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

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 dise...

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Autores principales: Cryer, Michael Joseph, Farhan, Serdar, Kaufmann, Christoph C., Jäger, Bernhard, Garg, Aakash, Krishnan, Prakash, Mehran, Roxana, Huber, Kurt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793375/
https://www.ncbi.nlm.nih.gov/pubmed/35068227
http://dx.doi.org/10.1177/10760296221074353
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author Cryer, Michael Joseph
Farhan, Serdar
Kaufmann, Christoph C.
Jäger, Bernhard
Garg, Aakash
Krishnan, Prakash
Mehran, Roxana
Huber, Kurt
author_facet Cryer, Michael Joseph
Farhan, Serdar
Kaufmann, Christoph C.
Jäger, Bernhard
Garg, Aakash
Krishnan, Prakash
Mehran, Roxana
Huber, Kurt
author_sort Cryer, Michael Joseph
collection PubMed
description 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.
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spelling pubmed-87933752022-01-28 Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review Cryer, Michael Joseph Farhan, Serdar Kaufmann, Christoph C. Jäger, Bernhard Garg, Aakash Krishnan, Prakash Mehran, Roxana Huber, Kurt Clin Appl Thromb Hemost Review 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. SAGE Publications 2022-01-24 /pmc/articles/PMC8793375/ /pubmed/35068227 http://dx.doi.org/10.1177/10760296221074353 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Cryer, Michael Joseph
Farhan, Serdar
Kaufmann, Christoph C.
Jäger, Bernhard
Garg, Aakash
Krishnan, Prakash
Mehran, Roxana
Huber, Kurt
Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review
title Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review
title_full Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review
title_fullStr Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review
title_full_unstemmed Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review
title_short Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation in Hospitalized COVID-19 Positive Patients: A Review
title_sort prothrombotic milieu, thrombotic events and prophylactic anticoagulation in hospitalized covid-19 positive patients: a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793375/
https://www.ncbi.nlm.nih.gov/pubmed/35068227
http://dx.doi.org/10.1177/10760296221074353
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