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COVID-19 Thrombotic Complications and Therapeutic Strategies

Alexander C Fanaroff1, Renato D Lopes2

  • 1Penn Cardiovascular Outcomes, Quality and Evaluative Research Center, University of Pennsylvania; Leonard Davis Institute, University of Pennsylvania; Cardiovascular Medicine Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Annual Review of Medicine
|September 21, 2022
PubMed

Insights

Treatment-dose anticoagulation benefits hospitalized, non-critically ill patients with COVID-19. Critically ill, discharged, or non-hospitalized patients with COVID-19 do not benefit from this treatment.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Hematology

Background:

  • COVID-19 is associated with arterial and venous thrombotic complications.
  • Hospitals initially used empirical anticoagulation strategies for COVID-19 patients.
  • Randomized controlled trials (RCTs) were needed to clarify anticoagulation's role.

Purpose of the Study:

  • To review the epidemiology and pathophysiology of thrombosis in COVID-19.
  • To analyze observational studies on anticoagulation effectiveness.
  • To present RCT findings on treatment-dose anticoagulation for COVID-19 patients.

Main Methods:

  • Review of epidemiological data on COVID-19-associated thrombosis.
  • Analysis of observational comparative effectiveness studies.
  • Synthesis of results from randomized controlled trials (RCTs).

Main Results:

  • Hospitalized, non-critically ill COVID-19 patients benefit from treatment-dose anticoagulation.
  • Critically ill, hospitalized COVID-19 patients do not benefit.
  • Discharged or non-hospitalized COVID-19 patients do not benefit.

Conclusions:

  • Treatment-dose anticoagulation is beneficial for specific COVID-19 patient groups.
  • Risk stratification is crucial for guiding anticoagulation decisions in COVID-19.
  • RCTs have refined anticoagulation protocols for COVID-19 management.

Keywords:
COVID-19anticoagulantsplatelet aggregation inhibitorsthrombosis

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