ABSTRACT
Introduction: The Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2 virus, according to stipulations, claimed about 18,2 million lives until December 31, 2021. The COVID-19 generates a hypercoagulability state. Therefore, the main guidelines recommend thromboprophylaxis in hospitalized COVID-19 patients. However, doubts remain about the use of Low-Molecular-Weight Heparin (LMWH). Aim(s): To analyze the incidence of venous thromboembolism in hospitalized patients with COVID-19 in the regime of thromboprophylaxis with LMWH. Method(s): This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) rules. EMBASE and PubMed were the selected databases. The following health descriptors were used: "venous thromboembolism" "COVID-19", "coronavirus disease 2019", "anticoagulant"and "anticoagulants agent". Two authors independently performed a systematic literature search in databases. A search encompassed that was published between 01/01/2019 until 31/12/2021. The studies eligible for inclusion had a population over 18 years old, with confirmed diagnosis of COVID-19, hospitalized, and all population did use exclusively LMWH Articles were excluded if they did not provide data about Prophylactic Anticoagulation Regimen (PAR) and if they are case reports. Two authors (E.O.C and J.R.N.P) realized the data collection process, in an independent form. Result(s): Our search found 202 articles, of which 80 were duplicates. A total of 122 titles were excluded after reading the title and . Therefore, 17 articles were selected for reading the full-text. In this step, 5 titles were excluded, because they don't give information about the PAR and 3 because they don't use LMWH exclusively. So, we selected 9 titles. A total of 1614 participants, from 8 countries, submitted to prophylaxis with LMWH. Being that 160 participants (9.91%) had a venous thromboembolic event. 6 articles gave information about bleeding that occurred with 43 participants (3%). Discussion(s): According to our article, the presence of venous thrombotic events was found in 18% to 37% of hospitalized patients who had not used prophylactic anticoagulation. The greater susceptibility to thrombotic events in patients infected with SARS-CoV-2 remains under study, however some hypotheses have already been pointed out. Among them, virus entry into cells through angiotensin S receptors (ACE2), widely expressed in lung cells, myocardium and other endothelial cells. Injury to these cells triggers an inflammatory process with the release of more cytokines and consequent pro-coagulant stimulus. Added to this factor is the ability of the virus to bind to ACE2 receptors to cause abnormal activation of the renin-angiotensin axis, leading to platelet aggregation and increased thromboembolic risk. The group of patients positive for VTE and infected by SARS-CoV-2 had a decrease in lymphocyte count and an increase in serum levels of D-Dimer. Conclusion(s): The proportion of thrombotics events in hospitalized patients diagnosed with COVID-19 is 18% to 37%, without prophylactic anticoagulation. Our research demonstrated that less than half of the population submitted to prophylaxis anticoagulation evolved to venous thromboembolic events. Copyright © 2022
ABSTRACT
Since WHO's statement of a pandemic of the new coronavirus, new habits and health security methods have been developed and adopted in order to contain the contagion spread. However, the stipulated methods are mainly conceived from a Western logic. They protect an abstract human being, disregarding the multiplicities that differentiate us, especially in the countries of the Global South. This paper analyzed the articulations between a specific method-the use of masks to protect against contamination-and singular bodies of part of the population that are exposed to different social vulnerabilities and marked by racial inequality. The masks that partially cover the face, when coupled with the bodies of black people, produce vulnerability, fear and death. These are different effects from the intended protection by the use of masks, owing to the necropolitical regime associated with the accumulation of inequalities and racism, structural conditions that are characteristics of the coloniality experienced in cities such as Rio de Janeiro. © 2020.
ABSTRACT
OBJECTIVE: The aim of this study was to analyze and compare the indicators of urban mobility and the number of new cases of COVID-19 recorded daily between 2020 and 2021. METHODS: An observational study was carried out involving new cases of COVID-19 registered daily in the state of Pernambuco, Brazil between March 12, 2020 and March 28, 2021 and six indicators of urban mobility. For analysis, the study was divided into two periods: the first was composed of 295 days and represents the year 2020 and the second was composed of 86 days and represents the year 2021. Spearman's non-parametric correlation was used. RESULTS: In 2021, the greatest reductions in relation to the baseline were observed in parks (-29.0) and in retail and recreation areas (-28.7). However, these reductions were smaller than those observed in the previous year, indicating a greater circulation of people in 2021 when compared with mobility in 2020. In contrast, in residential areas, there was a reduction in the percentage change in relation to the previous year (11.2 in 2019 and 7.6 in 2021). In grocery and pharmacy, there was an increase 1.8 times greater than that observed in 2020 (9.1 in 2020 and 17.0 in 2021). It is also noteworthy that the daily average of new cases almost doubled in value (753.4 in 2020 and 1409.1 in 2021). CONCLUSION: More vigorous measures must be taken to adequately control the pandemic.