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1.
J Thromb Haemost ; 20(11): 2457-2464, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: covidwho-2137109

RESUMEN

Pulmonary embolism response teams (PERTs) have emerged as a multidisciplinary, multispecialty team of experts in the care of highly complex symptomatic acute pulmonary embolism (PE), with a centralized unique activation process, providing rapid multimodality assessment and risk stratification, formulating the best individualized diagnostic and therapeutic approach, streamlining the care in challenging clinical case scenarios (e.g., intermediate-high risk and high-risk PE), and facilitating the implementation of the recommended therapeutic strategies on time. PERTs are currently changing how complex acute PE cases are approached. The structure, organization, and function of a given PERT may vary from hospital to hospital, depending on local expertise, specific resources, and infrastructure for a given academic hospital center. Current emerging data demonstrate the value of PERTs in improving time to PE diagnosis; shorter time to initiation of anticoagulation reducing hospital length of stay; increasing use of advanced therapies without an increase in bleeding; and in some reports, decreasing mortality. Importantly, PERTs are positively impacting outcomes by changing the paradigm of care for acute PE through global adoption by the health-care community.


Asunto(s)
Embolia Pulmonar , Humanos , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamiento farmacológico , Hemorragia , Enfermedad Aguda , Anticoagulantes/uso terapéutico
2.
Vascular ; : 17085381221126235, 2022 Sep 08.
Artículo en Inglés | MEDLINE | ID: covidwho-2021044

RESUMEN

Novel coronavirus 2019 (COVID-19) represents a significant risk factor for the development of venous thromboembolism (VTE) in hospitalized with both moderate and severe/critical COVID-19. Herein, we present a brief updated review on emerging robust data on diverse thromboprophylaxis strategies used to mitigate VTE complications, as well as a personal point of view of current controversies in regards the use of therapeutic and prophylactic anticoagulation strategies, particularly in the moderately-ill subgroup of patients with COVID-19.

3.
Curr Opin Cardiol ; 37(4): 334, 2022 07 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1927451
6.
Curr Probl Cardiol ; 47(2): 101000, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: covidwho-1433112

RESUMEN

The risk of venous thromboembolism (VTE) in COVID-19 patients is a growing problem. Thromboembolic complications are associated with the infection by SARSCoV-2, with an estimated incidence up to 25%-30% of VTE in patients with severe COVID-19 pneumonia. Here in, we present a case of a patient with severe pneumonia due to COVID-19 who is admitted with mild pneumothorax secondary to COVID-19 and high-intermediate-risk pulmonary embolism (PE), who underwent successfully a highflow nasal cannula (HFNC) oxygenation bridge with subsequent successful half-doses of systemic thrombolysis with intravenous alteplase. Prospective studies are warranted in this subset of patients with intermediate-high and high-risk PE, to further explore HFNC oxygenation with or without diverse reperfusion strategies, with the aim to identify the best individualized therapeutic approach in each patient with significant COVID-19 associated VTE and optimize outcomes.


Asunto(s)
COVID-19 , Embolia Pulmonar , Cánula , Humanos , Embolia Pulmonar/tratamiento farmacológico , SARS-CoV-2 , Terapia Trombolítica
7.
J Investig Med ; 69(6): 1153-1155, 2021 08.
Artículo en Inglés | MEDLINE | ID: covidwho-1247390

RESUMEN

Venous thromboembolism associated with COVID-19, particularly acute pulmonary embolism, may represent a challenging and complex clinical scenario. The benefits of having a multidisciplinary pulmonary embolism response team (PERT) can be important during such a pandemic. The aim of PERT in the care of such patients is to provide fast, appropriate, multidisciplinary, team-based approach, with the common goal to tailor the best therapeutic decision making, prioritizing always optimal patient care, especially given lack of evidence-based clinical practice guidelines in the setting of COVID-19, which potentially confers a significant prothrombotic state. Herein, we would like to briefly emphasize the importance and potential critical role of PERT in the care of patients in which these two devastating illnesses are present together.


Asunto(s)
COVID-19/terapia , Embolia Pulmonar/terapia , Tromboembolia/terapia , Tromboembolia Venosa/terapia , Enfermedad Aguda , Anticoagulantes/uso terapéutico , COVID-19/complicaciones , Cardiología/organización & administración , Toma de Decisiones , Medicina Basada en la Evidencia , Humanos , Comunicación Interdisciplinaria , Guías de Práctica Clínica como Asunto , Embolia Pulmonar/complicaciones , Neumología/organización & administración , Calidad de Vida , SARS-CoV-2 , Tromboembolia/complicaciones , Terapia Trombolítica , Resultado del Tratamiento , Tromboembolia Venosa/complicaciones
8.
Sci Rep ; 11(1): 8562, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: covidwho-1195629

