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[COVID-19 and venous thromboembolism]

A Trimaille1, G Bonnet2

  • 1Pôle d'activité médicochirurgicale cardiovasculaire, nouvel hôpital civil, centre hospitalier régional universitaire de Strasbourg, 67000 Strasbourg, France.

Annales De Cardiologie Et D'Angeiologie
|October 21, 2020
PubMed

Insights

COVID-19 significantly increases venous thromboembolism (VTE) risk due to endothelial dysfunction and inflammation. Accurate VTE risk stratification is crucial for guiding anticoagulation therapy in patients with COVID-19.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Cardiology

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to a higher occurrence of venous thromboembolism (VTE).
  • VTE often presents asymptomatically, negatively impacting patient outcomes.
  • Traditional risk factors (e.g., immobility, hypoxemia) and severe COVID-19 features (e.g., obesity, advanced age) contribute to VTE incidence.

Purpose of the Study:

  • To investigate the mechanisms underlying the increased VTE risk in COVID-19 patients.
  • To highlight the importance of VTE risk stratification for appropriate anticoagulation.
  • To discuss the current state of VTE management guidelines in COVID-19.

Main Methods:

  • Review of existing literature and observational data on VTE in COVID-19.
  • Analysis of pathophysiological mechanisms including endotheliitis and prothrombotic states.
  • Discussion of clinical features associated with severe COVID-19 and VTE.

Main Results:

  • COVID-19 induces endothelial disease via endotheliitis and a prothrombotic state from inflammation.
  • These factors contribute to widespread immunothrombosis in pulmonary vasculature.
  • Current VTE risk stratification relies mainly on observational data.

Conclusions:

  • Understanding COVID-19's impact on thrombosis is essential for patient care.
  • Risk stratification is critical for determining adequate anticoagulation.
  • Ongoing randomized controlled trials aim to refine anticoagulant regimens for hospitalized COVID-19 patients.

Keywords:
COVID-19Deep vein thrombosisEmbolie pulmonairePathologie thromboembolique veineusePulmonary embolismSARS-CoV-2ThromboseThrombose veineuse profondeThrombosisVenous thromboembolism

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