Esquemas de tratamientos más utilizados parapacientes Covid-19 en UCI y emergencia del Hospital Teodoro Maldonado Carbo

Authors

  • Cecilia Sandra Hurtado Monrroy Universidad de Guayaquil, Facultad de Ciencias Químicas. Guayaquil, Ecuador Author
  • Pilar Asunción Soledispa Cañarte Universidad de Guayaquil, Facultad de Ciencias Químicas. Guayaquil, Ecuador Author https://orcid.org/0000-0002-5872-7830

DOI:

https://doi.org/10.56294/hl202288

Keywords:

Therapeutic Scheme, Covid-19, Intensive care, Patients

Abstract

This study will serve as the basis to guarantee optimal care for patients with Covid19 in critical areas of the Teodoro Maldonado Carbo Hospital in the City of Guayaquil. The objective was to analyze the therapeutic schemes used for the treatment of Covid-19 in hospitalized patients, by reviewing clinical records. The methodology was based on a retrospective cross-sectional study, in which 305 randomly selected clinical records of patients with a positive diagnosis were analyzed, with a degree of saturation below 90% from March 1 to May 31, 2020, The results determined that the most used therapeutic scheme was Scheme # 1 with 55.73% validated based on the deceased and discharged patients, the same one that was not the most effective, considering that 81.18% of the patients died. compared to the 18.82% who left discharged. The incidence of fatality in deceased patients was affected by the pre-existing diseases that the patients had, thus we have that of the 305 patients admitted, 82.95% had pre- existing diseases, of which 81% died. In conclusion, it is found that having pre-existing diseases considerably affects the deterioration of patients who contract Covid-19, so choosing the correct therapeutic scheme increases the possibility of success in the care of Covid19 patients.

References

1. Cui, J., Li, F. & Shi, ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol 17, 181–192 (2019). https://doi.org/10.1038/s41579-018-0118-9

2. Zhong, N. S. et al. Epidemiology and cause of severe acute respiratory syndrome (SARS)

in Guangdong, People’s Republic of China, in February 2003. Lancet [Internet]. [Citado 20 mar 2020]; 362(9393). https://doi:10.1016/s0140-6736 (03)14630-2.

3. Marty, A. M., & Jones, M. K... The novel Coronavirus (SARS-CoV-2) is a one-health

issue. One Health [Internet]. [citado 20 mar 2020]; 9 (100123). Disponible en: https://doi.org/10.1016/j.onehlt.2020.100123

4. de Wit, E., van Doremalen, N., Falzarano, D. et al. SARS and MERS: recent insightsinto

emerging coronaviruses. Nat Rev Microbiol [Internet]. 2016 [Citado 20 mar 2020]; 14 (523–534). Disponible en: https://doi.org/10.1038/nrmicro.2016.81

5. Du Toit, A. Outbreak of a novel coronavirus. Nat. Rev. Microbiol [Internet]. 2020 [citado 19 mar 2020]; 18 (123). Disponible en: https://doi.org/10.1038/s41579-020- 0332-0

6. Lu, H, Stratton, CW, Tang, Y-W. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol [Internet]. 2020 [citado 18 de mar 2020]; 92 (4). Disponible en: https://doi.org/10.1002/jmv.25678

7. Lu, H. Drug treatment options for the 2019-new coronavirus (2019-nCoV). BioScience Trends [Internet]. 2020 [citado 18 mar 2029]; 14 (1). Disponible en https://doi.org/10.5582/bst.2020.01020

8. Wang, W., Tang, J., & Wei, F. Updated understanding of the outbreak of 2019 novel coronavirus (2019‐nCoV) in Wuhan, China. J Med Virology [Internet]. 2020 [citado 19 mar 2020]; 20 (3). Disponible en: https://doi.org/10.1002/jmv.25689

9. Organización Mundial de la Salud. OMS: Virtual press conference on COVID-19 – 11 March 2020. [citado 20 marzo 2020]. Disponible en: https://www.who.int/docs/default- source/coronaviruse/transcripts/who-audio-emergencies-coronavirus-press- conference- full-and-final-11mar2020.pdf?sfvrsn=cb432bb3_2

10. Folha de S. Paulo [Internet]. Brasil confirma primeiro caso do novo coronavírus. [citado 19 mar 2020]; Disponible en:

https://www1.folha.uol.com.br/equilibrioesaude/2020/02/brasil-confirma-primeiro- caso-do-novo-coronavirus.shtml

11. Elnacional.com [Internet]. Confirman primer caso de coronavirus en Venezuela. El Nacional. [actualizado 13 de Marzo2020, citado 18 marzo 2020]; Disponible en: https://www.elnacional.com/venezuela/confirman-primer-caso-de-coronavirus-en- venezuela/

12. Mehand MS, Al-Shorbaji F, Millett P, Murgue B. The WHO R&D Blueprint: 2018 review of emerging infectious diseases requiring urgent research and development efforts. Antiviral Res. 2018; 159:63- 67. doi: https://doi.org/10.1016/j.antiviral.2018.09.009

13. OMS. Pandemia de enfermedad por coronavirus(COVID-19). Obtenido de:<https://www.who.int/csr/don/12-january-2020-novel-coronavirus- china/es/> Consultado: 26-04 2020.

