COVID and venous thrombosis: systematic review of literature

Mazzaccaro, Daniela; Giannetta, Matteo; Fancoli, Fabiana; Milani, Valentina; Modafferi, Alfredo; Malacrida, Giovanni; Righini, Paolo; Marrocco-Trischitta, Massimiliano M.; Nano, Giovanni

doi:10.23736/s0021-9509.21.12022-1

Cited by 8 publications

(6 citation statements)

References 79 publications

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“…Circulating levels of plasminogen activator-1, which inhibits plasma fibrinolytic activity ( 130 ) and is secreted by several cell types including visceral fat adipocytes and macrophages ( 131 ), are elevated in obesity and associate with detrimental metabolic and prothrombotic effects ( 132 , 133 ). Plasminogen activator-1 is elevated in individuals with severe COVID-19 ( 107 , 134 ), possibly contributing to the increased risk of venous thrombosis seen in people with obesity and COVID-19 ( 135 ). In addition, obesity-induced endothelial dysfunction because of adipose tissue-derived endocrine and paracrine signals such as adipokines and extracellular vesicles carrying bioactive molecules causes endothelial dysfunction ( 136 ), thereby further worsening SARS-CoV-2-induced endothelial damage.…”

Section: Mechanisms By Which Preexisting Metabolic Alterations May In...mentioning

confidence: 99%

Diabetes Mellitus, Energy Metabolism, and COVID-19

Conte,

Cipponeri,

Roden

2023

Endocrine Reviews

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Obesity, diabetes mellitus (mostly type 2), and COVID-19 show mutual interactions because they are not only risk factors for both acute and chronic COVID-19 manifestations, but also because COVID-19 alters energy metabolism. Such metabolic alterations can lead to dysglycemia and long-lasting effects. Thus, the COVID-19 pandemic has the potential for a further rise of the diabetes pandemic. This review outlines how preexisting metabolic alterations spanning from excess visceral adipose tissue to hyperglycemia and overt diabetes may exacerbate COVID-19 severity. We also summarize the different effects of SARS-CoV-2 infection on the key organs and tissues orchestrating energy metabolism, including adipose tissue, liver, skeletal muscle, and pancreas. Last, we provide an integrative view of the metabolic derangements that occur during COVID-19. Altogether, this review allows for better understanding of the metabolic derangements occurring when a fire starts from a small flame, and thereby help reducing the impact of the COVID-19 pandemic.

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Section: Mechanisms By Which Preexisting Metabolic Alterations May In...mentioning

confidence: 99%

Diabetes Mellitus, Energy Metabolism, and COVID-19

Conte,

Cipponeri,

Roden

2023

Endocrine Reviews

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Section: Introductionmentioning

confidence: 99%

“…3 Cardiovascular complications, including arterial thromboembolism (ATE), venous thromboembolism (VTE), and myocardial infarction (MI) are reported. 4,5 Other COVID-19 pathology that may contribute to thromboembolic events includes hyperinflammation, cytokine release, platelet activation, and endothelial dysfunction. 6,7 Limited data exist on the occurrence of thromboembolic events in COVID-19 outpatients, with retrospective studies identifying a rate of <1% in this subgroup.…”

Section: Introductionmentioning

confidence: 99%

Real-World Analysis of Thromboembolic Events and Mortality of COVID-19 Outpatients in the United States

