ABSTRACT
The SARS-CoV-2 infection (COVID-19) is causing an ongoing pandemic and potentially fatal disease. Development of coagulopathy with thrombotic complications such as deep vein thrombosis and pulmonary embolism are emerging as factors for progression to severe disease and death. Also, a markedly increased level of D-dimer, a protein product of fibrin degradation, has been associated to mortality. Furthermore, activation of immune response due to virus infection may led to uncontrolled severe inflammation with damage to host cells and induction of endotheliitis and cellular apoptosis and pyroptosis. The use of low molecular weight heparin in early stage of the disease could prevent vascular complications and reduce the progression to severe stage of the disease. Aim of this paper was to summarize current evidence about vascular involvement in COVID-19 disease and potential antithrombotic therapy.
Subject(s)
Anticoagulants/therapeutic use , COVID-19/epidemiology , Cardiology , Consensus , Pandemics , Societies, Medical , Thrombosis/etiology , COVID-19/complications , Humans , SARS-CoV-2 , Thrombosis/blood , Thrombosis/prevention & control , COVID-19 Drug TreatmentABSTRACT
Our work concerns the actual problem of spread of SARS- CoV-2 outbreak which requires fast and correct as possible answer. In current scenario, the need of rapid answer put away the imperative of proper methodology. We focus on the serogical immunoassay for diagnosis of Covid-19 as an important weapon not only for diagnostic purpose, but also for epidemiologic one. The right equilibrium between high speed, low cost and accuracy is obtained with easy-to-use decentralized point-of-care test as the colloidal gold-based immunochromatographic strip assay which detects IgM and IgG antibodies directed against SARS-CoV-2. As our aim is to evaluate the efficacy of Covid-19 rapid tests and of serological assays in real-life settings, we designed a research protocol aimed to establish how to use correctly these diagnostics, taking into account the different possible clinical and epidemiological scenarios.
Subject(s)
Clinical Laboratory Techniques/methods , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Humans , Mass Screening/methods , Mass Screening/organization & administration , Mass Screening/standards , Pneumonia, Viral/epidemiology , Practice Guidelines as Topic , Primary Prevention/methods , Primary Prevention/organization & administration , Primary Prevention/standardsABSTRACT
The development of coagulopathy is emerging as one of the most significant poor prognostic features in COVID-19 pneumopathy. D-dimer, a protein product of fibrin degradation, has been found elevated in the most severe cases and correlated to mortality. Potentially involved factors in the impairment of coagulation caused by viral infection include the dysregulated inflammatory response, platelet and endothelial dysfunction with impaired fibrinolysis. Autoptic analysis in deaths fore severe COVID-19 disease revealed fibrin exudation in alveoli, blood vessel wall edema and hyaline thrombi in small vessels in other organs and tissues. Heparin is an anticoagulant molecule that also showed anti-inflammatory properties and a potential antiviral effect. The use of low molecular weight heparin could prevent thromboembolic complications in COVID-19 pneumopathy. However, the correct timing of prophylaxis according to the stage of COVID-19 disease and the appropriate therapeutic dosage to use in severe cases need further research.