Thromboprophylaxis in COVID-19 - Rationale and considerations

Adv Biol Regul. 2021 Aug:81:100819. doi: 10.1016/j.jbior.2021.100819. Epub 2021 Jul 23.

Abstract

The Corona Virus Disease-2019 (COVID-19) pandemic is associated with a very high incidence of thrombotic complications. The exact mechanisms for this excess risk for clots have not been elucidated although one of the often-quoted pathophysiological entity is immunothrombosis. Recognition of thrombotic complications early on in this pandemic led to an over-explosion of studies which looked at the benefits of anticoagulation to mitigate this risk. In this review, we examine the rationale for thromboprophylaxis in COVID-19 with particular reference to dosing and discuss what may guide the decision-making process to consider anticoagulation. In addition, we explore the rationale for thrombosis prevention measures in special populations including outpatient setting, pregnant females, children, those with high body mass index and those on extracorporeal membrane oxygenation.

Keywords: COVID-19; Corona virus; Heparin; Thromboprophylaxis; Thrombosis.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • COVID-19 / complications
  • COVID-19 / epidemiology
  • COVID-19 / therapy*
  • Clinical Decision-Making
  • Extracorporeal Membrane Oxygenation*
  • Humans
  • SARS-CoV-2*
  • Thrombosis / epidemiology
  • Thrombosis / etiology
  • Thrombosis / prevention & control*

Substances

  • Anticoagulants