14. Devaux CA, Rolain J-M, Colson P, Raoult D. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents. 2020; 105938.

15. Wellems TE, Plowe CV. Chloroquine-resistant malaria. J Infect Dis. 2001; 184(6): 770-6

16. Enrique Asensio1, Rafael Acunzo2, William Uribe3, Eduardo B. Saad4, Luis C. Sáenz5 http://www.covid19- druginteractions.org/). Recomendaciones para la medición del intervalo QT durante el uso de medicamentos para el tratamiento fr infección por Covid-19

17. Woosley R. Cardiac complications of chloroquine-based therapy. Cardiology 2020. https://www.practiceupdate.com/content/cardiac-complications-of-chloroquinebased- therapy/98054

18. http://www.who.int/ethics/publications/infectious-disease-outbreaks/en/. Consultado:

27-04-2020

19. Cepelowicz Rajter, J., Sherman, M., Fatteh, N., Vogel, F., Sacks, J., & Rajter, J.-

J. (10 de junio de 2020). Estudio ICON (Ivermectin in COvid Nineteen): el uso

de ivermectina se asocia con una menor mortalidad en pacientes hospitalizados con COVID19. medRxiv. doi:httpsdoi.org/10.1101/2020.06.06.20124461

20. Chaccour, C. J., Brew, J., & García, A. (29 de Mayo de 2020). Instituto de Salud Global de Barcelona. Recuperado el 12 de Septiembre de 2020,

de https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/ivermectin-and- covid-19-how-a-flawed-database-shaped-the-covid-19-response-of-several-latin- american-countries/2877257/0%20#

21. Zhou F., Yu T., Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort

study. Lancet. 2020;395:1054–1062., Y.R., Cao, Q.D., Hong, Z.S., Tan Y.Y., Chen,

S.D., Jin, H.J. (2020) The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Military Medical Research, 7, 11. doi: 10.1186/s40779-020-00240-0.

22. Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic treatments for coronavirusdisease 2019 (COVID-19): A review. JAMA. 2020.

23. Xu K, Cai H, Shen Y, Ni Q, Chen Y, Hu S, et al. [Management of corona virus

disease-19 (COVID-19): the Zhejiang experience]. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020;49(1):0.

24. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical charac-teristicsof 99 cases of 2019 novel coronavirus pneumonia in Wuhan,China: a descriptive study. Lancet 2020; 395: 507-13.

25. Luis Miguel Cárcamo MDa Miguel José Tejeda MDb Jorge A. Castro-Clavijo MDc Luisa M. Montoyad Laura Johanna Barrezueta MDe Sara Valentina Cardona MDf Dayana Andrea Arjona MDg Johnny Alexander Rendón MDh Características clínicas y sociodemográficas de pacientes fallecidos por COVID-19 en Colombia Repertorio de Medicina y Cirugía ISSN: 0121-7372 • ISSN electrónico: 2462-991X

26. Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y, et al. Remdesivir in adults with severe COVID-19: A randomized double blind placebo controlled, multicenter trial Lancet 2020:395:1569-78

27. Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the treatment of Covid-19 - Preliminary report. N Engl J Med. 2020.

28. Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, et al. A trial of lopinavir---ritonavir in adults hospitalized with severe Covid-19. N Engl J Med [Internet]. 2020,

29. Hung IFN, Lung KC, Tso EYK, Liu R, Chung TWH, Chu MY et al. Triple combination of interferon beta-1b, lopinavir ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet. 2020; 395(10238):1695-70. https://doi.org/10.1016/S0140-

6736(20)31042-4

30. Zhou D, Dai SM, Tong Q. COVID-19: a recommendation to examinethe effect of hydroxychloroquine in preventing infection and progression [e-pub before print]. J Antimicrob Chemother,https://doi.org/10.1093/jac/dkaa114

31. Rosenberg ES, Dufort EM, Udo T, Wilberschied LA, Kumar J, Tesoriero J, et al. Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with JAMA. 2020; 323(24):2493-2502. doi.10.1001/jama.2020

Published online May 11, 202

32. Borba MGS, Val FFA, Sampaio VS, Alexandre MAA, Melo GC, Brito M, et al. Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS- CoV2) infection: A randomized clinical trial. JAMA Netw Open. 2020; 3:e208857.

33. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factorsassociated with acute respiratory distress syndrome and death in patients with coronavirusdisease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020.

34. Xu X, Han M, Li T, Sun W, Wang D, Fu B, et al. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A. 2020; 117(20):10970-15. doi: 10.1073/pnas.2005615117.

35. Tratamientos disponibles sujetos a condiciones especiales de acceso para el manejo de la infección respiratoria por SARS-CoV-2 [Internet]. Agencia Española ˜de

Medicamentos y Productos Sanitarios[citado 7 Jun 2020]. Disponible en: https://www.aemps.gob.es/la-aemps/ultima-informacionde-la-aemps-acerca-del- covid%e2%80%9119/tratamientosdisponibles-para-el-manejo-de-la-infeccion- respiratoria-porsars-cov-2/.

36. Paranjpe I, Fuster V, Lala A, Russak A, Glicksberg BS, Levin MA, et al. Association of treatment dose anticoagulation with inhospital survival among hospitalized patients with COVID-19. J Am Coll Cardiol. 2020

37. Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A. 2020.

38. Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically ill patientswith COVID-19 with convalescent plasma. JAMA. 2020.

39. Cepelowicz Rajter, J., Sherman, M., Fatteh, N., Vogel, F., Sacks, J., & Rajter, J.-J. (10 de junio de 2020). Estudio ICON (Ivermectin in COvid Nineteen): el uso de ivermectina se asocia con una menor mortalidad en pacientes hospitalizados con COVID19. medRxiv. doi:https:// doi.org/10.1101/2020.06.06.20124461

40. Gino Corsini Acuña Laura Navarro Heredia Virus, un mundo microscópico Primera edición: marzo, 2020 Santiago, Chile Centro de Comunicación de las Ciencias http://ciencias.uautonoma.cl © Universidad Autónoma de Chile Avenida Pedro de Valdivia 425, Providencia Santiago, Chile Dirección editorial y corrección de textos: Isidora Sesnic Humeres Diseño, diagramación e ilustraciones: Felipe Serrano González ISBN versión digital: 978-956-8454-68-5

41. Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet [Internet] 2020 [citado 18 mar 2020] 395 (102223). Disponible en URL doi:10.1016/S0140-6736(20)30183-5

42. Zoonosis - Wikipedia, la enciclopedia libre [Internet]. [Citado 4 de marzo de 2020]. Disponible en: https://es.wikipedia.org/wiki/Zoonosis

43. Fehr AR, Perlman S. Coronaviruses: An Overview of Their Replication and Pathogenesis. In: Maier HJ, Bickerton E, Britton P (eds.) Coronaviruses: Methods and Protocols. New York, NY: Springer New York; 2015. p. 1–23.

44. Elshabrawy HA, Fan J, Haddad CS, Ratia K, Broder CC, Caffrey M, et al. Identification of a broad-spectrum antiviral small molecule against severe acute respiratory syndrome coronavirus and Ebola, Hendra, and Nipah viruses by using a novel high-throughput screening assay. J Virol. 2014; 88(8):4353–4365

45. Bosch BJ, van der Zee R, de Haan CAM, Rottier PJM. The coronavirusspike protein is a class I virus fusion protein: structural and functional character-ization of the fusion core complex. J Virolol. 2003;77(16):8801–8811

46. Zhang L, Shen F-M, Chen F, Lin Z. Origin and evolution of the 2019 novel coronavirus. Clinical infectiousdiseases: an official publication of the Infectious Diseases Society of America. [citado el 6 de abril de 2020]. Disponible en doi: 10.1093/cid/ciaa112.

47. Tang XL, Wu CC, Li X, Song YH, Yao XM, Wu XK, et al. On the origin and continuing evolution of SARS-CoV-2. National Science Review. 2020; 1–26. doi: 10.1093/nsr/nwaa036

48. Tian X, Li C, Huang A, Xia S, Lu S, Shi Z, et al. Potent binding of 2019 novel coronavirus spike protein by a SARS coronavirus-specific human monoclonal antibody. Emerg Microbes Infect. 2020; 9(1):382–385. doi: 10.1080/22221751.2020.1729069. 23. Masters PS. The molecular biology of coronaviruses. Adv Virus Res. 2006; 66:193–292.

49. Breastfeeding and COVID-19. Ginebra: Organización Mundial de la Salud; 2020 (disponible en https://www.who.int/newsroom/commentaries/detail/breastfeeding- and-covid-19).

50. Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. Jama. 2020. doi: 10.1001/ jama.2020.2648

51. Carter JB, Saunders VA. Virology: principles and applications. Second ed. Chichester, West Sussex: John Wiley & Sons; 2013.

52. José Francisco Ávila De Tomas Covid-19; PATOGENIA, PREVENCIÓN Y TRATAMIENTO 4ª Edición - 18.03.2020 ISBN: 978-84-16861-95-8

53. He X, Lau EH, Wu P, Deng X, Wang J, Hao X, et al. Temporal dynamics in viral shedding and transmissibility of COVID19. Nat Med. 2020; 26(5):672-5.

54. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findingsfrom 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020; 20(4):425-434. doi: 10.1016/ S1473-3099(20)30086-4.

55. Almazán F, Sola I, Zuñiga S, Marquez-Jurado S, Morales L, Becares M, et al. Coronavirus reverse genetic systems: infectious clones and replicons. Virus Res. 2014; 189:262–270.

56. World health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected [Internet]. 2020-ene.Disponible en: https://www.who.int/publications-detail/clinicalmanagement-of-severe-acute- respiratory-infection-when-novel-coronavirus- (ncov)-infection-is-suspected.

57. Stockman LJ, Bellamy R, Garner P. SARS: Systematic Review of Treatment Effects. PLOSMed [Internet]. 12 de septiembre de 2006 [citado 6 de febrero de 2020]; 3(9): e343. Disponible en: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.00303 43

58. Corticosteroids as Adjunctive Therapy in the Treatment of Influenza: An Updated Cochrane Systematic Review and Meta-analysis. -PubMed -NCBI [Internet]. [citado 6 de febrero de 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/31743228

59. Knowles S R, Phillips E J, Dresser L, Matukas L. Common adverse events associated with the use of ribavirin for Severe Acute Respiratory Syndrome in Canada. Clin Infect Dis 2003; 37 (8): 1139-42. https://doi. org/10.1086/378304.

60. Grein J, Ohmagari N, Shin D, Díaz G, Asperges E, Castagna A, et al. Compassionate use of remdesivir for patients with severe Covid-19. N Engl J Med 2020. April 10. https://doi. org/10.1056/NEJMoa2007016

61. Scavone C, Brusco S, Bertini M, Sportiello L, Rafaniello C, Zoccoli A, et al. Current pharmacological treatments for COVID-19: what is next? Br J Pharmacol 2020. April

24.https://doi.org/10.1111/bph.15072

62. lei l, Jian-ya G. Clinical characteristics of 51 patients discharged from hospital with COVID-19 in Chongqing, China. medRxiv 2020. Februry 23. https://doi.org/10.1101/2020. 02.20.20025536

63. Boriskin Y S, Leneva I A, Pecheur E I, Polyak SJ. Arbidol: A broad-spectrum antiviral compound that blocks viral fusion. Curr Med Chem 2008; 15 (10): 997-1005. http://dx.doi. org/10.2174/092986708784049658.

64. Zhu Z, Lu Z, Xu T, Chen C, Yang G, Zha T, et al. Arbidol monotherapy is superior to lopinavir/ritonavir in treating COVID-19. J Infect 2020. April. https://doi.org/10.1016/j. jinf.2020.03.060

65. Whitty C, Dexamethasone in the treatment of COVID-19: Implementation and management of supply for treatment in hospitals. United Kingdom. Medicines and Healthcare products Regulatory Agency. Central Alerting System. 2020.

66. Docherty A B, Harrison E M, Green C A, Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020; 369:m1985. PubMed

67. Mallapaty S. Can COVID vaccines stop transmission? Scientists race to find answers. Nature. 2021. DOI: 10.1038/d41586-021-00450-z

68. ECDC. SARS-CoV-2 increased circulation of variants of concern and vaccine rollout in the EU/EEA, 14th update. 2021. Disponible en: https://wwwecdceuropaeu/sites/default/files/documents/RRAcovid-19-14th-update-15- feb-2021pd.

69. Levine-Tiefenbrun M, Yelin I, Katz R, Herzel E, Golan Z, Schreiber L, et al. Decreased SARS-CoV-2 viral load following vaccination. . medRxiv 2021 . doi: 10.1101/2021.02.06.21251283

70. Petter E, Mor O, Zuckerman N, Oz-Levi D, Younger A, Aran D, et al. Initial real world evidence for lower viral load of individuals who have been vaccinated by BNT162b2. medRxiv 2021. doi: 10.1101/2021.02.08.21251329

71. Thompson MG, Burgess JL, Naleway AL, Tyner HL, Yoon SK, Meece J, et al. Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers- Eight U.S. Locations, December 2020-March 2021. MMWR Morb Mortal Wkly Rep. 2021;70(13):495-500. DOI: 10.15585/mmwr.mm7013e3

72. Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020. DOI: 10.1056/NEJMoa2034577

73. Prevention. CfDCa. Local reactions, systemic reactions, adverse events and serious adverse events: Moderna COVID-19 Vaccine. December Obtenido en https//wwwcdcgov/vaccines (covid-19/info-by:product/moderna/reactogenityhtml.

