Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 324, Issue -, Pages 261-266Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2020.09.064
Keywords
Anticoagulants; Antiplatelet; Antithrombotic therapy; Coronavirus; COVID-19; Thromboinflammatory syndrome
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In patients with severe or critical COVID-19 manifestations, anticoagulant therapy may lead to better outcomes and serve as a possible protective mechanism against the prothrombotic state induced by SARS-CoV-2. The use of antiplatelet/anticoagulant therapy should be guided by clinical context and disease severity.
In patients with severe or critical Coronavirus disease 2019 (COVID-19) manifestations, a thromboinflammatory syndrome, with diffuse microvascular thrombosis, is increasingly evident as the final step of pro-inflammatory cytokines storm. Actually, no proven effective therapies for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exist. Preliminary observations on anticoagulant therapy appear to be associated with better outcomes in moderate and severe COVID-19 patients with signs of coagulopathy and in those requiring mechanical ventilation. The pathophysiology underlying the prothrombotic state elicited by SARS-CoV-2 outlines possible protective mechanisms of antithrombotic therapy (in primis anticoagulants) for this viral illness. The indications for antiplatelet/anticoagulant use (prevention, prophylaxis, therapy) are guided by the clinical context and the COVID-19 severity. We provide a practical approach on antithrombotic therapy management for COVID-19 patients from a multidisciplinary point of view. (C) 2020 Elsevier B.V. All rights reserved.
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