COVID-19 IN PATIENTS WITH MYELOPROLIFERATIVE NEOPLASMS: THE RISK OF THROMBOEMBOLIC EVENTS AND CURRENT OPTIONS FOR ANTITHROMBOTIC PROPHYLAXIS

Abstract

Aim: to provide a literature review of the presently available data on the risk of thromboembolic events and current options for antithrombotic prophylaxis in patients with myeloproliferative neoplasms (MPN) patients with concomitant coronavirus disease 2019 (COVID-19). Material and methods. The thematic scientific papers, published predominantly during the last decade (including the references regarding SARS-CoV-2 infection (COVID-19) of the last three years), constituted the study material. The research methodology involved bibliosemantic method and structural and logical analysis. Results and discussion. MPN and SARS-CoV-2 infection (COVID-19) are both conditions with inherently enhanced susceptibility to thromboembolic events (venous and arterial). Along with the specific pathophysiological pathways, MPN and COVID-19, in case of their constellation, share overlapping pathomechanisms of hypercoagulability. As of today, the antithrombotic prophylaxis in MPN/COVID-19 patients (primary and secondary) is carried out according to the guidelines and algorithms, including those regarding general principles of the use of anticoagulants (oral or parenteral) and antiplatelet agents, and those specifically addressed to MPN or SARS-CoV-2 infection. These documents are constantly updating as the results of ongoing trials become available. Considering the relatively low prevalence of MPN, and the absence of specific guidelines, devoted to MPN in tandem with SARS-CoV-2 infection, the conduction of global registry studies is of crucial importance, aiming to provide a continuous and thorough collection and analysis of the data, related to the characteristics of this particular patients` population, pathological background and clinical features of thromboembolic complications, as well as short- and long-term outcomes. Conclusion. The comprehensive study of basic, epidemiological and clinical data regarding various aspects of thrombosis/thromboembolism in case of MPN/COVID-19 constellation, is a multidisciplinary task, which should be performed with an ultimate goal to improve already implemented and develop novel approaches to antithrombotic management of such patients.