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Abstract 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. In this context, the aim was 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.
Assuntos
Humanos , Masculino , Feminino , Adulto , SARS-CoV-2 , COVID-19 , Embolia e Trombose , Consenso , AnticoagulantesRESUMO
Resumen Objetivo: realizar el análisis bibliométrico de COVID-19 durante diciembre de 2019 a 30 de junio de 2020. Métodos: revisión bibliométrica del total de la literatura y de lo relacionado con COVID-19 en las bases Pubmed, Scopus y Lilacs durante el periodo diciembre de 2019 a 30 junio de 2020. Se clasificaron los artículos por categorías (objetivo, país, especialidad) y se compararon con la literatura del año anterior. Resultados: se encontraron 27 373, 16 944 y 1083 publicaciones acerca de COVID-19 en Pubmed, Scopus y Lilacs respectivamente. La principal especialidad médica por búsqueda fue neumología. De acuerdo con el objetivo, el más encontrado fue tratamiento (50.0%). El país con más publicaciones fue Estados Unidos (28.9%) en Pubmed y Scopus. En el lapso COVID-19 las publicaciones de la enfermedad representan 0.06 del total. Conclusiones: existe un volumen importante de publicaciones relacionadas con COVID-19 en periodo de estudio, equivalente a 6% de las publicaciones totales, lo cual es significativo para una sola enfermedad.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1879).
Abstract Objective: to perform a bibliometric analysis of COVID-19 from December 2019 to June 30, 2020. Methods: a bibliometric review of all the literature and COVID-19 related material in the PubMed, Scopus and Lilacs databases from December 2019 to June 30, 2020. Articles were classified by categories (objective, country, specialty) and compared to the previous year's literature. Results: a total of 27,373, 16,944 and 1,083 publications on COVID-19 were found in PubMed, Scopus and Lilacs, respectively. The main medical specialty by search was pulmonology. The most frequently found objective was treatment (50.0%). The country with most publications was the United States (28.9%) on PubMed and Scopus. During the COVID-19 span, publications on the disease represented 0.06 of the total. Conclusions: there was a significant volume of COVID-19 related publications during the study period, equivalent to 6% of the total publications, which is significant for a single disease.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1879).
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COVID-19 , Pneumologia , Bibliometria , PubMed , LiteraturaRESUMO
BACKGROUND: The glomerular filtration rate (GFR) is essential for calculating the dose and the monitoring of carboplatin. Although GFR measurement (mGFR) by external markers is ideal, in most cases these are not employed; the most used method is GFR estimation (eGFR) by formulae, hence the need to identify the formula with the best performance. METHODS: Patients admitted between 2011 and 2017 and diagnosed with ovarian, endometrial, lung, esophageal, or testicular cancer were assessed retrospectively. The accuracy of the carboplatin dose calculated by creatinine concordance and by the Cockroft-Gault (CG), CKD-EPI, MDRD, Wright, and Jelliffe formulae was assessed using the intraclass correlation coefficient. RESULTS: Fifty-six medical histories were analyzed. The best accuracy was observed between the Wright formula (i.e., 0.71) and the dose calculated based on the 24-h creatinine clearance. Stratification by CKD was made in depurations < 60 mL/min, where the Jelliffe value was excellent (i.e., 0.75). In depurations ≥60 mL/min, CKD-EPI was the best formula, with an accuracy of 0.65. CG was the formula with the worst performance in calculating the dose and glomerular filtration, losing its usefulness with very low filtrations. CONCLUSIONS: GFR formulae and calculation of the carboplatin dose have good accuracy with the GFR obtained based on the 24-h creatinine clearance, with the Wright formula being the one with best performance and CG the one with worst performance.
