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

Clinical and Applied Thrombosis/Hemostasis

卷:28

Review

Michael Joseph Cryer²  Bernhard Jäger⁴  Kurt Huber⁴ 

[1] The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA

[2] , Vienna, Austria

[3] Tucson Medical Center/Tucson Hospitals Medical Education Program, Tucson, Arizona, USA

[4] Sigmund Freud University, Medical School, Vienna, Austria

关键词: SARS-CoV2;    COVID-19;    thrombosis;    thromboembolism;    prophylactic anticoagulation;    antithrombotic therapy;   

DOI  :  10.1177/10760296221074353

 received in 2021-11-08, accepted in 2022-01-03,  发布年份 2022

来源: Sage Journals

【 摘 要 】

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.

【 授权许可】

CC BY-NC   
© The Author(s) 2022

【 图 表 】

Fig. 1