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Ann Med . COVID-19 and Venous Thromboembolism: Current Insights and Prophylactic Strategies

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  • Ann Med . COVID-19 and Venous Thromboembolism: Current Insights and Prophylactic Strategies


    Ann Med


    . 2020 Jul 3;1-13.
    doi: 10.1080/07853890.2020.1791355. Online ahead of print.
    COVID-19 and Venous Thromboembolism: Current Insights and Prophylactic Strategies


    Pasquale Ambrosino 1 , Alessandro Di Minno 2 , Mauro Maniscalco 1 , Matteo Nicola Dario Di Minno 3



    Affiliations

    Abstract

    The rapidly increasing number of studies on the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) indicate that this viral agent can cause the coronavirus disease 2019 (COVID-19), a syndrome with a wide spectrum of clinical presentations, ranging from a mild disease with flu-like symptoms to a life-threatening condition that requires specialized management at Intensive Care Units (ICU). Critical patients with COVID-19 have a high risk of thromboembolic complications, as expressed by a Padua prediction score always ≥4. Moreover, a number of clinical factors may increase the risk of major bleedings in these patients during ICU stay. Overall, literature data suggest that SARS-CoV-2 infection can rapidly develop into a severe condition with renal, pulmonary and hepatic complications, potentially increasing both thrombotic and haemorrhagic risk. Failure of prevention and interventional strategies for the haemostatic imbalance of severe COVID-19 patients may dramatically impact their prognosis. The role of thromboprophylaxis in this clinical setting is discussed. Key messagesSevere patients with the coronavirus disease 2019 (COVID-19) have a high risk of thromboembolic complications, as expressed by a Padua prediction score always ≥4.A number of clinical factors may also increase the risk of major bleedings in this clinical setting.A patient-tailored strategy with a case-by-case approach is needed when prescribing prophylactic anticoagulation to severe COVID-19 patients.

    Keywords: COVID-19; SARS-CoV-2; anticoagulants; disability; haemostasis; internal medicine; outcome; pulmonary rehabilitation; thrombosis.

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