Covid-19 Patients J Thromb Haemost. 2020 Apr 22. doi: 10.1111\/jth.14869.<\/li>\n<\/ol>\n<p><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jth.14869?casa_token=oy7DdH5uUpoAAAAA:wyMRNDVsbEbceZXKzTNLeiBKs5c7Nw5S1O94zzqSkjNR8hHilnfp_0d-5opV5kJHNIUtrz3ARuUvNIQW\" target=\"_blank\" rel=\"noopener\">Clique aqui para acessar o artigo na \u00edntegra.<\/a><\/p>\n<hr>\n<p><strong>COVID-19 AND THE CARDIOVASCULAR SYSTEM<\/strong><\/p>\n<p><strong>Resumo<\/strong><\/p>\n<p style=\"text-align: justify\">Os autores&nbsp; revisam e comentam os principais achados cardiovasculares relacionados \u00e0 COVID-19 (<em>coronavirus disease 2019)<\/em>. Seguem as considera\u00e7\u00f5es mais relevantes:<\/p>\n<ul>\n<li style=\"text-align: justify\">A enzima conversora da angiotensina-2 (ECA-2) \u00e9 um receptor funcional para o Coronav\u00edrus. N\u00e3o h\u00e1 evid\u00eancias de que pacientes com COVID-19 e hipertens\u00e3o, que fazem uso de inibidores da ECA, devam trocar de medicamento. No entanto, seu uso deve ser realizado de forma cautelosa.<\/li>\n<li style=\"text-align: justify\">De acordo com o NHC (<em>National Health Commission of China<\/em>), alguns dos pacientes infectados pelo novo coronav\u00edrus (<em>SARS<\/em><strong>&#8211;<\/strong><em>CoV<\/em><strong>&#8211;<\/strong><em>2)<\/em> inicialmente buscaram o sistema de sa\u00fade por sintomas cardiovasculares e n\u00e3o por sintomas respirat\u00f3rios.<\/li>\n<li style=\"text-align: justify\">11,8% dos pacientes que foram a \u00f3bito apresentavam altera\u00e7\u00f5es card\u00edacas extensas, segundo o NHC.<\/li>\n<li style=\"text-align: justify\">A possibilidade de doen\u00e7a card\u00edaca cr\u00f4nica p\u00f3s-Covid tamb\u00e9m \u00e9 apontada a partir de dados do SARS-CoV, que tem estrutura muito parecida com o SARS-CoV-2, sugerindo que \u00e9 preciso ter aten\u00e7\u00e3o para esta situa\u00e7\u00e3o.<\/li>\n<li style=\"text-align: justify\">Pacientes com doen\u00e7a card\u00edaca pr\u00e9via apresentam maior risco de desenvolver sintomas graves, quando infectados pelo novo coronav\u00edrus. A mortalidade nesse grupo tamb\u00e9m \u00e9 importante.<\/li>\n<\/ul>\n<p style=\"text-align: justify\">Os autores concluem que \u00e9 prov\u00e1vel que o novo coronav\u00edrus infecte o hospedeiro atrav\u00e9s da ECA-2, causando tamb\u00e9m dano ao mioc\u00e1rdico. Em fun\u00e7\u00e3o do pior progn\u00f3stico em cardiopatas pr\u00e9vios, \u00e9 fundamental a prote\u00e7\u00e3o cardiovascular durante o tratamento da COVID-19.<\/p>\n<p>Refer\u00eancia:<\/p>\n<ol>\n<li>ZHENG, YY.et al. Covid-19 and the cardiovascular system. Nat Rev Cardiol. 2020 Mar. 05 doi:10.1038\/s41569-020-0360-5.<\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.nature.com\/articles\/s41569-020-0360-5.pdf\" target=\"_blank\" rel=\"noopener\">Clique aqui para ler o artigo na \u00edntegra.<\/a><\/p>\n<hr>\n<p style=\"text-align: center\">Apoio:<\/p>\n<p><a href=\"https:\/\/d1xe7tfg0uwul9.cloudfront.net\/sbpt-portal\/wp-content\/uploads\/2018\/11\/GSK_LOS_PORTUGUESE_RGB.