NYMC Faculty Publications

Management of Thrombotic Complications in COVID-19: An Update

DOI

10.1007/s40265-020-01377-x

Journal Title

Drugs

First Page

1553

Last Page

1562

Document Type

Article

Publication Date

10-1-2020

Department

Medicine

Keywords

Anticoagulants, Betacoronavirus, COVID-19, Coronavirus Infections, Critical Illness, Humans, Pandemics, Pneumonia, Viral, SARS-CoV-2, Thrombosis, Venous Thromboembolism

Disciplines

Circulatory and Respiratory Physiology | Infectious Disease | Medicine and Health Sciences | Physiological Processes

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2), is now a global pandemic. This virus primarily affects the respiratory tract and causes lung injury characterized by acute respiratory distress syndrome. Although the pathophysiology of COVID-19 is not yet clear, the most widely accepted mechanism is systemic inflammation. A clinically significant effect of the inflammation is coagulopathy. As a result of this effect, patients are found to have a high risk of venous thromboembolism. Studies have reported a high incidence of thrombotic complications in critically ill patients with COVID-19. In this review, we discuss the most updated evidence on the pathophysiology, diagnosis, and treatment of the coagulopathy of COVID-19. Prophylactic anticoagulation is recommended for all in-patients with COVID-19. Those with a higher risk of developing thromboembolic events or who have already developed venous thromboembolism should be treated with therapeutic anticoagulation. We also discuss post-discharge prophylaxis for high-risk patients and some newly proposed treatments for the hypercoagulability that could improve the outcomes of the affected patients.

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