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Thromb Haemost 2020; 120(12): 1642-1653
DOI: 10.1055/s-0040-1718532
Theme Issue Article

Venous Thromboembolism in COVID-19

Sam Schulman
1   Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada
2   Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
,
Yu Hu
3   Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
,
Stavros Konstantinides
4   Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
5   Department of Cardiology, Democritus University of Thrace, Thrace, Greece
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Abstract

The coronavirus disease 2019 (COVID-19) is our latest pandemic, preceded by the H1N1 swine flu in 2009, which lasted approximately 19 months. One of the special characteristics of COVID-19 is the propensity to cause venous thromboembolism (VTE). Thromboinflammation seems to play a prominent role in the pathogenesis. We will here review some mechanisms in the pathogenesis and discuss some hematological biomarkers, and also whether they serve as useful risk factors for VTE. The role of general risk assessment models for medically ill patients specifically in COVID-19 is appraised. The type of prophylaxis and particularly whether standard or augmented doses of chemoprophylaxis should be used is reviewed based on available evidence. We are also comparing recommendations from 10 different guidance or position/consensus statements. Treatment recommendations for patients with COVID-19 and pulmonary embolism are discussed with current general treatment guidelines as reference. Specifics for patients with COVID-19 are pointed out and the potential role of thrombolytic treatment is explored.

Keywords

COVID-19 - D-dimer - risk assessment models - venous thromboembolism - prophylaxis - treatment


Publication History

Received: 05 August 2020

Accepted: 04 September 2020

Article published online:
24 October 2020

© 2020. Thieme. All rights reserved.

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