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Thromboprophylaxis strategies to improve the prognosis of COVID-19

Laurent Bertoletti1, Behnood Bikdeli2, Stéphane Zuily3

  • 1Service de Médecine Vasculaire et Thérapeutique, CHU de St-Etienne, Saint-Etienne, France; INSERM, UMR1059, Equipe Dysfonction Vasculaire et Hémostase, Université Jean-Monnet, F-42055 Saint-Etienne, France; INSERM, CIC-1408, CHU Saint-Etienne, F-42055 Saint-Etienne, France; F-CRIN INNOVTE network, Saint-Etienne, France.

Vascular Pharmacology
|June 6, 2021
PubMed

Insights

This review examines the use of anticoagulant drugs for COVID-19 patients. It discusses modified thromboprophylaxis regimens and their potential to combat COVID-19-related thromboinflammation.

Area of Science:

  • Internal Medicine
  • Hematology
  • Infectious Diseases

Background:

  • The COVID-19 pandemic highlighted significant challenges in medical knowledge, particularly concerning coagulation activation and high rates of venous thromboembolism (VTE) in hospitalized patients.
  • Elevated VTE rates in severe COVID-19 patients, even with standard thromboprophylaxis, prompted investigations into modified treatment strategies.

Purpose of the Study:

  • To review the evidence supporting the use of anticoagulant drugs in COVID-19 patients.
  • To explore modified thromboprophylaxis regimens for various patient groups (medically ill, ICU, outpatients).
  • To discuss the role of anticoagulants in addressing COVID-19-associated thromboinflammation.

Main Methods:

  • Comprehensive literature review of studies on COVID-19 and thromboembolism.
  • Analysis of data from randomized controlled trials evaluating new thromboprophylaxis regimens.
  • Discussion of the pathophysiological mechanisms linking COVID-19 and thrombosis.

Main Results:

  • Preliminary results from ongoing trials suggest potential benefits of modified thromboprophylaxis.
  • Anticoagulant drugs show promise in managing pulmonary endothelial dysfunction and thrombosis in COVID-19.
  • Understanding of COVID-19's impact on coagulation has evolved, guiding therapeutic adjustments.

Conclusions:

  • Modified thromboprophylaxis regimens are being investigated for COVID-19 patients.
  • Anticoagulant therapy may be crucial in mitigating thromboinflammation and improving outcomes in severe COVID-19.
  • Further research and clinical trials are essential to establish optimal anticoagulant strategies.

Keywords:
AnticoagulantCOVID-19CoagulationDeep venous thrombosisPulmonary embolismThromboprophylaxis

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