IMPLICAÇÕES MEDICAMENTOSAS A NÍVEL HEPÁTICO EM PACIENTES SUBMETIDOS A TRATAMENTO DA COVID-19
DRUG IMPLICATIONS AT THE HEPATIC LEVEL IN PATIENTS SUBMITTED TO COVID-19 TREATMENT
DOI:
https://doi.org/10.18066/revistaunivap.v29i64.4473
Abstract
The COVID-19 virus has brought to light a new illness that has raised several questions worldwide, one of which is related to the prophylaxis of the disease, i.e., which drugs can be used to treat the infected patient and what long-term side effects the patient may develop. The aim of the article is to analyze possible hepatic changes in patients undergoing COVID-19 prophylaxis in the ICU, identify the correlation with pharmacological choice, and evaluate long-term side effects. The research was conducted by analyzing electronic medical records of 101 patients undergoing COVID-19 prophylaxis in the ICU in 2020 and 2021. The main observed hepatic changes were in GGT and AST, with the most used medication in the COVID-19 cocktail being azithromycin, associated or not with hydroxychloroquine, ivermectin, or both. The research has some limitations, as it was conducted in only one hospital unit, and therefore, the results cannot be generalized to other regions. However, the significant findings highlight the importance of evaluating the long-term side effects of medications used in COVID-19 prophylaxis, especially in relation to the liver, and considering the correlation with pharmacological choice. This can help improve therapy and prevent serious complications in patients with COVID-19
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References
Alfano, G., Ferrari, A., Fontana, F., Mori, G., Ligabue, G., Giovanella, S., ... & Modena Covid-19 Working Group. (2021). Twenty-four-hour serum creatinine variation is associated with poor outcome in the novel coronavirus disease 2019 (COVID-19) patients. Kidney Research and Clinical Practice, 40(2), 231.
Ashraf, S., Farooq, I., Ashraf, M., Imran, M. A., ...& Izhar, M. (2021). Anti-COVID property of subcutaneous ivermectin in synergy with zinc among midlife moderately symptomatic patients: a structured summary of a study protocol for a randomised controlled trial. Trials, 22, 1-3.
Axfors, C., Schmitt, A. M., Janiaud, P., van’tHooft, J., Abd-Elsalam, S., Abdo, E. F., ...& Hemkens, L. G. (2021). Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nature communications, 12(1), 2349.
Baracaldo-Santamaría, D., Pabón-Londoño, S., & Rojas-Rodriguez, L. C. (2022). Drug safety of frequently used drugs and substances for self-medication in COVID-19. Therapeutic Advances in Drug Safety, 13, 20420986221094141.
Battaglini, D., Lopes-Pacheco, M., Castro-Faria-Neto, H. C., Pelosi, P., & Rocco, P. R. (2022). Laboratory biomarkers for diagnosis and prognosis in COVID-19. Frontiers in immunology, 13.
Bogliolo Filho, G. B. (2021). Patologia. Grupo GEN.
Brasil. (2013). Protocolo de Segurança na Prescrição, Uso e Administração de Medicamentos (Anexo 3). Fundação Oswaldo Cruz. Agência Nacional de Vigilância Sanitária. Ministério da Saúde.
Brasil. (2021). Nota Técnica Ivermectina. Lex Centro Colaborador do SUS: Avaliação de Tecnologias e Excelência em Saúde - CCATES.
Chi, G., Memar Montazerin, S., Lee, J. J., Kazmi, S. H. A., Shojaei, F., Fitzgerald, C., & Gibson, C. M. (2021). Effect of azithromycin and hydroxychloroquine in patients hospitalized with COVID‐19: Network meta‐analysis of randomized controlled trials. Journal of medical virology, 93(12), 6737-6749.
Ciotti, Marco et al. (2020). The COVID-19 pandemic. Critical reviews in clinical laboratory sciences, 57(6), 365-388.
Cofen. (2020). Paracer normativo nº 002/2020 COFEN. Brasília. Disponível
Debes, J. D., Anugwom, C. M., & Aby, E. S. (2020). Systematic analysis of acute liver injury during SARS-CoV-2 infection. DigestiveandLiverDisease, 52(9), 953-955.
