tetano
Editor, Senior Moderator
Int J Cardiol
. 2020 Sep 28;S0167-5273(20)33894-8.
doi: 10.1016/j.ijcard.2020.09.064. Online ahead of print.
Antithrombotic therapy in patients with COVID-19? -Rationale and Evidence
Cosmo Godino[SUP] 1 [/SUP], Andrea Scotti[SUP] 2 [/SUP], Norma Maugeri[SUP] 3 [/SUP], Nicasio Mancini[SUP] 4 [/SUP], Evgeny Fominskiy[SUP] 5 [/SUP], Alberto Margonato[SUP] 6 [/SUP], Giovanni Landoni[SUP] 7 [/SUP]
Affiliations
Abstract
In patients with severe or critical Coronavirus disease 2019 (COVID-19) manifestations, a thromboinflammatory syndrome, with diffuse microvascular thrombosis, is increasingly evident as the final step of pro-inflammatory cytokines storm. Actually, no proven effective therapies for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exist. Preliminary observations on anticoagulant therapy appear to be associated with better outcomes in moderate and severe COVID-19 patients with signs of coagulopathy and in those requiring mechanical ventilation. The pathophysiology underlying the prothrombotic state elicited by SARS-CoV-2 outlines possible protective mechanisms of antithrombotic therapy (in primis anticoagulants) for this viral illness. The indications for antiplatelet/anticoagulant use (prevention, prophylaxis, therapy) are guided by the clinical context and the COVID-19 severity. We provide a practical approach on antithrombotic therapy management for COVID-19 patients from a multidisciplinary point of view.
Keywords: Anticoagulants; Antiplatelet; Antithrombotic therapy; COVID-19; Coronavirus; Thromboinflammatory syndrome.
. 2020 Sep 28;S0167-5273(20)33894-8.
doi: 10.1016/j.ijcard.2020.09.064. Online ahead of print.
Antithrombotic therapy in patients with COVID-19? -Rationale and Evidence
Cosmo Godino[SUP] 1 [/SUP], Andrea Scotti[SUP] 2 [/SUP], Norma Maugeri[SUP] 3 [/SUP], Nicasio Mancini[SUP] 4 [/SUP], Evgeny Fominskiy[SUP] 5 [/SUP], Alberto Margonato[SUP] 6 [/SUP], Giovanni Landoni[SUP] 7 [/SUP]
Affiliations
- PMID: 33002521
- DOI: 10.1016/j.ijcard.2020.09.064
Abstract
In patients with severe or critical Coronavirus disease 2019 (COVID-19) manifestations, a thromboinflammatory syndrome, with diffuse microvascular thrombosis, is increasingly evident as the final step of pro-inflammatory cytokines storm. Actually, no proven effective therapies for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exist. Preliminary observations on anticoagulant therapy appear to be associated with better outcomes in moderate and severe COVID-19 patients with signs of coagulopathy and in those requiring mechanical ventilation. The pathophysiology underlying the prothrombotic state elicited by SARS-CoV-2 outlines possible protective mechanisms of antithrombotic therapy (in primis anticoagulants) for this viral illness. The indications for antiplatelet/anticoagulant use (prevention, prophylaxis, therapy) are guided by the clinical context and the COVID-19 severity. We provide a practical approach on antithrombotic therapy management for COVID-19 patients from a multidisciplinary point of view.
Keywords: Anticoagulants; Antiplatelet; Antithrombotic therapy; COVID-19; Coronavirus; Thromboinflammatory syndrome.