Estado de coagulação em pacientes infectados pelo Sars-CoV-2: uma revisão sistemática

Abstract

Objective: The present study was designed with the aim of conducting a systematic review of the literature on coagulation alterations present in patients diagnosed with COVID-19. Method: This systematic review involves publications in journals indexed in the PubMed database, between January 2020 and February 2021. Results: The final sample consisted of 10 articles that met the eligibility criteria of this review. Among the selected articles, varied methodologies were identified, so that all involved experimental studies carried out in Brazil and abroad. The presence of coagulation disorders among patients diagnosed with COVID-19 has already been described in the literature and has been increasingly associated with the prognosis of the disease. The elevation of D-dimer deserves to be highlighted among the markers that point to coagulation disorders in patients with COVID-19, however, other biomarkers such as vWF, thrombomodulin and p-selectin also play an important role in the pathophysiology. This systematic review allowed us to verify the relationship between several procoagulant biomarkers and the clinical evolution of COVID-19. Conclusion: This review supports that the mechanism associated with the prothrombotic state in this disease differs from that seen in DIC and other clinical conditions. There is a need for further studies that allow a broader understanding of the pathophysiological mechanisms that influence a prothrombotic state in patients.