74. Poland GA, Ovsyannikova IG, Kennedy RB. SARS-CoV-2 immunity: review and applications to phase 3 vaccine candidates. Lancet. 2020. DOI: 10.1016/s0140- 6736(20)32137-1

75. Lehman CD, Lamb LR, D’Alessandro HA. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach. AJR Am J Roentgenol. 2021. DOI: 10.2214/ajr.21.25688

76. Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R. Efficacy and Safetyof the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med. 2021;384:403–16

77. Stephenson KE, Le Gars M, Sadoff J, de Groot AM, Heerwegh D, Truyers C, et al. Immunogenicity of the Ad26.COV2.S Vaccine for COVID-19. Jama. 2021. DOI: 10.1001/jama.2021.3645

78. Schultz NH, Sørvoll IH, Michelsen AE, Munthe LA, Lund-Johansen F, Ahlen MT, et al. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N Engl J Med. 2021. DOI: 10.1056/NEJMoa2104882

79. Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination. N Engl J Med. 2021. DOI: 10.1056/NEJMoa2104840

80. Mahase E. Covid-19: US suspends Johnson and Johnson vaccine rollout over blood clots. Bmj. 2021; 373:n970. DOI: 10.1136/bmj.n970

81. Voysey M, Clemens SAC, Madhi SA, et al.; Oxford COVID Vaccine Trial Group.Safety and efficacy of the ChAdOx1nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interimanalysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021; 397(10269):99-111. https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-benefits-still- outweigh-risks-despite-possible-link-rare-blood-clots. [Consulta: 12 abril 2021].Rev Méd Urug 2021; 37(2):

82. Wise J.Covid-19: European countries suspend use of Oxford-AstraZeneca vaccine after reports of blood clots.BMJ. 2021; 372:n699. https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-benefits-still- outweigh-risks-despite-possible-link-rare-blood-clots. [Consulta: 12 abril 2021].Rev Méd Urug 2021; 37(2):

83. Malas MB, Naazie IN, Elsayed N, Mathlouthi A, Marmor R, Clary B.Thromboembolism risk of COVID-19 is highand associated with a higher risk of mortality: A systematicreview and meta-analysis. EClinicalMedicine. 2020; 29:100639. https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca- benefits-still-outweigh-risks-despite-possible-link-rare-blood-clots. [Consulta: 12 abril 2021].Rev Méd Urug 2021; 37(2):

84. Coutinho JM, Zuurbier SM, Aramideh M, Stam J The incidence of cerebral venous thrombosis: a cross-sectional study. Stroke. 2012; 43(12):3375-7. https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-benefits-still- outweigh-risks-despite-possible-link-rare-blood-clots. [Consulta: 12 abril 2021].Rev Méd Urug 2021; 37(2):

85. Fujun Peng, Ph.D., Yongshi Yang, M.D. Management and Treatment of COVID-19: The Chinese Experience. Doi: https://doi.org/10.1016/j.cjca.2020.04.010.

86. Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, et al. Viral load dynamics and disease severity in patients infected with SARSCoV-2 in Zhejiang province, China, January- March 2020: retrospective cohort study. BMJ. 2020:m1443

87. COVID-19 Science Advisory Table. 2021; 1(17).

88. EMA. COVID-19 Vaccine AstraZeneca. 2021, https://www.ema.europa.eu/en/medicines/human/summaries-opinion/covid-19- vaccine-astrazeneca

89. Voysey M, Costa-Clemens SA, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al.Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS- CoV-2: an interim analysis of four randomised controlled trials in Brazil, SouthAfrica, and the UK. Lancet. 2021;397:99–111

Downloads

Published

2022-12-30

How to Cite

1.
Hurtado Monrroy CS, Soledispa Cañarte PA. Esquemas de tratamientos más utilizados parapacientes Covid-19 en UCI y emergencia del Hospital Teodoro Maldonado Carbo. Health Leadership and Quality of Life [Internet]. 2022 Dec. 30 [cited 2025 Jul. 30];1:88. Available from: https://hl.ageditor.ar/index.php/hl/article/view/88