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Coocurrencia de anemia y prueba antiglobulínica directa (PAD) positiva en pacientes hospitalizados por COVID-19
dc.rights.license | Atribución-NoComercial-CompartirIgual 4.0 Internacional |
dc.contributor.advisor | Grajales Buitrago, Marco Antonio |
dc.contributor.advisor | Camacho Rodríguez, Bernardo Armando |
dc.contributor.advisor | Angarita de Botero, María del Pilar |
dc.contributor.advisor | Sánchez Pedraza, Ricardo |
dc.contributor.author | Burbano Gutiérrez, Juan Felipe |
dc.date.accessioned | 2022-02-01T19:45:25Z |
dc.date.available | 2022-02-01T19:45:25Z |
dc.date.issued | 2021 |
dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/80841 |
dc.description | ilustraciones |
dc.description.abstract | La infección por SARSCoV-2 causa la enfermedad por coronavirus del 2019 (COVID-19), considerada como pandemia, con complicaciones hematológicas derivadas de síndromes hiperinflamatorios y autoinmunidad en pacientes de alto riesgo y ancianos que desarrollan una infección grave por COVID-19. Una de las complicaciones documentadas es la anemia hemolítica autoinmune (AHAI), que está mediada por la emergencia de autoanticuerpos contra los eritrocitos del huésped. El diagnóstico de AHAI a menudo no se realiza, lo que conduce a resultados clínicos deficientes debido a anemia, disfunción endotelial e hipoperfusión tisular. Se realizó un estudio observacional de corte transversal por período para evaluar la coocurrencia de anemia y prueba de antiglobulina directa (PAD) positiva, en pacientes hospitalizados por COVID-19 en dos hospitales de Bogotá, Colombia, del 18 de marzo al 29 de abril. 2021. La asociación sustantiva entre anemia y PAD positiva se estimó por medio del coeficiente de agrupamiento o de cluster; Las variables de confusión que se sabe están asociadas con la anemia y PAD (p. ej., inflamación, gravedad de COVID-19, sangrado mayor y tratamiento con antibióticos) se controlaron mediante regresión logística multivariable. Se evaluaron 185 pacientes, 84 (45,4%) eran mujeres y la edad media fue 59,7 ± 14,7. Cien (54,1%) ingresaron a la unidad de cuidados intensivos, 67 (36,2%) con disfunción multiorgánica (medida por qSOFA ≥2). La prevalencia de anemia y PAD positiva fue del 19,4% (intervalo de confianza [IC] del 95%, 13,8 a 25,2). El coeficiente de cluster fue de 1,55, lo que demuestra una asociación sustancial no coincidencial. La disfunción multiorgánica, la PAD positiva y la terapia con antibióticos se asociaron significativamente con anemia durante la hospitalización (OR: 5,11 (IC 95%: 2,46 - 10,60), 2,72 (IC 95%: 1,32 – 5,60) y 2,48 (IC 95% 1,10 - 5,57), respectivamente. En conclusión, la coocurrencia de anemia y PAD positiva en pacientes hospitalizados con infección por SARS-CoV-2 no es una coincidencia y se asocia a insuficiencia multiorgánica y terapia con antibióticos. Para el médico, la anemia de nueva aparición después o durante la hospitalización debido a un COVID-19 grave debe despertar sospechas de AHAI. (texto tomado de la fuente) |
dc.description.abstract | Hematologic complications derived from hyperinflammatory syndromes and autoimmunity can be seen in high-risk and elderly patients who develop severe COVID-19 infection. One of the reported complications is autoimmune hemolytic anemia (AIHA), which is mediated by the emergency of autoantibodies against host erythrocytes. The diagnosis of AIHA is often unrecognized leading to poor clinical outcomes due to anemia, endothelial dysfunction, and tissue hypoperfusion. Herein, we conducted a cross-sectional, observational study to evaluate the prevalence of anemia and a positive Direct Antiglobulin Test (DAT), among hospitalized patients with COVID-19 in two hospitals in Bogota, Colombia during COVID surge from March 18 to April 29, 2021. The association between