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Thrombosis risk associated with COVID-19 infection. A scoping review

Fatimah Al-Ani1, Samer Chehade1, Alejandro Lazo-Langner2

  • 1Department of Medicine, Division of Hematology, Western University, London, ON, Canada.

Thrombosis Research
|June 3, 2020
PubMed

Insights

COVID-19 infection poses a high risk for thrombosis, with venous thromboembolism and stroke occurring in a significant percentage of patients. Optimal anticoagulation strategies and risk stratification remain undefined.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Hematology

Background:

  • The 2019 novel coronavirus (COVID-19) is associated with an increased risk of thrombotic complications.
  • Current information regarding COVID-19-related coagulopathy and thrombosis is limited and rapidly evolving.

Purpose of the Study:

  • To conduct a scoping review of studies assessing thrombosis and coagulopathy in COVID-19 patients.
  • To identify key areas for future research in managing thrombotic risks associated with COVID-19.

Main Methods:

  • A comprehensive scoping review was performed using a single-engine search.
  • Additional relevant studies were identified through secondary review and alert services.

Main Results:

  • Venous thromboembolism (VTE) and stroke occurred in approximately 20% and 3% of COVID-19 patients, respectively.
  • Severely ill patients, particularly those in intensive care units, exhibit a higher frequency of thrombotic events.
  • Elevated thrombotic risk persists despite anticoagulant prophylaxis, with optimal anticoagulation doses yet to be determined. Increased D-dimer levels are consistently reported in severe cases, but their prognostic value and optimal cut-off remain unknown.

Conclusions:

  • Urgent research is needed to define the true incidence of VTE in COVID-19 patients.
  • Developing algorithms for identifying susceptible patients, determining the role of biomarkers for risk stratification, and establishing optimal diagnostic and prophylactic strategies are critical.
  • Standardized diagnostic and reporting criteria for COVID-19-associated thrombosis are necessary.
Abstract

Keywords:
AnticoagulationCOVID-19Venous thromboembolism

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