ABC | Volume 115, Nº2, August 2020

Letter to the Editor Fernandes et al. Risks of Media Coverage of Scientific Data Arq Bras Cardiol. 2020; 115(2):278-280 Consider the following example: A 62-year-old female patient was admitted to the emergency room with large spontaneous hematomas throughout her body (Figure 1). Fifteen days prior, she had onset of hyaline rhinorrhea, without fever or myalgia. Fearing COVID-19, the patient sought information about pathology, and she came across some data in the media about a potential treatment with anticoagulants. She subsequently attempted to protect herself fromCOVID-19 using diverse anticoagulants concomitantly. Of her own accord, she began taking rivaroxaban, warfarin, and acetylsalicylic acid. Just in case, she had also taken hydroxychloroquine and azithromycin (also influenced by data from journalistic media, which mentioned studies on the potential benefits of these therapies. 11 ) Upon admission, she presented hemoglobin 12, international normalized ratio 26, and activated partial thromboplastin time ratio 2. She was hospitalized, and anticoagulation was reversed. She underwent both PCR and serology for SARS-CoV-2 (which causes COVID-19), both of Figure 1 – Spontaneous hematomas in a 62-year-old patient who used acetylsalicylic acid, rivaroxaban and warfarin to protect herself from COVID-19 (however, her PCR and serology tests were both negative). At the Emergence Room, her INR was 26 and the activated partial thromboplastin time ratio was 2. With the reversal of anticoagulation and clinical observation, the patient had no other bleeding complications. which were negative. In this manner, this patient, who had never had COVID-19, might have died due to complications from therapies which are still being evaluated for treating a disease which she never had. COVID-19 was identified only 5 months ago. Notwithstanding its severity and the high number of victims, time and experience are still necessary, in respect to both clinical management 12 and interpretation of scientific data produced in unprecedented quantities and speeds. The democratization of information is fundamental, and the press is doing an excellent job in this role. Raw technical information, however, without the necessary refinement provided by clinical experience, may have very harmful consequences if it is carelessly absorbed by a population that is fragile due to concerns about this disease. Access to information provided by the media is fundamental in order for patients to participate actively in their treatment. These treatments, however, should always be guided by the professionals who are most qualified to conduct them, namely physicians. 1. World Health Organization.(WHO) Coronavirus disease (COVID-19) Situation Report of the World Health Organization 2020.[Cited in 2020Apr12]. Available from: https://www.who.int/docs/default/ coronavirus 2. MesquitaCT,OliveiraA,SeixasFvL,PaesA.Infodemia,FakeNewsandMedicine: ScienceandTheQuest forTrut. Int JCardiovascSci. .2020:aheadofprint. 3. Helms J, Tacquard C, Severac F,Leonard-Lorant Y, Ohana M, Delabranche X, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: amulticenter prospective cohort study. Intensive CareMed. 2020. Doi:10.1007/s00134-020-06062-x 4. Dolhnikoff M, Duarte-Neto AN, de AlmeidaMonteiro RAFerraz da Silva LF, Oliveira EP, Saldiva PH, etal. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J ThrombHaemost. 2020;18(6):1517-9. 5. Zhang L, Yan X, Fan Q, Liu H, Liu H, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020; ahead print. References 279