Home
Issues
Aim & Scope
Open Access
Indexing
Why publish with us
Contact
Editorial Board
Instructions to Authors (PDF)
Manuscript Types
Manuscript Formatting
How to submit
Preprints
Authorship & COI
Principles of Transparency Checklist
Publication Ethics and Publication Malpractice Statement
CrossMark
Data Policies
REVIEW
Ιncidence, pathogenesis and management of thromboembolic complications in severe COVID-19
1
Internist – Intensivist
Department of Emergency Medicine, University Hospital ATTIKON
2
Professor Critical Care Medicine
Department of Critical Care Medicine
University Hospital ATTIKON
Publication date: 2021-08-30
Corresponding author
Maria Panagiota Almyroudi
Emergency Medicine University Hospital ATTIKON 1 Rimini str, 12462 Athens, Greece
Emergency Medicine University Hospital ATTIKON 1 Rimini str, 12462 Athens, Greece
Pneumon 2020;33(4):1-5
KEYWORDS
ABSTRACT
Arterial and venous thromboembolic events are frequent complications of severe COVID 19 with an estimated incidence approximately
30%. High levels of D-dimers and fibrinogen, prothrombin time (PT)
prolongation and mild thrombocytopenia compose the hypercoagulable profile of COVID 19 patients, while positive antiphospholipid
antibodies have also been reported. The hyperinflammatory state
in combination with the endothelial damage by the virus and the
diffuse microvascular thrombosis contribute to the pathogenesis.
Vigilance should be maintained for the early diagnosis of thrombotic
complications. Low molecular weight heparin (LMWH) has been
shown to reduce mortality in high risk patients, while the administration of higher dose of anticoagulants (intermediate, therapeutic)
in order to prevent thromboembolic disease is further investigated.
ABBREVIATIONS
APTT: Activated Partial Thromboplastin Time,
ACE2: Αngiotensin-converting enzyme 2,
DVT: Deep Vein Thrombosis,
DIC: Disseminated Intravascular Coagulation,
IL-6: Interleukin -6,
LMWH: Low molecular weight heparin,
PT: Prothrombin Time,
VTE: Venous Thromboembolism
CONFLICTS OF INTEREST
None.
REFERENCES (28)
1.
Piazza G, Campia U, Hurwitz S, et al. Registry of arterial and venous thromboembolic complications in patients with COVID-19. J Am Coll Cardiol 2020; 76:2060-72. doi: 10.1016/j. jacc.2020.08.070.
2.
Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020; 191:145-7. doi: 10.1016/j.thromres.2020.04.013.
3.
Klok FA, Kruip MJHA, van der Meer NJM, et al. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis. Thromb Res 2020; 191:148-50. doi: 10.1016/j.thromres.2020.04.041.
4.
Helms J, Tacquard C, Severac F, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: A multicenter prospective cohort study. Intensive Care Med 2020; 1-10. doi: 10.1007/s00134-020-06062-x.
5.
Songping Cui, Shuo Chen, Xiunan Li, Shi Liu, Feng Wang. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost 2020; 18:1421-4. doi: 10.1111/jth.14830.
6.
Nahum J, Morichau-Beauchant T, Daviaud F, et al. Venous thrombosis among critically ill patients with coronavirus disease 2019 (COVID-19). JAMA Netw Open 2020; 3:e2010478. doi: 10.1001/jamanetworkopen.2020.10478.
7.
Llitjos J‐F, Leclerc M, Chochois C, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID‐19 patients. J Thromb Haemost 2020; 18:1743-6. doi: 10.1111/ jth.14869.
8.
Belani P, Schefflein J, Kihira S, et al. COVID-19 is an independent risk factor for acute ischemic stroke. AJNR Am J Neuroradiol 2020; 41:1361-4. doi: 10.3174/ajnr.A6650.
9.
Yanan Li, Man Li, Mengdie Wang, et al. Acute cerebrovascular disease following COVID-19: A single center, retrospective, observational study. Stroke Vasc Neurol 2020; 5:279-84. doi: 10.1136/svn-2020-000431. Epub 2020 Jul 2.
10.
