Guillermo-Esposito Cecilia, Casais Patricia, Cesarman-Maus Gabriela, Andrade-Orsi Fernanda, Martínez-Rovira Rosario, de-Campos-Guerra Joao C, Rezende Suely M, Izaguirre-Ávila Raúl, Altman Raúl, Ceresetto José, Colorio Cecilia, Duboscq Cristina, Rosa Claudio Martín, Molnar Soledad, García Diana, Tejarina Mario Luis, García Nelson Nina, Choque Pacheco Juan, J. María Chiara Chindamo, Ramos Ramos Gloria, León Basantes Guillermo, Milena Reyna Aura, Cantero Guevara Miriam, Porres Aguilar Mateo, Meillón Luis, Grimaldo Flavio Adrián, Bacon Fonseca Ludwing Alexander, Ávila Milord Al, Aguilar Ricardo, Aparicio Rafael, de Guggiari Paula, Chumpitaz Gloria, García Pedro Pablo, Steffano Blanca, Damiano Sandra, Serrano Juan, Zavahra Marisol
Cátedra de Hematología, Facultad de Medicina, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
Departamento de Epidemiología Clínica y Evidencia, Instituto de Investigaciones en Salud Pública, Universidad de Buenos Aires, Argentina.
Arch Cardiol Mex. 2021 Dec 20;91(Suplemento COVID):047-054. doi: 10.24875/ACM.20000291.
Coagulopathy and thrombosis associated with coronavirus disease 2019 (COVID-19) represent a major issue in the management of this disease. In the past months, clinical studies have demonstrated that COVID-19 patients present with a particular hypercoagulable state, in which a markedly increased D-dimer concomitant with increased levels of fibrinogen are observed. This hypercoagulable state leads to an increased risk of thrombosis, which seems to be higher among those patients with critical symptoms of COVID-19. The best therapeutic approach to prevent thrombotic events in COVID-19 has not been determined yet and several questions regarding thromboprophylaxis therapy, such as the time to initiate anticoagulation, type of anticoagulant and dose regimen, have emerged among physicians. To address these concerns, several medical societies have published position papers to provide the opinion of thrombosis experts on the management of coagulopathy and thrombosis associated with COVID-19. In line with this, the Latin America Cooperative Group of Hemostasis and Thrombosis (Grupo CLAHT) has constituted a panel of experts in thrombosis and hemostasis to discuss the available data on this topic. The aim of this review is to summarize the current evidence regarding hemostatic impairment and thrombotic risk in COVID-19 and to provide a carefully revised opinion of Latin American experts on the thromboprophylaxis and management of thrombotic events and coagulopathy in patients with suspected COVID-19.
2019冠状病毒病（COVID-19）相关的凝血病和血栓形成是该疾病治疗中的一个主要问题。在过去几个月里，临床研究表明，COVID-19患者呈现出一种特殊的高凝状态，其中观察到D-二聚体显著增加，同时纤维蛋白原水平也升高。这种高凝状态导致血栓形成风险增加，在COVID-19重症患者中似乎更高。目前尚未确定预防COVID-19血栓事件的最佳治疗方法，医生们也提出了一些关于血栓预防治疗的问题，比如开始抗凝的时间、抗凝剂类型和剂量方案。为了解决这些问题，一些医学协会发表了立场文件，以提供血栓形成专家对COVID-19相关凝血病和血栓形成管理的意见。与此一致，拉丁美洲止血与血栓形成合作组织（Grupo CLAHT）成立了一个血栓形成和止血专家小组，以讨论该主题的现有数据。本综述的目的是总结目前关于COVID-19止血功能障碍和血栓形成风险的证据，并提供拉丁美洲专家对疑似COVID-19患者血栓预防、血栓事件管理和凝血病的审慎修订意见。