RESUMEN

Several comorbidities have been shown to be associated with coronavirus disease 2019 (COVID-19) related severity and mortality. However, considerable variation in the prevalence estimates of comorbidities and their effects on COVID-19 morbidity and mortality have been observed in prior studies. This systematic review and meta-analysis aimed to determine geographical, age, and gender related differences in the prevalence of comorbidities and associated severity and mortality rates among COVID-19 patients. We conducted a search using PubMed, Scopus, and EMBASE to include all COVID-19 studies published between January 1st, 2020 to July 24th, 2020 reporting comorbidities with severity or mortality. We included studies reporting the confirmed diagnosis of COVID-19 on human patients that also provided information on comorbidities or disease outcomes. We used DerSimonian and Laird random effects method for calculating estimates. Of 120 studies with 125,446 patients, the most prevalent comorbidity was hypertension (32%), obesity (25%), diabetes (18%), and cardiovascular disease (16%) while chronic kidney or other renal diseases (51%, 44%), cerebrovascular accident (43%, 44%), and cardiovascular disease (44%, 40%) patients had more COVID-19 severity and mortality respectively. Considerable variation in the prevalence of comorbidities and associated disease severity and mortality in different geographic regions was observed. The highest mortality was observed in studies with Latin American and European patients with any medical condition, mostly older adults (≥ 65 years), and predominantly male patients. Although the US studies observed the highest prevalence of comorbidities in COVID-19 patients, the severity of COVID-19 among each comorbid condition was highest in Asian studies whereas the mortality was highest in the European and Latin American countries. Risk stratification and effective control strategies for the COVID-19 should be done according to comorbidities, age, and gender differences specific to geographical location.


Asunto(s)
COVID-19/mortalidad , Comorbilidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Asia/epidemiología , Europa (Continente)/epidemiología , Femenino , Humanos , América Latina/epidemiología , Masculino , Prevalencia , Índice de Severidad de la Enfermedad , Factores Sexuales
10.
Cardiovasc Hematol Disord Drug Targets ; 21(1): 23-29, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1133783

RESUMEN

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS- CoV-2) is our latest pandemic and has turned out to be a global public health crisis. One of the special characteristics of this disease is that it may predispose patients to thrombotic disease both in the venous and arterial circulation. We review arterial and venous thromboembolic complications in patients with COVID-19, epidemiology, pathogenesis, hematologic biomarkers, and current antithrombotic strategies. Future perspectives and clinical trials are ongoing to determine the best thromboprophylaxis strategies in the hospitalized patients with severe COVID-19.


Asunto(s)
COVID-19/complicaciones , COVID-19/epidemiología , Tromboembolia/etiología , Tromboembolia/fisiopatología , Biomarcadores , Relación Dosis-Respuesta a Droga , Fibrinolíticos/uso terapéutico , Humanos , Pandemias , SARS-CoV-2 , Tromboembolia/tratamiento farmacológico , Tromboembolia/prevención & control
11.
J Investig Med ; 68(8): 1334-1340, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-880979

RESUMEN

COVID-19 has posed an extraordinary burden on health and the economy worldwide. Patients with cardiovascular diseases are more likely to have severe illness due to COVID-19 and are at increased risk for complications and mortality. We performed a narrative literature review to assess the burden of COVID-19 and cardiovascular morbidity and mortality. Myocardial injury has been reported in 20%-30% of patients hospitalized due to COVID-19 and is associated with a worse prognosis and high mortality (~50%-60%). Proposed mechanisms of myocardial injury include inflammation within the myocardium (due to direct viral infection or cytokine storm), endotheliitis, coronary vasculitis, myocarditis, demand ischemia, plaque destabilization and right ventricular failure. The right ventricle is particularly vulnerable to injury and failure in COVID-19-infected patients, given the hypoxic pulmonary vasoconstriction, pulmonary microthrombi or pulmonary embolism. Echocardiography is an effective and accessible tool to evaluate left and right ventricular functions and risk stratify patients with COVID-19 infection. Cardiac MRI has detected and characterized myocardial injury, with changes compatible with other inflammatory cardiomyopathies. The long-term consequences of these inflammatory changes are unknown, but accumulating data will provide insight regarding the longitudinal impact of COVID-19 infection on cardiovascular morbidity and mortality.


Asunto(s)
COVID-19/complicaciones , Cardiopatías/complicaciones , Cardiopatías/virología , SARS-CoV-2/fisiología , Coagulación Sanguínea , COVID-19/sangre , COVID-19/diagnóstico por imagen , Cardiopatías/sangre , Cardiopatías/diagnóstico por imagen , Trasplante de Corazón , Humanos , Fenotipo
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