scholarly journals COVID-19 and Venous Thromboembolism: From Pathological Mechanisms to Clinical Management

2021 ◽  
Vol 11 (12) ◽  
pp. 1328
Author(s):  
Xianghui Zhou ◽  
Zhipeng Cheng ◽  
Yu Hu
Keyword(s):  
Venous Thromboembolism ◽  
Pathophysiological Mechanism ◽  
Antithrombotic Drugs ◽  
Clinical Prognosis ◽  
Complex Interactions ◽  
Global Pandemic ◽  
Antifibrinolytic Drugs ◽  
Inflammatory Drugs ◽  
Thrombotic Diseases ◽  
Historical Controls

Coronavirus disease 2019 (COVID-19), which is becoming a global pandemic, is caused by SARS-CoV-2 infection. In COVID-19, thrombotic events occur frequently, mainly venous thromboembolism (VTE), which is closely related to disease severity and clinical prognosis. Compared with historical controls, the occurrence of VTE in hospitalized and critical COVID-19 patients is incredibly high. However, the pathophysiology of thrombosis and the best strategies for thrombosis prevention in COVID-19 remain unclear, thus needing further exploration. Virchow’s triad elements have been proposed as important risk factors for thrombotic diseases. Therefore, the three factors outlined by Virchow can also be applied to the formation of venous thrombosis in the COVID-19 setting. A thorough understanding of the complex interactions in these processes is important in the search for effective treatments for COVID-19. In this work, we focus on the pathological mechanisms of VTE in COVID-19 from the aspects of endothelial dysfunction, hypercoagulability, abnormal blood flow. We also discuss the treatment of VTE as well as the ongoing clinical trials of heparin anticoagulant therapy. In addition, according to the pathophysiological mechanism of COVID-19-associated thrombosis, we extended the range of antithrombotic drugs including antiplatelet drugs, antifibrinolytic drugs, and anti-inflammatory drugs, hoping to find effective drug therapy and improve the prognosis of VTE in COVID-19 patients.

scholarly journals COVID-19 Pathogenesis: From Molecular Pathway to Vaccine Administration

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 903
Author(s):  
Francesco Nappi ◽  
Adelaide Iervolino ◽  
Sanjeet Singh Avtaar Singh
Keyword(s):  
Hospital Setting ◽  
Pathophysiological Mechanism ◽  
Systemic Response ◽  
Respiratory Complications ◽  
Thrombotic Risk ◽  
Global Pandemic ◽  
The Impact ◽  
Multiple Variants ◽  
Roll Out

The Coronavirus 2 (SARS-CoV-2) infection is a global pandemic that has affected millions of people worldwide. The advent of vaccines has permitted some restitution. Aside from the respiratory complications of the infection, there is also a thrombotic risk attributed to both the disease and the vaccine. There are no reliable data for the risk of thromboembolism in SARS-CoV-2 infection in patients managed out of the hospital setting. A literature review was performed to identify the pathophysiological mechanism of thrombosis from the SARS-CoV-2 infection including the role of Angiotensin-Converting Enzyme receptors. The impact of the vaccine and likely mechanisms of thrombosis following vaccination were also clarified. Finally, the utility of the vaccines available against the multiple variants is also highlighted. The systemic response to SARS-CoV-2 infection is still relatively poorly understood, but several risk factors have been identified. The roll-out of the vaccines worldwide has also allowed the lifting of lockdown measures and a reduction in the spread of the disease. The experience of the SARS-CoV-2 infection, however, has highlighted the crucial role of epidemiological research and the need for ongoing studies within this field.

scholarly journals Non-steroidal anti-inflammatory drugs and risk of venous thromboembolism: a systematic review and meta-analysis

Rheumatology ◽  
2014 ◽  
Vol 54 (4) ◽  
pp. 736-742 ◽  
Author(s):  
Patompong Ungprasert ◽  
Narat Srivali ◽  
Karn Wijarnpreecha ◽  
Prangthip Charoenpong ◽  
Eric L. Knight
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Meta Analysis ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals D-dimer kit with a High FDP/D-Dimer Ratio is Useful for Diagnosing Thrombotic Diseases

2022 ◽  
Vol 28 ◽  
pp. 107602962110705
Author(s):  
Nozomi Ikeda ◽  
Hideo Wada ◽  
Yuhuko Ichikawa ◽  
Minoru Ezaki ◽  
Motoko Tanaka ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Critically Ill ◽  
Disseminated Intravascular Coagulation ◽  
Critically Ill Patients ◽  
Degradation Products ◽  
Intravascular Coagulation ◽  
Fibrin Degradation Products ◽  
Peripheral Arterial ◽  
Thrombotic Diseases ◽  
D Dimer

