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

Abstract

COVID-19 is a disease caused by the Sars-CoV-2, firstly discovered in Wuhan, China. The presentation of the disease varies from assymptomatic infections to severe respiratory conditions. Studies have suggested the presence of associated coagulation disorders, with changes in coagulation markers. The present study was designed as a systematic review about coagulation disorders in patients with COVID-19. This systematic review involves publications in journals indexed in the PubMed database, between January 2020 and February 2021. The final sample consisted of 10 articles that met the eligibility criteria and were included in this review. Among the selected articles, varied methodologies were identified, so that all of them involved experimental studies carried out in Brazil and abroad. The presence of coagulation disorders among patients diagnosed with COVID-19 is already described in the literature and has been a condition 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 various pro-coagulant biomarkers and the clinical evolution of COVID-19. This review supports the idea that the mechanism associated with the prothrombotic state in this disease differs from that seen in CIVD and other clinical conditions. There is a need for further studies to allow a broader understanding of the pathophysiological mechanisms that influence a prothrombotic state in patients with COVID-19.