Domingos, C. S., Bonisson, M. B., Ayres, L. F. A., & de Paula, P. M. (2020). Aplicação Da Escala De Fugulin Em Um Setor De Emergência. Revista Remecs-Revista Multidisciplinar de Estudos Científicos em Saúde, 218-218.
Echeverría-Esnal, D., Martin-Ontiyuelo, C., Navarrete-Rouco, M. E., De-Antonio Cuscó, M., Ferrández, O., Horcajada, J. P., & Grau, S. (2021). Azithromycin in the treatment of COVID-19: a review. Expert review of anti-infective therapy, 19(2), 147-163.
Ferreira-da-Silva, R., Ribeiro-Vaz, I., Morato, M., Silva, A. M., & Polónia, J. J. (2021). O Papel da Farmacovigilância em Contexto da Pandemia por COVID-19. Acta Médica Portuguesa, 34(3), 173-175.
Figueiredo, B. Q., Cancela, B. R., Rodrigues, A. E. L., Falcão, A. L. S., do Prado, D. M. M., da Rocha, D., ... & Segundo, S. (2022). Análise das possíveis intoxicações decorrentes do uso indiscriminado da ivermectina e hidroxicloroquina durante a pandemia de COVID-19. Research, Society and Development, 11(3), e14511326441-e14511326441.
Fischbach, F. T., & Fischbach, M. Barnett D. (2015). Exames Laboratoriais e Diagnósticos em Enfermagem. Grupo GEN.
Hernandez, A. V., Roman, Y. M., Pasupuleti, V., Barboza, J. J., & White, C. M. (2020). Hydroxychloroquine or chloroquine for treatment or prophylaxis of COVID-19: a living systematic review. Annals of internal medicine, 173(4), 287-296.
Hong, W., Park, Y. K., Kim, B. O., Park, S. K., Shin, J., Jang, S. P., ... & Hwang, T. H. (2022). Use of combined treatment of 3rd-generation cephalosporin, azithromycin and antiviral agents on moderate SARs-CoV-2 patients in South Korea: A retrospective cohort study. Plosone, 17(5), e0267645.
Khamis, F., Al-Zakwani, I., Al Naamani, H., Al Lawati, S., Pandak, N., Omar, M. B., ...& Al Awaidy, S. T. (2020). Clinical characteristics and outcomes of the first 63 adult patients hospitalized with COVID-19: an experience from Oman. Journal of Infection and Public Health, 13(7), 906-913.
Lorenzoni, G., Rosi, P., De Rosa S., Ranieri, V. M., Navalesi, P. & Gregori, D. (2022). Status de vacinação COVID-19 entre adultos internados em unidades de terapia intensiva em Veneto, Itália. Jama Netw, 5(5).
Machado, M. L.L., Souza, A. T. B., Linhares, P. V. A., Ferreira, C. F. M., Silva, D. F. O., Martins, R. R., & Cobucci, R. N. (2021). Effectiveness and safety of ivermectin in the treatment of COVID-19: protocol for a systematic review and meta-analysis. BMJ open, 11(9), e050532.
Martins-Filho, P. R., Ferreira, L. C., Heimfarth, L., de Souza Araújo, A. A., &Quintans-Júnior, L. J. (2021). Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials. The Lancet Regional Health-Americas, 2, 100062.
Melo Filho, A. L. A., Feniman, G. M. M., Trentim, R. J., Bruno, D. D., & de Almeida, B. H. C. (2023). A Hidroxicloroquina no tratamento de COVID-19, uma revisão sistemática de estudos controlados randomizados. Brasília Med, 59, 1-7.
Montastruc, F., Thuriot, S., & Durrieu, G. (2020). Hepatic disorders with the use of remdesivir for coronavirus 2019. Clinical Gastroenterology and Hepatology, 18(12), 2835-2836.
Morell-Garcia, D., Ramos-Chavarino, D., Bauça, J. M., Argente del Castillo, P., Ballesteros-Vizoso, M. A., Garcia de Guadiana-Romualdo, L., ... & García-Raja, A. (2021). Urine biomarkers for the prediction of mortality in COVID-19 hospitalized patients. Scientificreports, 11(1), 1-13.
