ANTIKOAGULANSI I KORTIKOSTEROIDI U LEČENJU KOVID-19 OBOLJENJA – ŠTA ZNAMO DO SADA?

  • Marija Milenković Urgentni centar, Univerzitetski Klinički centar Srbije, Beograd, Srbija
  • Marija Dukić Kliničko-bolnički centar Bežanijska kosa, Beograd, Srbija
  • Ivan Rović Medicinski fakultet Univerziteta u Beogradu, Beograd, Srbija
  • Đuro Šijan Medicinski fakultet Univerziteta u Beogradu, Beograd, Srbija
  • Adi Hadžibegović Urgentni centar, Univerzitetski Klinički centar Srbije, Beograd, Srbija
  • Višeslav Popadić Kliničko-bolnički centar Bežanijska kosa, Beograd, Srbija
  • Slobodan Klašnja Kliničko-bolnički centar Bežanijska kosa, Beograd, Srbija
  • Milica Brajković Kliničko-bolnički centar Bežanijska kosa, Beograd, Srbija
  • Marija Zdravković Kliničko-bolnički centar Bežanijska kosa, Beograd, Srbija
DOI: https://doi.org/10.5937/3-35014
Ključne reči: KOVID-19, SARS-KoV-2, antikoagulantna terapija, tromboza, kortikosteroidi

Sažetak


Više od godinu i po dana traje borba protiv pandemije KOVID-19 oboljenja. Kao nezaobilazni deo najnovijih protokola, razmatra se upotreba kortikosteroida i antikoagulanasa u lečenju, ali i u  prevenciji komplikacija. Na ovom mestu, želimo da prikažemo prednosti, ali i mane, upotrebe kortikosteroidne i antikoagulantne terapije u infekciji Sars-KoV-2 virusom,  u skladu sa dostupnim podacima. Na samom početku pandemije, uočena je veća učestalost trombotičkih događaja koji pogoršavaju tok i ishod oboljenja. Pokazalo se da povišene vrednosti D-dimera ne koreliraju sa postojanjem venske tromboze i nisu pouzdan dokaz duboke venske tromboze ili plućne tromboembolije. Prema Nacionalnom protokolu za lečenje obolelih od KOVID-19 infekcije (12. verzija), preporučuje se upotreba antikoagulantne terapije kod hospitalizovanih bolesnika. S obzirom na postojanje rizika od nastanka različitih neželjenih reakcija, poput krvarenja i heparinom uzrokovane trombocitopenije, potrebno je pažljivo ordiniranje antikoagulantne terapije, uz praćenje njenih efekata. Kada su u pitanju kortikosteroidi, naglasak  je na njihovoj efikasnosti  kod  pacijenata sa umereno teškom  i teškom kliničkom slikom koji zahtevaju kiseoničku potporu. Efikasnost kortikosteroidne terapije se ogleda u snižavanju mortaliteta, smanjenju potreba za mehaničkom ventilacijom i bržim prevođenjem obolelih iz jedinica intenzivnog lečenja, kao i kraćem trajanju hospitalizacije. Individualna procena koristi i rizika pri uključivanju ovih lekova u terapiju bolesnika sa potvrđenom infekcijom Sars-KoV-2 virusom je od vitalnog značaja za postizanje željenih efekata terapije.

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Objavljeno
2022/03/24
Broj časopisa
Vol. 3 Br. 1 (2022): Srpski medicinski časopis Lekarske komore
Rubrika
Pregledni članci