Anticoagulant treatment in COVID-19: a narrative review

Author:

Carfora Vincenzo,Spiniello Giorgio,Ricciolino Riccardo,Di Mauro Marco,Migliaccio Marco Giuseppe,Mottola Filiberto Fausto,Verde Nicoletta,Coppola Nicola,Coppola Nicola,Sagnelli Caterina,De Pascalis Stefania,Stanzione Maria,Stornaiuolo Gianfranca,Cascone Angela,Martini Salvatore,Macera Margherita,Monari Caterina,Calò Federica,Bianco Andrea,Russo Antonio,Gentile Valeria,Camaioni Clarissa,De Angelis Giulia,Marino Giulia,Astorri Roberta,De Sio Ilario,Niosi Marco,Borrelli Serena,Celia Benito,Ceparano Maria,Cirillo Salvatore,De Luca Maria,Mazzeo Grazia,Paoli Giorgio,Russo Maria Giovanna,Carfora Vincenzo,Di Mauro Marco,Migliaccio Marco Giuseppe,Mottola Filiberto Fausto,Ricciolino Riccardo,Spiniello Giorgio,Verde Nicoletta,

Abstract

AbstractThe actual Coronavirus Disease (COVID 19) pandemic is due to Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the coronavirus family. Besides the respiratory involvement, COVID 19 patients frequently develop a pro-coagulative state caused by virus-induced endothelial dysfunction, cytokine storm and complement cascade hyperactivation. It is common to observe diffuse microvascular thrombi in multiple organs, mostly in pulmonary microvessels. Thrombotic risk seems to be directly related to disease severity and worsens patients’ prognosis. Therefore, the correct understanding of the mechanisms underlying COVID-19 induced prothrombotic state can lead to a thorough assessment of the possible management strategies. Hence, we review the pathogenesis and therapy of COVID 19-related thrombosis disease, focusing on the available evidence on the possible treatment strategies and proposing an algorithm for the anticoagulation strategy based on disease severity.

Funder

Università degli Studi della Campania Luigi Vanvitelli

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine,Hematology

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