Nicol, D. (2019). Manual de Exames Diagnósticos. Grupo A.
Nunes, L. L. A., & Lima, T. D. M. (2020). Use of medicines for covid-19 treatment in patients with loss of kidney function: a narrative review. Brazilian Journal of Nephrology, 43, 254-262.
Organização Pan-Americana da Saúde (2021). Folha informativa sobre COVID-19.
Pani, A., Lauriola, M., Romandini, A., & Scaglione, F. (2020). Macrolides and viral infections: focus on azithromycin in COVID-19 pathology. International journal of antimicrobial agents, 56(2), 106053.
Person, O. C., Simonian, A. A., Puga, M. E. D. S., & Atallah, Á. N. (2022). Efetividade das intervenções para COVID-19 à luz das revisões sistemáticas Cochrane. Revista Diagn. Tratamento, 27(2): 61-71.
Pias, C., de Paula Mascolo, N., Rabelo-Silva, E. R., da Costa Linch, G. F., & de Souza, E. N. (2015). Complexidade da assistência em unidade de terapia intensiva: subsídios para dimensionamento de pessoal de enfermagem. Cogitare enfermagem, 20(3), 533-539.
Pontes, L., Danski, M. T. R., Piubello, S. M. N., Pereira, J. D. F. G., Jantsch, L. B., Costa, L. B., & Arrué, A. M. (2021). Perfil clínico e fatores associados ao óbito de pacientes COVID-19 nos primeiros meses da pandemia. Escola Anna Nery, 26.
Popp, M., Stegemann, M., Metzendorf, M. I., Gould, S., Kranke, P., Meybohm, P., & Weibel, S. (2021). Ivermectin for preventing and treating COVID‐19. Cochrane Database of Systematic Reviews, (7).
Shen, Q., Li, J., Zhang, Z., Guo, S., Wang, Q., An, X., & Chang, H. (2022). COVID-19: systemic pathology and its implications for therapy. International Journal of Biological Sciences, 18(1), 386.
Soares, V. S. P., & Xavier, S. M. (2011). Perfil de complexidade dos clientes hospitalizados na unidade de tratamento de doenças infecciosas, segundo a Escala de Fugulin. Rev Qualidade HC, 2.
Souza, L. L., Sá, A. M., & Gimenez, F. V. M. (2023). O uso da Azitromicina no tratamento da COVID-19: Uma Revisão De Literatura. Revista Foco, 16(02), e931-e931.
Sultana, A., Sharma, R., Hossain, M. M., Bhattacharya, S. & Purohit, N. (2020). Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions. Indian J Med Ethics 5(4), 308-11.
Wen, M., Lu, J., & Xie, Y. (2020). Clinical characteristics of coronavirus disease 2019 patients complicated with liver injury. Zhongnan da xuexuebao. Yi xue ban= Journal of Central South University. Medical Sciences, 45(5), 555-559.
Wendel-Garcia, P. D., Erlebach, R., Hofmaenner, D. A., Camen, G., Schuepbach, R. A., Jüngst, C., ... & David, S. (2022). Long-term ketamine infusion-induced cholestatic liver injury in COVID-19-associated acute respiratory distress syndrome. Critical Care, 26(1), 1-12.
Wu, G., Zhou, S., Wang, Y., Lv, W., Wang, S., Wang, T., & Li, X. (2020). A prediction model of outcome of SARS-CoV-2 pneumonia based on laboratory findings. Scientific Reports, 10(1), 1-9.
Yip, T. C. F., Lui, G. C. Y., Wong, V. W. S., Chow, V. C. Y., Ho, T. H. Y., Li, T. C. M., ... & Wong, G. L. H. (2021). Liver injury is independently associated with adverse clinical outcomes in patients with COVID-19. Gut, 70(4), 733-742.
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2023-12-08
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Ribeiro, E. A., Bellaver, E. H., & Zancanaro, V. (2023). DRUG IMPLICATIONS AT THE HEPATIC LEVEL IN PATIENTS SUBMITTED TO COVID-19 TREATMENT. Revista Univap, 29(64). https://doi.org/10.18066/revistaunivap.v29i64.4473
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Copyright (c) 2023 Revista Univap
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International.
