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Anticoagulation in COVID-19: A Systematic Review, Meta-analysis, and Rapid Guidance From Mayo Clinic

Robert D McBane1, Victor D Torres Roldan2, Alexander S Niven3

  • 1Gonda Vascular Center, Mayo Clinic, Rochester, MN; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.

Mayo Clinic Proceedings
|November 6, 2020
PubMed

Insights

Coronavirus disease 2019 (COVID-19) patients face a high risk of thrombosis, especially with severe illness. This review synthesizes data on COVID-19 thrombosis, its prognosis, and anticoagulation, offering expert guidance.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Hematology

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with an increased risk of thrombotic events.
  • Understanding the coagulopathy and thrombosis in COVID-19 is crucial for patient management.

Purpose of the Study:

  • To systematically review and synthesize current data on thrombosis risk in COVID-19.
  • To analyze the prognostic implications of thrombosis in COVID-19 patients.
  • To evaluate the effects of anticoagulation therapies in COVID-19.

Main Methods:

  • Systematic review of 37 studies, including 4070 unique citations.
  • Meta-analysis was conducted where feasible.
  • Guidance developed by a multidisciplinary specialist panel.

Main Results:

  • Coagulopathy and thrombotic events are frequent in COVID-19 patients.
  • Thrombosis risk and severity are higher in more severe forms of COVID-19.
  • Evidence certainty is generally low and evolving.

Conclusions:

  • COVID-19 is linked to significant coagulopathy and thrombosis, particularly in severe cases.
  • Further research is needed to clarify thrombosis risk and optimal anticoagulation strategies.
  • Clinical guidance for thrombosis prevention and management in COVID-19 is provided.

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