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Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review

Authors :
Michael Joseph Cryer MD
Serdar Farhan MD
Christoph C. Kaufmann MD
Bernhard Jäger MD
Aakash Garg MD
Prakash Krishnan MD
Roxana Mehran MD
Kurt Huber MD
Source :
Clinical and Applied Thrombosis/Hemostasis, Vol 28 (2022)
Publication Year :
2022
Publisher :
SAGE Publishing, 2022.

Abstract

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.

Details

Language :
English
ISSN :
19382723 and 10760296
Volume :
28
Database :
Directory of Open Access Journals
Journal :
Clinical and Applied Thrombosis/Hemostasis
Publication Type :
Academic Journal
Accession number :
edsdoj.261091dbbac4aad9e3d348b1afe9586
Document Type :
article
Full Text :
https://doi.org/10.1177/10760296221074353