This license allows others to distribute, remix, tweak, and build upon your work, even commercially, as long as they credit you for the original creation.
http://creativecommons.org/licenses/by/4.0/legalcode
DOI:
https://doi.org/10.18066/revistaunivap.v29i64.4473Abstract
The COVID-19 virus has brought to light a new illness that has raised several questions worldwide, one of which is related to the prophylaxis of the disease, i.e., which drugs can be used to treat the infected patient and what long-term side effects the patient may develop. The aim of the article is to analyze possible hepatic changes in patients undergoing COVID-19 prophylaxis in the ICU, identify the correlation with pharmacological choice, and evaluate long-term side effects. The research was conducted by analyzing electronic medical records of 101 patients undergoing COVID-19 prophylaxis in the ICU in 2020 and 2021. The main observed hepatic changes were in GGT and AST, with the most used medication in the COVID-19 cocktail being azithromycin, associated or not with hydroxychloroquine, ivermectin, or both. The research has some limitations, as it was conducted in only one hospital unit, and therefore, the results cannot be generalized to other regions. However, the significant findings highlight the importance of evaluating the long-term side effects of medications used in COVID-19 prophylaxis, especially in relation to the liver, and considering the correlation with pharmacological choice. This can help improve therapy and prevent serious complications in patients with COVID-19
Downloads
References
Alfano, G., Ferrari, A., Fontana, F., Mori, G., Ligabue, G., Giovanella, S., ... & Modena Covid-19 Working Group. (2021). Twenty-four-hour serum creatinine variation is associated with poor outcome in the novel coronavirus disease 2019 (COVID-19) patients. Kidney Research and Clinical Practice, 40(2), 231.
Ashraf, S., Farooq, I., Ashraf, M., Imran, M. A., ...& Izhar, M. (2021). Anti-COVID property of subcutaneous ivermectin in synergy with zinc among midlife moderately symptomatic patients: a structured summary of a study protocol for a randomised controlled trial. Trials, 22, 1-3.
Axfors, C., Schmitt, A. M., Janiaud, P., van’tHooft, J., Abd-Elsalam, S., Abdo, E. F., ...& Hemkens, L. G. (2021). Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nature communications, 12(1), 2349.
Baracaldo-Santamaría, D., Pabón-Londoño, S., & Rojas-Rodriguez, L. C. (2022). Drug safety of frequently used drugs and substances for self-medication in COVID-19. Therapeutic Advances in Drug Safety, 13, 20420986221094141.
Battaglini, D., Lopes-Pacheco, M., Castro-Faria-Neto, H. C., Pelosi, P., & Rocco, P. R. (2022). Laboratory biomarkers for diagnosis and prognosis in COVID-19. Frontiers in immunology, 13.
Bogliolo Filho, G. B. (2021). Patologia. Grupo GEN.
Brasil. (2013). Protocolo de Segurança na Prescrição, Uso e Administração de Medicamentos (Anexo 3). Fundação Oswaldo Cruz. Agência Nacional de Vigilância Sanitária. Ministério da Saúde.
Brasil. (2021). Nota Técnica Ivermectina. Lex Centro Colaborador do SUS: Avaliação de Tecnologias e Excelência em Saúde - CCATES.
Chi, G., Memar Montazerin, S., Lee, J. J., Kazmi, S. H. A., Shojaei, F., Fitzgerald, C., & Gibson, C. M. (2021). Effect of azithromycin and hydroxychloroquine in patients hospitalized with COVID‐19: Network meta‐analysis of randomized controlled trials. Journal of medical virology, 93(12), 6737-6749.
Ciotti, Marco et al. (2020). The COVID-19 pandemic. Critical reviews in clinical laboratory sciences, 57(6), 365-388.
Cofen. (2020). Paracer normativo nº 002/2020 COFEN. Brasília. Disponível
Debes, J. D., Anugwom, C. M., & Aby, E. S. (2020). Systematic analysis of acute liver injury during SARS-CoV-2 infection. DigestiveandLiverDisease, 52(9), 953-955.
