Systemic inflammation in COVID-19 patients may induce various types of venous and arterial thrombosis: A systematic review.
Scand J Immunol
; 94(5): e13097, 2021 Nov.
Article
in English
| MEDLINE | ID: covidwho-1388398
ABSTRACT
COVID-19 is a global pandemic with a daily increasing number of affected individuals. Thrombosis is a severe complication of COVID-19 that leads to a worse clinical course with higher rates of mortality. Multiple lines of evidence suggest that hyperinflammation plays a crucial role in disease progression. This review compiles clinical data of COVID-19 patients who developed thrombotic complications to investigate the possible role of hyperinflammation in inducing hypercoagulation. A systematic literature search was performed using PubMed, Embase, Medline and Scopus to identify relevant clinical studies that investigated thrombotic manifestations and reported inflammatory and coagulation biomarkers in COVID-19 patients. Only 54 studies met our inclusion criteria, the majority of which demonstrated significantly elevated inflammatory markers. In the cohort studies with control, D-dimer was significantly higher in COVID-19 patients with thrombosis as compared to the control. Pulmonary embolism, deep vein thrombosis and strokes were frequently reported which could be attributed to the hyperinflammatory response associated with COVID-19 and/or to the direct viral activation of platelets and endothelial cells, two mechanisms that are discussed in this review. It is recommended that all admitted COVID-19 patients should be assessed for hypercoagulation. Furthermore, several studies have suggested that anticoagulation may be beneficial, especially in hospitalized non-ICU patients. Although vaccines against SARS-CoV-2 have been approved and distributed in several countries, research should continue in the field of prevention and treatment of COVID-19 and its severe complications including thrombosis due to the emergence of new variants against which the efficacy of the vaccines is not yet clear.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Arteries
/
Blood Platelets
/
Endothelium, Vascular
/
Venous Thrombosis
/
SARS-CoV-2
/
COVID-19
/
Inflammation
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
/
Vaccines
/
Variants
Limits:
Animals
/
Humans
Language:
English
Journal:
Scand J Immunol
Year:
2021
Document Type:
Article
Affiliation country:
Sji.13097
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