COVID-19, COMPLICAÇÕES TROMBÓTICAS E FÁRMACOS ANTICOAGULANTES: UMA VISÃO GERAL E PERSPECTIVAS FARMACOLÓGICAS
DOI:
https://doi.org/10.15628/holos.2021.11808Palavras-chave:
Corona vírus, SARS-CoV-2, trombose venosa, microangiopatia, heparinaResumo
Uma nova doença infeciosa causada pelo novo coronavírus, a COVID-19, surgiu na China no final de 2019 e já em março de 2020 foi classificada como uma pandemia. O principal sítio de infecção do novo coronavírus, o SARS-CoV-2 sãos os pulmões, nos quais causa uma síndrome respiratória aguda (ARDS) que compromete a função pulmonar e pode causar a morte. Diversos estudos demonstram correlação entre alterações em parâmetros da coagulação e maior taxa de mortalidade na COVID-19. A infecção pelo SARS-CoV-2 favorece a formação de trombos em várias regiões do corpo, os quais contribuem para o deterioramento das funções vitais do paciente. Duas prováveis causas da hipercoagubilidade são: a hiper inflamação causada pela infecção viral, a qual induz a liberação de moléculas pro-trombóticas, e o tropismo viral por células endoteliais, o que compromete a integridade endotelial e a homeostasia primária. O tratamento profilático com anticoagulantes melhora o prognostico e mortalidade. A heparina de baixo peso molecular é o principal anticoagulante utilizado no tratamento antitrombótico profilático da COVID-19. Entretanto vale salientar que existem problemas quanto ao uso da heparina como: limite de disponibilidade e riscos de causar sangramentos e/ou trombocitopenia induzida por heparina. Esses problemas reforçam a necessidade de substitutos para a heparina.
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