Lee SG, Fralick M, Sholzberg M. Coagulopathy associated with COVID-19. CMAJ 2020; 192:E583. doi: 10.1503/cmaj.200685.
11.
Ning Tang, Dengju Li, Xiong Wang, Ziyong Sun. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020; 18:844-7. doi: 10.1111/jth.14768.
12.
Jecko Thachil, Ning Tang, Satoshi Gando, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost 2020; 18:1023-6. doi: 10.1111/ jth.14810.
13.
Yan Zhang, Wei Cao, Wei Jiang, et al. Profile of natural anticoagulant, coagulant factor and anti-phospholipid antibody in critically ill COVID-19 patients. J Thromb Thrombolysis 2020; 50:580-6. doi: 10.1007/s11239-020-02182-9.
14.
Dimopoulos G, Sakelliou A, Flevari A, Tzannis K, GiamarellosBourboulis EJ. Ferritin levels in critically ill patients. A marker of ourtome? Pneumon 2020; 33:XXX-XX.
15.
Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID-19. J Thromb Haemost 2020; 18:1559-61. doi: 10.1111/jth.14849.
16.
Ranucci M, Ballotta A, Di Dedda U. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. J Thromb Haemost 2020; 18:1747-51. doi: 10.1111/jth.14854.
17.
Almyroudi M-P, Dimopoulos G, Halvatsiotis P. The role of diabetes mellitus and obesity in COVID 19 patients. Pneumon 2020; 33:114-7.
18.
Spence JD, de Freitas GR, Pettigrew LC, et al. Mechanisms of stroke in COVID-19. Cerebrovasc Dis 2020; 1-8. doi: 10.1159/000 509581.
19.
Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and thrombotic or thromboembolic disease: Implications for prevention, antithrombotic therapy, and follow-up: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75:2950-73. doi: 10.1016/j. jacc.2020.04.031.
20.
Shadi Yaghi, Koto Ishida, Jose Torres, et al. SARS2-CoV-2 and stroke in a New York Healthcare System. Stroke 2020; 51:2002- 11. doi: 10.1161/STROKEAHA.120.030335.
21.
Bangalore S, Sharma A, Slotwiner A, et al. ST-Segment elevation in patients with Covid-19 - A Case Series. N Engl J Med 2020; 382:2478-80. doi: 10.1056/NEJMc2009020.
22.
Ning Tang, Huan Bai, Xing Chen, Jiale Gong, Dengju Li, Ziyong Sun. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020; 18:1094-9. doi: 10.1111/ jth.14817.
23.
Lan Shen, Lin Qiu, Dong Liu, et al. The association of low molecular weight heparin use and in-hospital mortality among patients hospitalized with COVID-19. Cardiovasc Drugs Ther 2021. doi: 10.1007/s10557-020-07133-3.
24.
Bikdeli B, Madhavan MV, Gupta A, et al. Pharmacological agents targeting thromboinflammation in COVID-19: Review and implications for future research. Thromb Haemost 2020; 120:1004-24. doi: 10.1055/s-0040-1713152.
25.
Wang J, Hajizadeh N, Moor EE, et al. Tissue plasminogen activator (tPA) treatment for COVID‐19 associated acute respiratory distress syndrome (ARDS): A case series. J Thromb Haemost 2020; 18:1752-5. doi: 10.1111/jth.14828.
26.
Spyropoulos AC, Levy JH, Ageno W, et al. Scientific and Standardization Committee communication: Clinical guidance on the diagnosis, prevention, and treatment of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost 2020;18:1859-65. doi: 10.1111/jth.14929.
27.
Konstantinides S, Chalikias G. Management of pulmonary embolism. The New European Guidelines. Pneumon 2014; 27:294-9.
28.
Moores LK, Tritschler T, Brosnahan S, et al. Prevention, diagnosis, and treatment of VTE in patients with coronavirus disease 2019: CHEST Guideline and Expert Panel Report. Chest 2020; 158:1143-63. doi: 10.1016/j.chest.2020.05.559.
Share
RELATED ARTICLE
| eISSN: | 1791-4914 |
| ISSN: | 1105-848X |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
