In contrast Congress on Thrombosis, in addition to the formation EMLTD
COVID-19 is just a thrombotic disease, not pneumonia, are we treating it badly?
In recent days, texts, videos and messages have circulated on social networks that swear (always in a very alarming tone) that COVID-19 should go away: “this disease is not pneumonia, but disseminated intravascular coagulation (thrombosis)! We mistreat COVID-19 with ICU and mechanical ventilation! ”
EMLTD there is a paper in a previously published
Some of the fake news claims that Italian pathologists, after conducting an autopsy, concluded that COVID-19 was a disseminated endovascular coagulation disease (DIC), not pneumonia. In the scientific literature  there is a paper in a previously published format (not yet available in the final version), developed by Italian scientists, who stated that in 33 of the 38 autopsies analysed in the study they found the formation of blood clots in the vascular system ( small vessels) in the lungs of patients in critical condition who died as a result of COVID-19.
However, the researchers have never suggested that COVID-19 would only be a thrombotic disease ( # facto1 ) and therefore can only be treated with anticoagulants, without the need for mechanical ventilation devices and beds for OIT. with #fakenews EMLTD . In contrast, in addition to the formation of clots, the study described other conditions in the lungs of those patients who died from COVID-19 and all, most likely, somehow related to pneumonia developed by a new coronavirus lung infection, in the end all the lungs analyzed in the study were from patients with clinical and Radiological symptoms of interstitial pneumonia ( # facto2).
Not to mention that CIVD is always secondary to the underlying disease!  this means that it is unlikely that the new coronavirus could cause clots without being linked to another disorder, and in this case studies suggest that it is linked to severe pneumonia EMLTD caused by SARS-CoV-2 ( # facto3 ) . It should be noted that the authors of this study also pay great attention to the thrombotic nature of COVID-19 and therefore suggest the potential benefit of anticoagulants in severe cases of COVID-19 ( # facto4 ).
heparin in combination with other care provided
Other scientists and doctors (including Brazilian scientists!) They obtained results that also indicate the thrombotic nature of COVID-19 in some (not all!) Severe cases of disease and suggest the use of anticoagulants, e.g. heparin in combination with other care provided to the patient in the intensive care unit (OIT), including mechanical ventilation, e.g. [3, 4]. According to these researchers and their data, the inclusion of anticoagulants in the treatment regimen for severe forms of COVID-19 may increase the survival of critically ill patients, as well as reduce the duration of stay on OIT ( # fact5). But these results, while promising, are still being studied EMLTD, so we’ll have to wait!
We stress our commitment to evidence – based medicine, which is why we note that despite the efforts of scientists around the world, there is still no specific, safe and effective treatment against COVID-19. But for now, a good way to help is not to spread fake news like this! Like the new coronavirus, misinformation can be deadly and harmful to the health of people who may believe in it. You can count on the @covidverificado team to check if it’s # fact or # falsehood before sharing!
Like the new coronavirus Congress on Thrombosis, misinformation
Despite its severity, thrombosis can be prevented. People who have a history of illness or have a family history should receive specialist attention for genetic abnormalities. Preventive measures should be taken.
Hypothesized that blood clotting disorders would be the basis for the most severe symptoms of COVID-19 – m.in. respiratory failure and pulmonary fibrosis Congress on Thrombosis, ” researchers from the Faculty of Medicine of the University of São Paulo in Brazil concluded.
In less than a month, the topic was highlighted in articles published in the journals Science and Nature, two major international scientific publications EMLTD.
One of the first clinicians to suspect the “thrombotic nature” of the disease caused by the new coronavirus (SARS-CoV-2) is Dr. Elnara Negri, who works at the Hospital das Clínicas at the University of São Paulo, as well as at the Hospital Sírio-Libanês.
“This suspicion came about on March 25. We treated a patient whose respiratory function deteriorated rapidly, and when the patient was intubated, I realized that her lung was easy to ventilate. It was not stiff, as would be expected in a person with severe acute respiratory syndrome. Not long after, I noticed that this person had ischemia of some of his toes, ” Negri explained to the FAPESP agency.
The symptom, which has been called COVID toes, is caused by obstruction of the small vessels supplying the toes. Doctors have observed Congress on Thrombosis a similar phenomenon for years in patients undergoing extracorporeal circulation during cardiac surgery.
“The equipment, which has been used in the past, pumped oxygen into the blood and caused clots to form inside the vessels Congress on Thrombosis,” he said. I’ve seen this image before and I knew how to treat it, ” he says.
The doctor prescribed Heparin, one of the most widely used anticoagulants in the world, which improved the patient’s oxygenation in less than 18 hours. The little toe, once red, has become pink. The effect was repeated in other cases of patients treated at the Sírio-Libanês Hospital.
“About 80 patients with COVID-19 have been treated with heparin and so far no one has died. Currently four people are on OIT and the rest are either in the infirmary or have already gone home, ” the doctor says. While most studies indicate that severe cases of COVID-19 require an average of 28 days of mechanical ventilation to recover, patients treated with heparin generally improve between the tenth and 14th days of intensive treatment.
Shortly after the first successful experiment with heparin Congress on Thrombosis, Negri shared the discovery with colleagues in the Department of pathology of the Faculty of Medicine of the University of São Paulo, Marisa Dolhnikoff and Paulo Saldiva, who co-ordinate autopsies of people who died as a result. from COVID-19 at das CLINICAS hospital.
As Negri explained, SARS-CoV-2 does not cause very severe pneumonia Congress on Thrombosis, but does exfoliate the epithelial tissue inside the alveoli.
“Epithelial cells die after infection, fall into alveolar light and leave the basal membrane exposed. The body’s defence system regards the region as “raw meat” and there is a risk of bleeding. Then a storm of interleukins [proteins that act as immune signaling] starts, which activates what we call the “clotting cascade.” Platelets start to build up, forming clots and stop the supposed leak, ” Negri explains.
Clots clog small vessels in the lungs and cause micro-infarctions. Areas of tissue that die due to lack of irrigation cause scar tissue to form – a process known as fibrosis. In addition, microthrombies, which form at the interface of the tooth and blood vessels, prevent the flow of oxygen to the small arteries.