Domingos, C. S., Bonisson, M. B., Ayres, L. F. A., & de Paula, P. M. (2020). Aplicação Da Escala De Fugulin Em Um Setor De Emergência. Revista Remecs-Revista Multidisciplinar de Estudos Científicos em Saúde, 218-218.
Echeverría-Esnal, D., Martin-Ontiyuelo, C., Navarrete-Rouco, M. E., De-Antonio Cuscó, M., Ferrández, O., Horcajada, J. P., & Grau, S. (2021). Azithromycin in the treatment of COVID-19: a review. Expert review of anti-infective therapy, 19(2), 147-163.
Ferreira-da-Silva, R., Ribeiro-Vaz, I., Morato, M., Silva, A. M., & Polónia, J. J. (2021). O Papel da Farmacovigilância em Contexto da Pandemia por COVID-19. Acta Médica Portuguesa, 34(3), 173-175.
Figueiredo, B. Q., Cancela, B. R., Rodrigues, A. E. L., Falcão, A. L. S., do Prado, D. M. M., da Rocha, D., ... & Segundo, S. (2022). Análise das possíveis intoxicações decorrentes do uso indiscriminado da ivermectina e hidroxicloroquina durante a pandemia de COVID-19. Research, Society and Development, 11(3), e14511326441-e14511326441.
Fischbach, F. T., & Fischbach, M. Barnett D. (2015). Exames Laboratoriais e Diagnósticos em Enfermagem. Grupo GEN.
Hernandez, A. V., Roman, Y. M., Pasupuleti, V., Barboza, J. J., & White, C. M. (2020). Hydroxychloroquine or chloroquine for treatment or prophylaxis of COVID-19: a living systematic review. Annals of internal medicine, 173(4), 287-296.
Hong, W., Park, Y. K., Kim, B. O., Park, S. K., Shin, J., Jang, S. P., ... & Hwang, T. H. (2022). Use of combined treatment of 3rd-generation cephalosporin, azithromycin and antiviral agents on moderate SARs-CoV-2 patients in South Korea: A retrospective cohort study. Plosone, 17(5), e0267645.
Khamis, F., Al-Zakwani, I., Al Naamani, H., Al Lawati, S., Pandak, N., Omar, M. B., ...& Al Awaidy, S. T. (2020). Clinical characteristics and outcomes of the first 63 adult patients hospitalized with COVID-19: an experience from Oman. Journal of Infection and Public Health, 13(7), 906-913.
Lorenzoni, G., Rosi, P., De Rosa S., Ranieri, V. M., Navalesi, P. & Gregori, D. (2022). Status de vacinação COVID-19 entre adultos internados em unidades de terapia intensiva em Veneto, Itália. Jama Netw, 5(5).
Machado, M. L.L., Souza, A. T. B., Linhares, P. V. A., Ferreira, C. F. M., Silva, D. F. O., Martins, R. R., & Cobucci, R. N. (2021). Effectiveness and safety of ivermectin in the treatment of COVID-19: protocol for a systematic review and meta-analysis. BMJ open, 11(9), e050532.
Martins-Filho, P. R., Ferreira, L. C., Heimfarth, L., de Souza Araújo, A. A., &Quintans-Júnior, L. J. (2021). Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials. The Lancet Regional Health-Americas, 2, 100062.
Melo Filho, A. L. A., Feniman, G. M. M., Trentim, R. J., Bruno, D. D., & de Almeida, B. H. C. (2023). A Hidroxicloroquina no tratamento de COVID-19, uma revisão sistemática de estudos controlados randomizados. Brasília Med, 59, 1-7.
Montastruc, F., Thuriot, S., & Durrieu, G. (2020). Hepatic disorders with the use of remdesivir for coronavirus 2019. Clinical Gastroenterology and Hepatology, 18(12), 2835-2836.
Morell-Garcia, D., Ramos-Chavarino, D., Bauça, J. M., Argente del Castillo, P., Ballesteros-Vizoso, M. A., Garcia de Guadiana-Romualdo, L., ... & García-Raja, A. (2021). Urine biomarkers for the prediction of mortality in COVID-19 hospitalized patients. Scientificreports, 11(1), 1-13.
