TY - JOUR
T1 - Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients
T2 - A Review
AU - Cryer, Michael Joseph
AU - Farhan, Serdar
AU - Kaufmann, Christoph C.
AU - Jäger, Bernhard
AU - Garg, Aakash
AU - Krishnan, Prakash
AU - Mehran, Roxana
AU - Huber, Kurt
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2022/1
Y1 - 2022/1
N2 - The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality worldwide. Although initial reports concentrated on severe respiratory illness, emerging literature has indicated a substantially elevated risk of thromboembolic events in patients with COVID-19 disease. Pro-inflammatory cytokine release has been linked to endothelial dysfunction and activation of coagulation pathways, as evident by elevated D-dimer levels and deranged coagulation parameters. Both macrovascular and microvascular thromboses have been described in observational cohort and post-mortem studies. Concurrently, preliminary data have suggested the role of therapeutic anticoagulation in preventing major thromboembolic complications in moderately but not critically ill patients. However, pending results from randomized controlled trials, clear guidance is lacking regarding the intensity and duration of anticoagulation in such patients. Herein, we review the existing evidence on incidence and pathophysiology of COVID-19 related thromboembolic complications and guide anticoagulation therapy based on current literature and societal consensus statements.
AB - The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality worldwide. Although initial reports concentrated on severe respiratory illness, emerging literature has indicated a substantially elevated risk of thromboembolic events in patients with COVID-19 disease. Pro-inflammatory cytokine release has been linked to endothelial dysfunction and activation of coagulation pathways, as evident by elevated D-dimer levels and deranged coagulation parameters. Both macrovascular and microvascular thromboses have been described in observational cohort and post-mortem studies. Concurrently, preliminary data have suggested the role of therapeutic anticoagulation in preventing major thromboembolic complications in moderately but not critically ill patients. However, pending results from randomized controlled trials, clear guidance is lacking regarding the intensity and duration of anticoagulation in such patients. Herein, we review the existing evidence on incidence and pathophysiology of COVID-19 related thromboembolic complications and guide anticoagulation therapy based on current literature and societal consensus statements.
KW - COVID-19
KW - SARS-CoV2
KW - antithrombotic therapy
KW - prophylactic anticoagulation
KW - thromboembolism
KW - thrombosis
UR - http://www.scopus.com/inward/record.url?scp=85123703874&partnerID=8YFLogxK
U2 - 10.1177/10760296221074353
DO - 10.1177/10760296221074353
M3 - Review article
C2 - 35068227
AN - SCOPUS:85123703874
SN - 1076-0296
VL - 28
JO - Clinical and Applied Thrombosis/Hemostasis
JF - Clinical and Applied Thrombosis/Hemostasis
ER -