COVID-19 und Thrombosen

COVID-19 wird durch SARS-CoV-2, einen hoch ansteckenden Krankheitserreger, verursacht. Dieser Artikel fokussiert primär auf die Prophylaxe, Diagnose, Akutbehandlung und Nachsorge von Patienten mit Venenthrombosen und Lungenembolien im Zusammenhang mit einer SARS-CoV-2-Infektion. Für die spezialisierte Diagnostik und Behandlung von Patienten (mit oder ohne COVID-19), die arterielle Thrombosen oder Thrombosen in atypischer Lokalisation entwickeln, wird auf fachspezifische Übersichtsarbeiten verwiesen.

Schlüsselwörter

COVID-19 - Thrombose - Embolie - Lungenembolie - Impfung

• Literatur

• 1 Tan BK, Mainbourg S, Friggeri A. et al. Arterial and venous thromboembolism in COVID-19: a study-level meta-analysis. Thorax 2021; 76: 970-979
• 2 Wichmann D, Sperhake JP, Lutgehetmann M. et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med 2020; 173: 268-277
• 3 Ackermann M, Verleden SE, Kuehnel M. et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med 2020; 383: 120-128
• 4 Skendros P, Mitsios A, Chrysanthopoulou A. et al. Complement and tissue factor-enriched neutrophil extracellular traps are key drivers in COVID-19 immunothrombosis. J Clin Invest 2020; 130: 6151-6157
• 5 Libby P, Luscher T. COVID-19 is, in the end, an endothelial disease. Eur Heart J 2020; 41: 3038-3044
• 6 Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020; 135: 2033-2040
• 7 Iba T, Levy JH, Connors JM. et al. The unique characteristics of COVID-19 coagulopathy. Crit Care 2020; 24: 360
• 8 Leentjens J, van Haaps TF, Wessels PF. et al. COVID-19-associated coagulopathy and antithrombotic agents-lessons after 1 year. Lancet Haematol 2021; 8: e524-e533
• 9 ATTACC Investigators, ACTIV-4a Investigators, REMAP-CAP Investigators. et al. Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19. N Engl J Med 2021; 385: 790-802
• 10 REMAP-CAP Investigators, ACTIV-4a Investigators, ATTACC Investigators. et al. Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19. N Engl J Med 2021; 385: 777-789
• 11 Sadeghipour P, Talasaz AH, Rashidi F. INSPIRATION Investigators. et al. Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial. JAMA 2021; 325: 1620-1630
• 12 The Task Force for the management of COVID-19 of the European Society of Cardiology. ESC Guidance for Diagnosis and Management of CVD during the COVID-19 Pandemic – Updated. Zugriff am 16. November 2021 unter: https://www.escardio.org/Education/COVID-19-and-Cardiology
• 13 Konstantinides SV, Meyer G, Becattini C. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020; 41: 543-603
• 14 Hobohm L, Keller K, Munzel T. et al. EkoSonic(R) endovascular system and other catheter-directed treatment reperfusion strategies for acute pulmonary embolism: overview of efficacy and safety outcomes. Expert Rev Med Devices 2020; 17: 739-749
• 15 Steffel J, Collins R, Antz M. et al. 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation. Europace 2021; 23: 1612-1676
• 16 Barco S, Schmidtmann I, Ageno W. et al. Early discharge and home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: an international multicentre single-arm clinical trial. Eur Heart J 2020; 41: 509-518
• 17 Taha M, Samavati L. Antiphospholipid antibodies in COVID-19: a meta-analysis and systematic review. RMD Open 2021; 7: e001580
• 18 Bauersachs R, Langer F, Kalka C. et al. Treatment of the antiphospholipid syndrome with direct oral anticoagulants: Position statement of German societies. Vasa 2019; 48: 483-486
• 19 Greinacher A, Thiele T, Warkentin TE. et al. Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination. N Engl J Med 2021; 384: 2092-2101
• 20 Konstantinides SV. Thrombotic complications of vaccination against SARS-CoV-2: what pharmacovigilance reports tell us – and what they don’t. Eur Respir J 2021; 58: 2101111