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Prevention and management of thrombosis in hospitalised patients with COVID-19 pneumonia.
Vincent, Jean-Louis; Levi, Marcel; Hunt, Beverley J.
  • Vincent JL; Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: jlvincent@intensive.org.
  • Levi M; Department of Medicine and Cardiometabolic Programme-National Institute for Health Research UCLH/UCL Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK; Department of Vascular Medicine, Amsterdam University Medical Center (location Academic Medical Center), Amsterdam, Netherlands.
  • Hunt BJ; Kings Healthcare Partners and Thrombosis & Haemophilia Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Lancet Respir Med ; 10(2): 214-220, 2022 02.
Article in English | MEDLINE | ID: covidwho-1537210
ABSTRACT
A proportion of people infected with SARS-CoV-2 develop moderate or severe COVID-19, with an increased risk of thromboembolic complications. The inflammatory response to SARS-CoV-2 infection can cause an acute-phase response and endothelial dysfunction, which contribute to COVID-19-associated coagulopathy, the clinical and laboratory features of which differ in some respects from those of classic disseminated intravascular coagulation. Understanding of the pathophysiology of thrombosis in COVID-19 is needed to develop approaches to management and prevention, with implications for short-term and long-term health outcomes. Evidence is emerging to support treatment decisions in patients with COVID-19, but many questions remain about the optimum approach to management. In this Viewpoint, we provide a summary of the pathophysiology of thrombosis and associated laboratory and clinical findings, and highlight key considerations in the management of coagulopathy in hospitalised patients with severe COVID-19, including coagulation assessment, identification of thromboembolic complications, and use of antithrombotic prophylaxis and therapeutic anticoagulation. We await the results of trials that are underway to establish the safety and benefits of prolonged thromboprophylaxis after hospital discharge.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Venous Thromboembolism / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: Lancet Respir Med Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Venous Thromboembolism / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: Lancet Respir Med Year: 2022 Document Type: Article