PT  - JOURNAL ARTICLE
AU  - Felicio Savioli
AU  - Lucas Ribeiro dos Santos
AU  - Marcio Luis Duarte
AU  - Andreia Cristina Feitosa do Carmo
AU  - Aecio Gois
AU  - Luis Nakano
AU  - Fernando Jose Da Silva Ramos
AU  - Laerte Pastore
AU  - Eduardo Leite Vieira Costa
TI  - Fibrinolytic therapy in patients with COVID-19 and ARDS: protocol for a systematic review and meta-analysis
AID  - 10.1136/bmjopen-2022-066623
DP  - 2023 Jan 01
TA  - BMJ Open
PG  - e066623
VI  - 13
IP  - 1
4099  - http://bmjopen.bmj.com/content/13/1/e066623.short
4100  - http://bmjopen.bmj.com/content/13/1/e066623.full
SO  - BMJ Open2023 Jan 01; 13
AB  - Introduction In COVID-19-related acute respiratory distress syndrome (ARDS), the clot play a role in gas exchange abnormalities. Fibrinolytic therapy can improve alveolar ventilation by restoring blood flow. In this systematic review and meta-analysis protocol, we aim to assess the safety and efficacy of fibrinolytic therapy in such a population.Methods We will perform a systematic search in MEDLINE, EMBASE, Cochrane CENTRAL and LILACS databases without language restrictions for relevant randomised controlled trials (RCTs) and quasi-RCTs. Two review authors will independently perform data extraction and quality assessments of data from included studies. In case of divergence, a third author will be contacted. The Cochrane handbook will be used for guidance. If the results are not appropriate for a meta-analysis, a descriptive analysis will be performed.Discussion This systematic review and meta-analysis protocol will provide current evidence about the safety and efficacy of fibrinolytic therapy in patients with COVID-19 and ARDS. These findings will provide if fibrinolytic therapy might be an option for a desperate clinical setting, where all medical efforts have been used.PROSPERO registration number PROSPERO CRD42020187482.Ethics and dissemination Ethics committee approval is not necessary. We intend to update the public registry, report any protocol amendments and publish the results in a widely accessible journal.