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Thrombosis, an important piece in the COVID-19 puzzle: From pathophysiology to therapy

Elena Bobescu1, Luigi Geo Marceanu2, Alexandru Covaciu1

  • 1Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov; Brasov- Romania;Department of Cardiology, Clinical County Emergency Hospital Brasov; Brasov-Romania.

Anatolian Journal of Cardiology
|September 9, 2021
PubMed

Insights

Coronavirus disease 2019 (COVID-19) significantly increases thrombosis risk. Heparin is recommended for treatment, showing benefits beyond anticoagulation, alongside improved patient prognosis with existing anticoagulant therapy.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Cardiovascular Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) presents complex challenges in patient care.
  • A significant aspect of COVID-19 is its high thrombogenic potential, leading to thrombotic complications.

Purpose of the Study:

  • To review existing literature on COVID-19 associated thrombosis.
  • To explore the pathophysiology, treatment strategies, and impact on patient outcomes.

Main Methods:

  • Systematic search of online databases including MEDLINE/PubMed, Google Scholar, ScienceDirect, Wiley Online Library, and Nature Public Health Emergency Collection.
  • Selection of studies specifically focusing on COVID-19 and thrombosis.

Main Results:

  • Elevated D-dimer levels in COVID-19 patients correlate with infection severity and mortality, serving as a predictive factor for thrombosis.
  • Patients on chronic anticoagulant therapy prior to COVID-19 infection generally experienced better prognoses.
  • Heparin demonstrated anticoagulant, antiviral, and anti-inflammatory effects, positioning it as a recommended treatment.

Conclusions:

  • COVID-19 infections are frequently complicated by thrombotic pathology.
  • High D-dimer levels predict a severe prognosis; heparin is the recommended anticoagulant, followed by direct oral anticoagulants, associated with reduced mortality.
  • Further large-scale randomized studies and therapeutic guidelines are necessary for managing COVID-19 associated thrombosis.

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