anemia and a positive DAT was estimated by cluster coefficient; confounding variables known to be associated with anemia (eg, inflammation, COVID-19 severity, mayor bleeding and antibiotic therapy) were controlled by multivariate logistic regression. One hundred and eighty-five patients were evaluated, 84 (45,4%) were female, and the mean age was 59,7 ± 14,7. One hundred (54,1%) were admitted to intensive care unit, 67 (36,2%) with multi-organ dysfunction (measured by qSOFA ≥2). The prevalence of anemia and positive DAT was 19.4% (95% confidence interval [CI], 13.8 to 25.2). Cluster coefficient was 1.55 showing a substantive non coincidental association. Multi-organic dysfunction, positive DAT and antibiotic therapy were significantly associated with anemia that occurred during hospitalization (OR:5,11 (95% CI 2,46 – 10,60), 2,72 (95% CI 1,32 – 5,60) and 2,48 (95% CI 1,10 – 5,57), respectively In summary, the prevalence of anemia and positive DAT in hospitalized patients with SARS-CoV-2 infection is not coincidental and it is associated to multiple organ failure and antibiotic therapy. For the clinician, new onset anemia following hospitalization due to severe COVID-19 should raise suspicion for AIHA. |
dc.format.mimetype | application/pdf |
dc.language.iso | spa |
dc.publisher | Universidad Nacional de Colombia |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-sa/4.0/ |
dc.subject.ddc | 610 - Medicina y salud::616 - Enfermedades |
dc.subject.other | Infecciones por Coronavirus |
dc.subject.other | Coronavirus Infections |
dc.subject.other | Anemia |
dc.subject.other | Anemia Hemolítica Autoinmune |
dc.subject.other | Anemia, Hemolytic, Autoimmune |
dc.title | Coocurrencia de anemia y prueba antiglobulínica directa (PAD) positiva en pacientes hospitalizados por COVID-19 |
dc.type | Trabajo de grado - Especialidad Médica |
dc.type.driver | info:eu-repo/semantics/masterThesis |
dc.type.version | info:eu-repo/semantics/acceptedVersion |
dc.publisher.program | Bogotá - Medicina - Especialidad en Hematología |
dc.contributor.researcher | Amador Rodríguez, Mónica Patricia |
dc.contributor.researcher | Gaviria García, Paula Andrea |
dc.contributor.researcher | Grass Guáqueta, Jeser Santiago |
dc.contributor.researcher | Deantonio Paéz, Danna Valentina |
dc.description.degreelevel | Especialidades Médicas |
dc.description.degreename | Especialista en Hematología |
dc.description.researcharea | Hematología |
dc.identifier.instname | Universidad Nacional de Colombia |
dc.identifier.reponame | Repositorio Institucional Universidad Nacional de Colombia |
dc.identifier.repourl | https://repositorio.unal.edu.co/ |
dc.publisher.department | Departamento de Medicina Interna |
dc.publisher.faculty | Facultad de Medicina |
dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
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dc.rights.accessrights | info:eu-repo/semantics/openAccess |
dc.subject.proposal | COVID-19 |
dc.subject.proposal | SARS-CoV-2 |
dc.subject.proposal | Anemia |
dc.subject.proposal | Anemia hemolítica autoinmune |
dc.subject.proposal | Prueba antiglobulínica directa |
dc.subject.proposal | Autoimmune hemolytic anemia |
dc.subject.proposal | Direct antiglobulin test |
dc.title.translated | Prevalence of anemia and positive direct antiglobulin test (DAT) in hospitalized patients with COVID-19 |
dc.type.coar | http://purl.org/coar/resource_type/c_bdcc |
dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
dc.type.content | Text |
dc.type.redcol | http://purl.org/redcol/resource_type/TM |
oaire.accessrights | http://purl.org/coar/access_right/c_abf2 |
dcterms.audience.professionaldevelopment | Estudiantes |
dcterms.audience.professionaldevelopment | Investigadores |
dcterms.audience.professionaldevelopment | Público general |
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