Nicol, D. (2019). Manual de Exames Diagnósticos. Grupo A.
Nunes, L. L. A., & Lima, T. D. M. (2020). Use of medicines for covid-19 treatment in patients with loss of kidney function: a narrative review. Brazilian Journal of Nephrology, 43, 254-262.
Organização Pan-Americana da Saúde (2021). Folha informativa sobre COVID-19.
Pani, A., Lauriola, M., Romandini, A., & Scaglione, F. (2020). Macrolides and viral infections: focus on azithromycin in COVID-19 pathology. International journal of antimicrobial agents, 56(2), 106053.
Person, O. C., Simonian, A. A., Puga, M. E. D. S., & Atallah, Á. N. (2022). Efetividade das intervenções para COVID-19 à luz das revisões sistemáticas Cochrane. Revista Diagn. Tratamento, 27(2): 61-71.
Pias, C., de Paula Mascolo, N., Rabelo-Silva, E. R., da Costa Linch, G. F., & de Souza, E. N. (2015). Complexidade da assistência em unidade de terapia intensiva: subsídios para dimensionamento de pessoal de enfermagem. Cogitare enfermagem, 20(3), 533-539.
Pontes, L., Danski, M. T. R., Piubello, S. M. N., Pereira, J. D. F. G., Jantsch, L. B., Costa, L. B., & Arrué, A. M. (2021). Perfil clínico e fatores associados ao óbito de pacientes COVID-19 nos primeiros meses da pandemia. Escola Anna Nery, 26.
Popp, M., Stegemann, M., Metzendorf, M. I., Gould, S., Kranke, P., Meybohm, P., & Weibel, S. (2021). Ivermectin for preventing and treating COVID‐19. Cochrane Database of Systematic Reviews, (7).
Shen, Q., Li, J., Zhang, Z., Guo, S., Wang, Q., An, X., & Chang, H. (2022). COVID-19: systemic pathology and its implications for therapy. International Journal of Biological Sciences, 18(1), 386.
Soares, V. S. P., & Xavier, S. M. (2011). Perfil de complexidade dos clientes hospitalizados na unidade de tratamento de doenças infecciosas, segundo a Escala de Fugulin. Rev Qualidade HC, 2.
Souza, L. L., Sá, A. M., & Gimenez, F. V. M. (2023). O uso da Azitromicina no tratamento da COVID-19: Uma Revisão De Literatura. Revista Foco, 16(02), e931-e931.
Sultana, A., Sharma, R., Hossain, M. M., Bhattacharya, S. & Purohit, N. (2020). Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions. Indian J Med Ethics 5(4), 308-11.
Wen, M., Lu, J., & Xie, Y. (2020). Clinical characteristics of coronavirus disease 2019 patients complicated with liver injury. Zhongnan da xuexuebao. Yi xue ban= Journal of Central South University. Medical Sciences, 45(5), 555-559.
Wendel-Garcia, P. D., Erlebach, R., Hofmaenner, D. A., Camen, G., Schuepbach, R. A., Jüngst, C., ... & David, S. (2022). Long-term ketamine infusion-induced cholestatic liver injury in COVID-19-associated acute respiratory distress syndrome. Critical Care, 26(1), 1-12.
Wu, G., Zhou, S., Wang, Y., Lv, W., Wang, S., Wang, T., & Li, X. (2020). A prediction model of outcome of SARS-CoV-2 pneumonia based on laboratory findings. Scientific Reports, 10(1), 1-9.
Yip, T. C. F., Lui, G. C. Y., Wong, V. W. S., Chow, V. C. Y., Ho, T. H. Y., Li, T. C. M., ... & Wong, G. L. H. (2021). Liver injury is independently associated with adverse clinical outcomes in patients with COVID-19. Gut, 70(4), 733-742.
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Copyright (c) 2023 Revista Univap
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International.
This license allows others to distribute, remix, tweak, and build upon your work, even commercially, as long as they credit you for the original creation.
http://creativecommons.org/licenses/by/4.0/legalcode
