Thrombosis, an Important Piece in the COVID-19 Puzzle – From Pathophysiology to Therapy

2021 
Background: A lot of data about COVID-19 was already published but this is only a part of the pandemic puzzle pieces. Once we will have all the pieces together, we will be able to successfully treat this disease with so many challenges. This infectious disease has a high thrombogenic potential. The study aims to review published data about COVID-19 associated thrombosis, from pathophysiology to treatment and the role in patient’s evolution. Data sources: We have searched for articles and studies published in online platforms: MEDLINE/PubMed database, Google Scholar, ScienceDirect, Wiley Online Library, Nature Public Health Emergency Collection. Results: We have found numerous articles regarding the COVID-19 infection. We selected only those focused on the thrombosis. D-dimers had predictive value in identifying thrombosis and high level had correlated with the severity of the infection and death. The most patients who were on chronic anticoagulant therapy before contacting the virus had a better prognosis. Heparin has other favorable effects such as a direct antiviral and anti-inflammatory effect in addition to its anticoagulant effect. Conclusions: COVID-19 infections are frequently complicated by the thrombotic pathology. High plasma level of D-dimers is predictive factor for severe prognosis and the recommended anticoagulant, associated with low mortality is heparin followed by a direct oral anticoagulant. Randomized studies in large groups of patients and therapeutic guidelines are still needed in this issue.
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