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Review
. 2021 Apr;51(3):642-648.
doi: 10.1007/s11239-020-02242-0.

Anticoagulant treatment in COVID-19: a narrative review

Vincenzo Carfora #  1 , Giorgio Spiniello #  1 , Riccardo Ricciolino  1 , Marco Di Mauro  1 , Marco Giuseppe Migliaccio  1 , Filiberto Fausto Mottola  1 , Nicoletta Verde  1 , Nicola Coppola  2 ; Vanvitelli COVID-19 group
Collaborators, Affiliations
Free PMC article
Review

Anticoagulant treatment in COVID-19: a narrative review

Vincenzo Carfora et al. J Thromb Thrombolysis. 2021 Apr.
Free PMC article

Abstract

The 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.

Keywords: Anticoagulation; COVID-19; SARS-CoV-2; Thrombosis.

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