Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality worldwide. Although initial reports concentrated on severe respiratory illness, emerging literature has indicated a substantially elevated risk of thromboembolic events in patients with COVID-19 disease. Pro-inflammatory cytokine release has been linked to endothelial dysfunction and activation of coagulation pathways, as evident by elevated D-dimer levels and deranged coagulation parameters. Both macrovascular and microvascular thromboses have been described in observational cohort and post-mortem studies. Concurrently, preliminary data have suggested the role of therapeutic anticoagulation in preventing major thromboembolic complications in moderately but not critically ill patients. However, pending results from randomized controlled trials, clear guidance is lacking regarding the intensity and duration of anticoagulation in such patients. Herein, we review the existing evidence on incidence and pathophysiology of COVID-19 related thromboembolic complications and guide anticoagulation therapy based on current literature and societal consensus statements.
Keywords: COVID-19; SARS-CoV2; antithrombotic therapy; prophylactic anticoagulation; thromboembolism; thrombosis.
【저자키워드】 COVID-19, SARS-CoV2, Thromboembolism, thrombosis., antithrombotic therapy, prophylactic anticoagulation, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, pandemic, therapy, Randomized controlled trials, anticoagulation, thrombosis, Respiratory illness, risk, D-dimer, cytokine, Prophylactic, Endothelial dysfunction, COVID-19 disease, Coagulation, Cohort, Critically ill, pathophysiology, Thromboembolism, Post-mortem, morbidity and mortality, incidence, respiratory, severe respiratory illness, disease, patients, Guidance, critically ill patients, antithrombotic therapy, prophylactic anticoagulation, therapeutic anticoagulation, Evidence, Antithrombotic, D-dimer level, Pathways, anticoagulation therapy, intensity, Consensus, thromboembolic, Activation, Thromboembolic events, coagulation pathways, pro-inflammatory cytokine release, Preliminary data, Coagulation parameters, cytokine release, thromboembolic complications, Thromboembolic event, initial, described, indicated, elevated, suggested, patients with COVID-19, thromboembolic complication, 【제목키워드】 review, milieu,