COVID-19 Thrombotic Complications and Therapeutic Strategies.

IF 15.1 1区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Annual review of medicine Pub Date : 2023-01-27 DOI:10.1146/annurev-med-042921-110257

Alexander C Fanaroff, Renato D Lopes

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引用次数: 3

Abstract

Shortly after the emergence of coronavirus disease 2019 (COVID-19) in late 2019, clinicians rapidly recognized an apparent association between the disease and both arterial and venous thrombotic complications, which was confirmed in epidemiologic studies. Based on these data, hospitals empirically developed and implemented protocols with different strategies for anticoagulation of hospitalized COVID-19 patients. Subsequent randomized controlled trials (RCTs) clarified the role of anticoagulation in patients hospitalized with COVID-19 and recently discharged from the hospital. In this review, we discuss the epidemiology and pathophysiology of thrombosis in patients with COVID-19, observational comparative effectiveness analyses that provided hints of a benefit from anticoagulation, and finally the RCTs that established which patients with COVID-19 benefit from treatment-dose anticoagulation. These RCTs have demonstrated that hospitalized, noncritically ill patients with COVID-19 benefit from treatment-dose anticoagulation, but patients who are hospitalized and critically ill, discharged from the hospital, or not hospitalized do not benefit.

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COVID-19血栓形成并发症和治疗策略。

2019年底，在2019冠状病毒病(COVID-19)出现后不久，临床医生迅速认识到该疾病与动脉和静脉血栓形成并发症之间存在明显关联，这在流行病学研究中得到了证实。根据这些数据，医院经验性地制定和实施了不同策略的COVID-19住院患者抗凝治疗方案。随后的随机对照试验(RCTs)明确了抗凝治疗在COVID-19住院和近期出院患者中的作用。在这篇综述中，我们讨论了COVID-19患者血栓形成的流行病学和病理生理，观察性比较疗效分析提供了抗凝治疗获益的线索，最后确定了哪些COVID-19患者从治疗剂量抗凝治疗中获益的随机对照试验。这些随机对照试验表明，住院的COVID-19非危重患者受益于治疗剂量的抗凝治疗，但住院和危重患者、出院或未住院的患者没有受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Annual review of medicine 医学-医学：内科

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24.90

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0.00%

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期刊介绍： The Annual Review of Medicine, which has been published since 1950, focuses on important advancements in diverse areas of medicine. These include AIDS/HIV, cardiology, clinical pharmacology, dermatology, endocrinology/metabolism, gastroenterology, genetics, immunology, infectious disease, neurology, oncology/hematology, pediatrics, psychiatry, pulmonology, reproductive medicine, and surgery. The journal's current volume has transitioned from a gated access model to an open access model through the Annual Reviews' Subscribe to Open program. All articles published in the journal are now available under a CC BY license.

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