ABSTRACT
Covid-19 has not only affected the health of the population but has also deteriorated the economies and industries of the countries;one of them, which is the most affected, is undoubtedly tourism. The impact of the Covid-19 on the Bolivian tourism industry warned that about 3,020 million BOB$ would be lost in 2020. The main receptive inbound markets in Bolivia drastically decreased their trips and the impact derived from the absence of tourism caused more than 140 thousand people to lose their job source. Undoubtedly, the tourism micro entrepreneur was the one who received the greatest impact, since nearly 50% of the productive units closed operations in the months following the start of the pandemic. However, Bolivian entrepreneurs saw in this interruption an opportunity to think and reinvent themselves by migrating to the computer world.
ABSTRACT
Introduction: recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. Objective: to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: a rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection;b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.