Considerations in prophylaxis and treatment of VTE in COVID-19 Patients

Behnood Bikdeli, Mahesh V. Madhavan, David Jimenez, Taylor Chuich, Isaac Dreyfus, Elissa Driggin, Caroline Der Nigoghossian, Walter Ageno, Mohammad Madjid, Yutao Guo, Liang V. Tang, Yu Hu, Jay Giri, Mary Cushman, Isabelle Quéré, Evangelos P. Dimakakos, C. Michael Gibson, Giuseppe Lippi, Emmanuel J. Favaloro, Jawed Fareed, Joseph A. Caprini, Alfonso J. Tafur, John R. Burton, Dominic P. Francese, Elizabeth Y. Wang, Anna Falanga, Claire McLintock, Beverley J. Hunt, Alex C. Spyropoulos, Geoffrey D. Barnes, John W. Eikelboom, Ido Weinberg, Sam Schulman, Marc Carrier, Gregory Piazza, Joshua A. Beckman, P. Gabriel Steg, Gregg W. Stone, Stephan Rosenkranz, Samuel Z. Goldhaber, Sahil A. Parikh, Manuel Monreal, Harlan M. Krumholz, Stavros V. Konstantinides, Jeffrey I. Weitz and Gregory Y.H. Lip


Coronavirus disease 2019 (COVID-19), a viral respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may predispose patients to thrombotic disease, both in the venous and arterial circulations, due to excessive inflammation, platelet activation, endothelial dysfunction, and stasis. In addition, many patients receiving antithrombotic therapy for thrombotic disease may develop COVID-19, which can have implications for choice, dosing, and laboratory monitoring of antithrombotic therapy. Moreover, during a time with much focus on COVID-19, it is critical to consider how to optimize the available technology to care for patients without COVID-19 who have thrombotic disease. Herein, we review the current understanding of the pathogenesis, epidemiology, management and outcomes of patients with COVID-19 who develop venous or arterial thrombosis, and of those with preexisting thrombotic disease who develop COVID-19, or those who need prevention or care for their thrombotic disease during the COVID-19 pandemic.

Keywords: Coronavirus disease 2019, SARS-CoV-2, thrombosis, antithrombotic therapy, anticoagulant, antiplatelet.

© 2020 Published by Elsevier on behalf of the American College of Cardiology Foundation.
Journal of the American College of Cardiology
April 2020
DOI: 10.1016/j.jacc.2020.04.031