Antithrombotic therapy in patients with COVID-19? -Rationale and Evidence.

Abstract

In patients with severe or critical Coronavirus disease 2019 (COVID-19) manifestations, a thromboinflammatory syndrome, with diffuse microvascular thrombosis, is increasingly evident as the final step of pro-inflammatory cytokines storm. Actually, no proven effective therapies for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exist. Preliminary observations on anticoagulant therapy appear to be associated with better outcomes in moderate and severe COVID-19 patients with signs of coagulopathy and in those requiring mechanical ventilation. The pathophysiology underlying the prothrombotic state elicited by SARS-CoV-2 outlines possible protective mechanisms of antithrombotic therapy (in primis anticoagulants) for this viral illness. The indications for antiplatelet/anticoagulant use (prevention, prophylaxis, therapy) are guided by the clinical context and the COVID-19 severity. We provide a practical approach on antithrombotic therapy management for COVID-19 patients from a multidisciplinary point of view.

• Authors: Cosmo Godino, Andrea Scotti, Norma Maugeri, Nicasio Mancini, Evgeny Fominskiy, Alberto Margonato, Giovanni Landoni
• Journal: International journal of cardiology (Int J Cardiol) Vol. 324 Pg. 261-266 (02 01 2021) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 33002521 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2020 Elsevier B.V. All rights reserved.

Chemical References

• Anticoagulants
• Fibrinolytic Agents

Topics

• Anticoagulants (therapeutic use)
• COVID-19 (blood, physiopathology)
• Evidence-Based Medicine (trends)
• Fibrinolytic Agents (therapeutic use)
• Humans
• Thrombosis (blood, drug therapy, physiopathology)
• COVID-19 Drug Treatment