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Thromboembolic Complications in Covid-19: From Clinical Scenario to Laboratory Evidence

Alberto Palazzuoli1, Michela Giustozzi2, Gaetano Ruocco1

  • 1Cardiovascular Diseases Unit, Department of Medical Sciences, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy.

Life (Basel, Switzerland)
|April 30, 2021
PubMed

Insights

COVID-19 infection significantly increases cardiovascular risks, particularly thromboembolic events. Understanding the vascular endothelium

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Hematology

Background:

  • SARS-CoV-2 infection, a pandemic since March 2020, is linked to significant cardiovascular complications, primarily thromboembolic events.
  • Many thromboembolic complications occur in patients with seemingly moderate risk, highlighting gaps in current risk assessment.
  • The vascular endothelium plays a critical role in recruiting inflammatory and thrombotic pathways, contributing to disseminated intravascular coagulation and cardiovascular issues in COVID-19.

Purpose of the Study:

  • To elucidate the pathophysiological mechanisms linking SARS-CoV-2 infection to heightened thromboembolic risk.
  • To review histological lesions and blood coagulation mechanisms implicated in COVID-19.
  • To propose risk stratification and prophylactic anticoagulation strategies for COVID-19 patients.

Main Methods:

  • Review of histological findings in COVID-19 related to coagulation.
  • Analysis of blood coagulation mechanisms in SARS-CoV-2 infection.
  • Identification of laboratory parameters and clinical risk factors for thromboembolic events.
  • Proposal of risk-based prophylactic anticoagulation strategies.

Main Results:

  • COVID-19 involves specific histological lesions and altered blood coagulation mechanisms.
  • Key laboratory and clinical risk factors for thromboembolic events in COVID-19 patients are identified.
  • A risk stratification approach for prophylactic anticoagulation is proposed based on risk categories.

Conclusions:

  • A deeper understanding of the infection-thrombosis link is crucial for effective treatment.
  • Accurate risk assessment is essential for precise risk stratification and appropriate prophylactic anticoagulation.
  • Prospective, multi-center data are needed to refine risk assessment and treatment strategies for COVID-19-associated thromboembolic events.

Keywords:
COVID-19 infectionantithrombotic therapycoagulationthrombosis

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