Peacock

Crawford

Chen

et al. 2022

Clin Appl Thromb Hemost

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Limited data are available on thromboembolic events (TEEs) and mortality in outpatients with coronavirus disease 2019 (COVID-19). This retrospective, observational cohort study identified non-hospitalized COVID-19 outpatients (01/21/2020-01/07/2021) using de-identified Optum® COVID-19 Electronic Health Records data. Patient characteristics, occurrence of TEEs, all-cause mortality, and anticoagulant or thrombolytic medication use were evaluated. Of 1,246,067 patients with COVID-19 diagnosis, 141 471 met entry criteria. Mean (standard deviation [SD]) age was 46.1 (17.2) years, 56.8% were female, 72.9% Caucasian, 11.2% African American, and 11.1% Hispanic. Comorbidity burden was low (mean [SD] Quan-Charlson comorbidity index score of 0.43 [1.10]); however, of those with body mass index data, half were obese. During the follow-up period, a TEE occurred in 1.4%, with the proportion of patients with ischemic stroke, myocardial infarction, deep vein thrombosis, and pulmonary embolism being similar (approximately 0.4% each). All-cause mortality was 0.7%. Medications included corticosteroids (13.7%), anticoagulants (4.9%), and antiplatelets (2.9%). Overall, in this large cohort analysis, certain demographic and clinical characteristics of patients who experienced TEEs were identified and may help guide management decisions and future clinical trials for COVID-19 outpatients.

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“…Venous thromboembolism has been frequently described in severe cases, 2 conversely there are fewer reports of arterial thrombosis and embolism. 3 …”

Section: Introductionmentioning

confidence: 99%

“…Since the beginning of the pandemic of coronavirus disease (COVID- 19), increasing evidence suggests that severe acute respiratory syndrome coronavirus-2 (SARS CoV-2), might produce hypercoagulable state with subsequent arterial and venous thrombosis and thromboembolism, through various pathophysiological mechanisms, such as endothelial dysfunction, activation of coagulation cascade, immobilization, hypoxia and systemic inflammation. 1 Venous thromboembolism has been frequently described in severe cases, 2 conversely there are fewer reports of arterial thrombosis and embolism. 3 While venous thrombosis is usually managed conservatively with appropriate anticoagulation therapy, arterial thrombosis may present with catastrophic clinical pictures requiring urgent surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment of Abdominal Aorta Floating Thrombus in a Patient with Recurrent Peripheral Embolization and COVID-19

Giannetta

Mazzaccaro

Righini

et al. 2022

Vasc Endovascular Surg

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Purpose To present stent-graft treatment of floating thrombus in the abdominal aorta. A review of the literature about aortic floating thrombus (AFT) was also performed. Case report A 56-year-old female with no risk factors for vascular disease but with history of a mild COVID-19 infection in the previous month, for which she had started anticoagulant therapy at a prophylactic dosage, developed an acute ischemia of the lower limbs and was diagnosed with floating thrombosis of the abdominal aorta. The thrombus was excluded from the aortic blood flow by deployment of a stent-graft in the abdominal aorta. At 12 months, the patient was well, and the thrombus in the abdominal aorta appears to be completely excluded by the stent-graft. A review of the available literature from 1980 to 2022 showed 74 cases of AFT located in the aortic arch, in the descending thoracic and in the abdominal aorta. In most cases the AFT involved the aortic arch (38/74, 51.3%) and/or the descending thoracic aorta (30/74, 40.5%), while the abdominal aorta was involved in 6 cases. In 2 of these 6 cases, the patients had a COVID-19 infection. The AFT was mostly approached either medically with anticoagulation/systemic thrombolysis (32/74, 43.2%) or with surgical removal (31/74, 41.9%), while endovascular coverage of the thrombus with an endograft was performed in 6 cases of AFT located in the aortic arch and in the descending thoracic aorta (3 cases each). Conclusion There is no consensus about the optimal treatment of AFT. In selected cases, abdominal stent-grafts may be used for stabilization and exclusion of symptomatic abdominal aorta floating thrombosis to prevent progression and recurrent embolization.

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COVID and venous thrombosis: systematic review of literature

Abstract: The final version may contain major or minor changes.Subscription: Information about subscribing to Minerva Medica journals is online at: http://www.minervamedica.it/en/how-to-order-journals.php Reprints and permissions: For information about reprints and permissions send an email to:

Cited by 8 publications

References 79 publications

Diabetes Mellitus, Energy Metabolism, and COVID-19

Diabetes Mellitus, Energy Metabolism, and COVID-19

Real-World Analysis of Thromboembolic Events and Mortality of COVID-19 Outpatients in the United States

Endovascular Treatment of Abdominal Aorta Floating Thrombus in a Patient with Recurrent Peripheral Embolization and COVID-19

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