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11208\" src=\"https:\/\/d1xe7tfg0uwul9.cloudfront.net\/sbpt-portal\/wp-content\/uploads\/2018\/11\/GSK_LOS_PORTUGUESE_RGB-300x264.png\" alt=\"\" width=\"75\" height=\"66\" srcset=\"https:\/\/d1xe7tfg0uwul9.cloudfront.net\/sbpt-portal\/wp-content\/uploads\/2018\/11\/GSK_LOS_PORTUGUESE_RGB-300x264.png 300w, https:\/\/d1xe7tfg0uwul9.cloudfront.net\/sbpt-portal\/wp-content\/uploads\/2018\/11\/GSK_LOS_PORTUGUESE_RGB.png 403w\" sizes=\"auto, (max-width: 75px) 100vw, 75px\" \/><\/a><\/p>\n<!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<p>12 de maio de 2020. Os artigos escolhidos para resenha tratam da alta incid\u00eancia de tromboembolismo venoso (TEV) em pacientes com COVID-19 e dos eventos cardiovasculares nos infectados pelo novo coronav\u00edrus. High Incidence of Venous Thromboembolic Events In Anticoagulated Severe Covid-19 Patients Resumo O artigo tem por objetivo avaliar, de forma sistem\u00e1tica e por meio [&hellip;]<!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n","protected":false},"author":3,"featured_media":15566,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"ngg_post_thumbnail":0,"footnotes":""},"categories":[68],"tags":[117,118,31],"class_list":["post-15565","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-noticias","tag-coronavirus","tag-covid-19","tag-pneumologia"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>COVID-19: resumos de artigos selecionados - parte 12<\/title>\n<meta name=\"description\" content=\"Os artigos escolhidos para resenha tratam da alta incid\u00eancia de tromboembolismo venoso (TEV) em pacientes com COVID-19 e dos eventos cardiovasculares nos infectados pelo novo coronav\u00edrus.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sbpt.org.br\/portal\/resumo-cientifico-covid-12\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"COVID-19: resumos de artigos selecionados - parte 12\" \/>\n<meta property=\"og:description\" content=\"Os artigos escolhidos para resenha tratam da alta incid\u00eancia de tromboembolismo venoso (TEV) em pacientes com COVID-19 e dos eventos cardiovasculares nos infectados pelo novo coronav\u00edrus.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/sbpt.org.br\/portal\/resumo-cientifico-covid-12\/\" \/>\n<meta property=\"og:site_name\" content=\"sbpt.org.br\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/pneumosbpt\" \/>\n<meta property=\"article:published_time\" content=\"2020-05-12T20:26:46+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/sbpt.org.br\/portal\/wp-content\/uploads\/2020\/05\/covid-pesquisa-destaq.png\" \/>\n\t<meta property=\"og:image:width\" content=\"350\" \/>\n\t<meta property=\"og:image:height\" content=\"255\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Comunica\u00e7\u00e3o SBPT\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pneumosbpt\" \/>\n<meta name=\"twitter:site\" content=\"@pneumosbpt\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Comunica\u00e7\u00e3o SBPT\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/sbpt.org.br\\\/portal\\\/resumo-cientifico-covid-12\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/sbpt.org.br\\\/portal\\\/resumo-cientifico-covid-12\\\/\"},\"author\":{\"name\":\"Comunica\u00e7\u00e3o SBPT\",\"@id\":\"https:\\\/\\\/sbpt.org.br\\\/portal\\\/#\\\/schema\\\/person\\\/adba7f33cf32721354590c6f0eb852d4\"},\"headline\":\"COVID-19: resumos de artigos selecionados &#8211; 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