Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment

Detalhes bibliográficos
Autor(a) principal: Gasecka, Aleksandra
Data de Publicação: 2020
Outros Autores: Borovac, Josip A., Guerreiro, Rui Azevedo, Giustozzi, Michela, Parker, William, Caldeira, Daniel, Chiva-Blanch, Gemma
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/44620
Resumo: © 2020 Springer Nature Switzerland AG. Part of Springer Nature. This article is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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spelling Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatmentCOVID-19InflammationProphylaxisSARS-CoV-2ThrombosisVenous thromboembolism© 2020 Springer Nature Switzerland AG. Part of Springer Nature. This article is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Introduction: Emerging evidence points to an association between severe clinical presentation of COVID-19 and increased risk of thromboembolism. One-third of patients hospitalized due to severe COVID-19 develops macrovascular thrombotic complications, including venous thromboembolism, myocardial injury/infarction and stroke. Concurrently, the autopsy series indicate multiorgan damage pattern consistent with microvascular injury. Prophylaxis, diagnosis and treatment: COVID-19 associated coagulopathy has distinct features, including markedly elevated D-dimers concentration with nearly normal activated partial thromboplastin time, prothrombin time and platelet count. The diagnosis may be challenging due to overlapping features between pulmonary embolism and severe COVID-19 disease, such as dyspnoea, high concentration of D-dimers, right ventricle with dysfunction or enlargement, and acute respiratory distress syndrome. Both macro- and microvascular complications are associated with an increased risk of in-hospital mortality. Therefore, early recognition of coagulation abnormalities among hospitalized COVID-19 patients are critical measures to identify patients with poor prognosis, guide antithrombotic prophylaxis or treatment, and improve patients' clinical outcomes. Recommendations for clinicians: Most of the guidelines and consensus documents published on behalf of professional societies focused on thrombosis and hemostasis advocate the use of anticoagulants in all patients hospitalized with COVID-19, as well as 2-6 weeks post hospital discharge in the absence of contraindications. However, since there is no guidance for deciding the intensity and duration of anticoagulation, the decision-making process should be made in individual-case basis. Conclusions: Here, we review the mechanistic relationships between inflammation and thrombosis, discuss the macrovascular and microvascular complications and summarize the prophylaxis, diagnosis and treatment of thromboembolism in patients affected by COVID-19.Springer NatureRepositório da Universidade de LisboaGasecka, AleksandraBorovac, Josip A.Guerreiro, Rui AzevedoGiustozzi, MichelaParker, WilliamCaldeira, DanielChiva-Blanch, Gemma2020-10-20T13:13:34Z20202020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/44620engCardiovasc Drugs Ther (2020)0920-320610.1007/s10557-020-07084-91573-7241info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-08T16:45:47Zoai:repositorio.ul.pt:10451/44620Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:57:09.342713Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
title Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
spellingShingle Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
Gasecka, Aleksandra
COVID-19
Inflammation
Prophylaxis
SARS-CoV-2
Thrombosis
Venous thromboembolism
title_short Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
title_full Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
title_fullStr Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
title_full_unstemmed Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
title_sort Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment
author Gasecka, Aleksandra
author_facet Gasecka, Aleksandra
Borovac, Josip A.
Guerreiro, Rui Azevedo
Giustozzi, Michela
Parker, William
Caldeira, Daniel
Chiva-Blanch, Gemma
author_role author
author2 Borovac, Josip A.
Guerreiro, Rui Azevedo
Giustozzi, Michela
Parker, William
Caldeira, Daniel
Chiva-Blanch, Gemma
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Gasecka, Aleksandra
Borovac, Josip A.
Guerreiro, Rui Azevedo
Giustozzi, Michela
Parker, William
Caldeira, Daniel
Chiva-Blanch, Gemma
dc.subject.por.fl_str_mv COVID-19
Inflammation
Prophylaxis
SARS-CoV-2
Thrombosis
Venous thromboembolism
topic COVID-19
Inflammation
Prophylaxis
SARS-CoV-2
Thrombosis
Venous thromboembolism
description © 2020 Springer Nature Switzerland AG. Part of Springer Nature. This article is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
publishDate 2020
dc.date.none.fl_str_mv 2020-10-20T13:13:34Z
2020
2020-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/44620
url http://hdl.handle.net/10451/44620
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Cardiovasc Drugs Ther (2020)
0920-3206
10.1007/s10557-020-07084-9
1573-7241
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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