The need to manage the risk of thromboembolism in COVID-19 patients

• Published in: Journal of vascular surgery Vol. 72; no. 3; pp. 799 - 804
• Main Authors: Khan, Inayat Hussain, Savarimuthu, Sugeevan, Leung, Marco Shiu Tsun, Harky, Amer
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2020; by the Society for Vascular Surgery. Published by Elsevier Inc
• Subjects: Age Factors; Anticoagulants - administration & dosage; Anticoagulation; Betacoronavirus - immunology; Blood Coagulation - immunology; Comorbidity; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - virology; COVID-19; COVID-19 and vascular disease; Cytokine Release Syndrome - complications; Cytokine Release Syndrome - immunology; Cytokine Release Syndrome - virology; D-dimer; Fibrin Fibrinogen Degradation Products - analysis; Humans; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - virology; Risk Factors; SARS-CoV-2; Severity of Illness Index; Sex Factors; Thromboembolism - blood; Thromboembolism - diagnosis; Thromboembolism - etiology; Thromboembolism - prevention & control; Thrombosis; Venous thromboembolism; COVID-19; D-dimer; Anticoagulation; Thrombosis; Venous thromboembolism
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2020.05.015

COVID-19 first appeared in Wuhan, Hubei Province, China, in December 2019. Thought to be of zoonotic origin, it has been named SARS-CoV-2 (COVID-19) and has spread rapidly. As of April 20, 2020, there have been >2.4 million cases recorded worldwide. The inflammatory process, cytokine storm, and lung injury that are associated with COVID-19 can put patients at an increased risk of thrombosis. The total incidence of thrombotic events in COVID-19 patients is currently uncertain. Those with more severe disease and with other risk factors, including increasing age, male sex, obesity, cancer, comorbidities, and intensive care unit admission, are at higher risk of these events. However, there is little international guidance on managing these risks in COVID-19 patients. In this paper, we explore the current evidence and theories surrounding thrombosis in these unique patients and reflect on experience from our center.