Thromboembolic risk and anticoagulant therapy in COVID‐19 patients: emerging evidence and call for action

Abstract

Summary Emerging evidence shows that severe coronavirus disease 2019 (COVID‐19) can be complicated with coagulopathy, namely disseminated intravascular coagulation, which has a rather prothrombotic character with high risk of venous thromboembolism. The incidence of venous thromboembolism among COVID‐19 patients in intensive care units appears to be somewhat higher compared to that reported in other studies including such patients with other disease conditions. D‐dimer might help in early recognition of these high‐risk patients and also predict outcome. Preliminary data show that in patients with severe COVID‐19, anticoagulant therapy appears to be associated with lower mortality in the subpopulation meeting sepsis‐induced coagulopathy criteria or with markedly elevated d‐dimer. Recent recommendations suggest that all hospitalized COVID‐19 patients should receive thromboprophylaxis, or full therapeutic‐intensity anticoagulation if such an indication is present.

COVID-19 severe pneumonia in Mexico City – First experience in a Mexican hospital

“…Our patients were managed following these recommendations. (23,24) Our study has several limitations: it is a small descriptive case series report, and there may be confounders in the analysis of the results, in concordance with most described data in the current literature. Another disadvantage is the lack of generalisability and the fact that 9 patients remained in the hospital at the time of data censoring on April 19, 2020.…”

Arterial thromboembolic complications in COVID‐19 in low‐risk patients despite prophylaxis

“…3 A few publications have highlighted the incidence of venous thromboembolic complications in COVID-19. 4,5 We present three patients who were found to have arterial thrombosis as a complication of COVID-19. All three patients were admitted to Northwell Plainview Hospital during March or April of 2020 and were on prophylactic or fulldose anti-coagulation at the time of these events.…”

Correlation of coagulation parameters with clinical outcomes in Coronavirus-19 affected minorities in United States: Observational cohort

“…Despite many protocols, the effect of anticoagulation on mortality with COVID is uncertain with only a few reports showing that there may be a benefit. Indeed, even the effect of anticoagulation in the symptomatic thromboses/vessel occlusion associated with COVID is unclear (15). It may be that this disease presents with more of a thrombotic microangiopathy (TMA) picture and may be more amenable to TMA therapeutics.…”