Introduction Although D-dimer is a useful biomarker of thrombosis, there are many D-dimer kits, with high and low fibrinogen and fibrin degradation products (FDP)/ D-dimer ratios. Methods Plasma D-dimer levels were measured using three different kits in critically ill patients to examine the usefulness of such measurements for detecting the thrombotic diseases and determining the correlation with the FDP and FDP/D-dimer ratio. Results Although three D-dimer kits showed marked utility for diagnosing disseminated intravascular coagulation (DIC) and peripheral arterial and venous thromboembolism (PAVTE), the D-dimer levels determined using the three kits varied among diseases. Indeed, one D-dimer kit showed a high FDP/D-dimer ratio, and another kit showed a low FDP/D-dimer ratio. D-dimer kit with low FDP/D-dimer ratio tended to have high cut-off values and low specificity for diagnosing DIC and PAVTE. In D-dimer kit with high FDP/D-dimer ratio, FDP/D-dimer ratios in patients with thrombosis was significantly higher than that in patients without thrombosis. Conclusion All three D-dimer kits show utility for detecting thrombotic diseases. However, the D-dimer levels determined using the kits varied due to differences in the FDP/D-dimer ratio. In combination with the FDP level, a D-dimer kit with a high FDP/D-dimer ratio may be useful.

scholarly journals Challenges and Opportunities from Targeting Inflammatory Responses to SARS-CoV-2 Infection: A Narrative Review

2020 ◽  
Vol 9 (12) ◽  
pp. 4021
Author(s):  
Vincenzo Lariccia ◽  
Simona Magi ◽  
Tiziano Serfilippi ◽  
Marwa Toujani ◽  
Santo Gratteri ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
Early Stage ◽  
Clinical Care ◽  
Current Evidence ◽  
Global Pandemic ◽  
Challenges And Opportunities ◽  
Inflammatory Processes ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Novel Coronavirus

The novel coronavirus disease 2019 (COVID-19) is a global pandemic that continues to sweep across the world, posing an urgent need for effective therapies and prevention of the spread of the severe acute respiratory syndrome related to coronavirus-2 (SARS-CoV-2). A major hypothesis that is currently guiding research and clinical care posits that an excessive and uncontrolled surge of pro-inflammatory cytokines (the so-called “cytokine storm”) drives morbidity and mortality in the most severe cases. In the overall efforts made to develop effective and safe therapies (including vaccines) for COVID-19, clinicians are thus repurposing ready-to-use drugs with direct or indirect anti-inflammatory and immunomodulatory activities. Speculatively, there are many opportunities and challenges in targeting immune/inflammatory processes in the evolving settings of COVID-19 disease because of the need to safely balance the fight against virus and aggressive inflammation versus the suppression of host immune defenses and the risk of additional harms in already compromised patients. To this end, many studies are globally underway to weigh the pros and cons of tailoring drugs used for inflammatory-driven conditions to COVID-19 patient care, and the next step will be to summarize the growing clinical trial experience into clean clinical practice. Based on the current evidence, anti-inflammatory drugs should be considered as complementary approaches to anti-viral drugs that need to be timely introduced in the management of COVID-19 according to disease severity. While drugs that target SARS-CoV-2 entry or replication are expected to confer the greatest benefits at the early stage of the infection, anti-inflammatory drugs would be more effective in limiting the inflammatory processes that drive the worsening of the disease.

scholarly journals A rare case of co-occurrence of pulmonary embolism and left ventricular thrombus in a patient with COVID-19

2020 ◽  
Vol 8 ◽  
pp. 2050313X2097453
Author(s):  
Iyad Farouji ◽  
Kok Hoe Chan ◽  
Rushdy Abanoub ◽  
Gunwant Guron ◽  
Jihad Slim ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Severe Acute Respiratory Syndrome ◽  
Arterial Thrombosis ◽  
Rare Case ◽  
Left Ventricular ◽  
Significant Morbidity ◽  
Disease Manifestation ◽  
Ventricular Thrombus ◽  
Global Pandemic

The global pandemic of severe acute respiratory syndrome coronavirus 2 has caused significant morbidity and mortality, not only causing devastating lung injury but also has an enormous effect on the cardiovascular system. The hypercoagulable state associated with coronavirus 2019 plays a major role in the disease manifestation. Venous thromboembolism including pulmonary embolism remains the most common thrombotic manifestation of the disease as compared to arterial thrombosis. Nonetheless, the co-occurrence of both venous and arterial thrombosis in a coronavirus 2019 patient, to our knowledge, has rarely been reported. Herein, we are presenting a case of co-occurrence of left ventricular thrombosis with pulmonary embolism in the setting of coronavirus 2019 with successful treatment with apixaban.

Endothelium, venous thromboembolism and ischaemic cardiovascular events

2010 ◽  
Vol 103 (01) ◽  
pp. 56-61 ◽  
Author(s):  
Stefania Momi ◽  
Rino Migliacci ◽  
Paolo Gresele
Keyword(s):  
Venous Thromboembolism ◽  
Arterial Thrombosis ◽  
Cardiovascular Events ◽  
Clinical Observation ◽  
Pathophysiological Mechanism ◽  
Clinical Observations ◽  
The Common ◽  
Clinical Conditions

SummaryThe association between venous thromboembolism and arterial thrombosis has emerged as consistent clinical observation in the last few years. While several experimental, epidemiological and pharmacologic studies support this association, the initial pathophysiological mechanism linking these two clinical conditions remains to be established. This review discusses the pathophysiological bases and a number of experimental and clinical observations suggesting that the common link between venous thromboembolism and arterial thrombosis is represented by a dysfunctional endothelium.

Sign in / Sign up

Export Citation Format

Share Document