Supervisors info:
Αργυρή Γιαλεράκη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Στυλιανή Κοκόρη, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μαριάννα Πολίτου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
COVID-19, which is responsible for an unprecedented health crisis with significant health, social and economic consequences, is caused by the emerging coronavirus of Severe Acute Respiratory Syndrome 2 (SARS-CoV-2), which belongs to the Sars family.
It is now well established that it predisposes to arterial and venous thrombotic complications, possibly due to excessive inflammation, coagulopathy, immobilization, and in later stages, disseminated intravascular coagulation, facts that further support the consolidation of the theory that COVID-19 is a coagulation disorder.
Several prognostic factors for venous thromboembolism have been identified. Factors reported are older age, higher D-dimers, lower lymphocyte counts and prolonged aPTT, and associated with a higher risk of thrombotic events.
Although a wealth of guidelines and documents have been published quickly, given the urgency of the pandemic, a large number of reputable publications from reliable centers as well as official referrals from medical companies in various countries, suggest anticoagulant management strategies in different environments (outpatients, hospitalized, after discharge). However, the optimal thromboprophylaxis strategy is not uniform among the various proposed protocols.
Anticoagulant therapies were among the first to be evaluated in clinical trials to improve outcomes for patients with mild, moderate, or critical illness treated with COVID-19 at home, in a shared ward, or in an intensive care unit. These studies have so far yielded mixed findings, ranging from the beneficial effects of prophylactic or therapeutic doses of anticoagulants to no difference between their therapeutic and prophylactic intense. Few are the studies that deal with the use of antiplatelet drugs, and even in co-administration with anticoagulant therapy, as opposed to the use of anticoagulants for either prophylactic or therapeutic action. The main cause of this inequality is the well-established knowledge and widespread use of anticoagulants, especially low molecular weight heparin in thromboprophylaxis and treatment.
The aim of the present study is a systematic literature review of COVID-19 related to the disorders of the disease, and the prophylactic and therapeutic anticoagulant or antiplatelet therapy administered to these patients.
Keywords:
Covid-19, Sars-Cov-2, Antiplatelet treatment, Anticoagulation, Thromboprophylaxis
