Thromboprophylaxis in hospitalized COVID-19 patients: the efficacy and safety of the approved hospital protocol

Kolanko, Emanuel; Senderek, Tomasz; Prokop-Staszecka, Anna; Kruk, Aleksandra; Broniatowska, Elżbieta; Konieczyńska, Małgorzata; Kopiński, Piotr; Pudło, Joanna; Undas, Anetta

doi:10.20452/pamw.16102

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…Meanwhile, some studies have shown that therapeutic doses do not increase the risk of bleeding ( 158 ). However, some studies have avoided an increased dose of thromboprophylaxis due to a slight increase in bleeding events ( 159 , 160 ). The difficulty of using anti-thrombotic therapy during the period of severe and critical illness highlights the importance of timely comprehensive antithrombotic therapy before the late stage.…”

Section: Inhibiting the Prothrombotic Statementioning

confidence: 99%

Persistent Lung Injury and Prothrombotic State in Long COVID

et al. 2022

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Lung injury may persist during the recovery period of COVID-19 as shown through imaging, six-minute walk, and lung function tests. The pathophysiological mechanisms leading to long COVID have not been adequately explained. Our aim is to investigate the basis of pulmonary susceptibility during sequelae and the possibility that prothrombotic states may influence long-term pulmonary symptoms of COVID-19. The patient’s lungs remain vulnerable during the recovery stage due to persistent shedding of the virus, the inflammatory environment, the prothrombotic state, and injury and subsequent repair of the blood-air barrier. The transformation of inflammation to proliferation and fibrosis, hypoxia-involved vascular remodeling, vascular endothelial cell damage, phosphatidylserine-involved hypercoagulability, and continuous changes in serological markers all contribute to post-discharge lung injury. Considering the important role of microthrombus and arteriovenous thrombus in the process of pulmonary functional lesions to organic lesions, we further study the possibility that prothrombotic states, including pulmonary vascular endothelial cell activation and hypercoagulability, may affect long-term pulmonary symptoms in long COVID. Early use of combined anticoagulant and antiplatelet therapy is a promising approach to reduce the incidence of pulmonary sequelae. Essentially, early treatment can block the occurrence of thrombotic events. Because impeded pulmonary circulation causes large pressure imbalances over the alveolar membrane leading to the infiltration of plasma into the alveolar cavity, inhibition of thrombotic events can prevent pulmonary hypertension, formation of lung hyaline membranes, and lung consolidation.

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Section: Inhibiting the Prothrombotic Statementioning

confidence: 99%

Persistent Lung Injury and Prothrombotic State in Long COVID

et al. 2022

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“…A total of 36 articles were included in the pooled analysis ( Table 1 ). 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 The majority (28; 78%) consisted of retrospective cohort studies whereas three (8%) were RCTs and five (14%) were prospective cohort studies ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Arterial Thrombotic Events in Hospitalized COVID-19 Patients: A Short Review and Meta-Analysis

Candeloro

Schulman

2022

Semin Thromb Hemost

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It is well established that the risk of venous thromboembolism is high in coronavirus disease 19 (COVID-19). The frequency of arterial thromboembolic events (ATEs) in hospitalized patients with COVID-19 is unclear, as is the magnitude of these events in comparison with other infections. We searched MEDLINE from February 2020 to February 2022 for prospective or retrospective cohort studies and randomized clinical trials that reported the number of acute myocardial infarction (AMI), acute ischemic stroke (AIS), acute limb ischemia (ALI), or other ATE as defined by the original authors in hospitalized patients with COVID-19. The pooled frequencies were calculated through meta-analysis using random effects model with logit transformation and presented with relative 95% prediction intervals (95% PI). We retrieved a total of 4,547 studies, 36 of which (28 retrospective cohorts, five prospective cohorts and three randomized trials) were finally included in our analysis. The resulting cohort counted 100,949 patients, 2,641 (2.6%) of whom experienced ATE. The pooled ATE frequency was 2.0% (95% PI, 0.4–9.6%). The pooled ATE frequency for AMI, AIS, ALI, and other ATE was 0.8% (95% PI, 0.1–8.1%), 0.9% (95% PI, 0.3–2.9%), 0.2% (95% PI, 0.0–4.2%), and 0.5% (95% PI, 0.1–3.0%), respectively. In comparison with the ATE incidence reported in three studies on non-COVID viral pneumonia, we did not detect a significant difference from the results in our analysis. In conclusion, we found a non-negligible proportion of ATE in patients hospitalized for COVID-19. Our results are similar to those found in hospitalized patients with influenza or with non-COVID viral pneumonia.

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“…LMWH was chosen mainly because of its higher efficacy and comparable safety compared to VKA [12,29]. LMWH remains the best thromboprophylaxis option for hospitalized patients with high risk of incident of VTE [30].…”

Section: Discussionmentioning

confidence: 99%

Cancer associated thrombosis: comparison of characteristics, treatment, and outcomes in oncological and non-oncological patients followed by Pulmonary Embolism Response Team

Pietrasik¹,

Kurzyna²,

Smyk³

et al. 2023

Polish Archives of Internal Medicine

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This study is a retrospective analysis of consecutive patients with venous thromboembolism (VTE) treated by the Pulmonary Embolism Response Team CELZAT (PERT-CELZAT) that compares the clinical characteristics, outcomes, and mortality of patients with and without cancer. It shows that patients with cancer can be successfully treated for pulmonary embolism (PE) with their in-hospital outcomes and mortality rate at the same level as patients without cancer. The study postulates that patients with PE, especially those in the intermediate and high-risk group or with contraindications for standard therapy, should be followed by a multidisciplinary team. This may result in lower complication rates and lower in-hospital mortality. However, the long-term follow-up shows that, despite successful treatment in the acute phase, the cancer patients had shorter survival times, which may be associated with the progression of neoplastic disease.

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Thromboprophylaxis in hospitalized COVID-19 patients: the efficacy and safety of the approved hospital protocol

Cited by 5 publications

References 35 publications

Persistent Lung Injury and Prothrombotic State in Long COVID

Persistent Lung Injury and Prothrombotic State in Long COVID

Arterial Thrombotic Events in Hospitalized COVID-19 Patients: A Short Review and Meta-Analysis

Cancer associated thrombosis: comparison of characteristics, treatment, and outcomes in oncological and non-oncological patients followed by Pulmonary Embolism Response Team

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