Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, 1 place de l'Hôpital, 67000, Strasbourg, France.
INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, 67000, Strasbourg, France.
J Thromb Thrombolysis. 2020 Nov;50(4):799-808. doi: 10.1007/s11239-020-02231-3.
A common and potent consideration has recently entered the landscape of the novel coronavirus disease of 2019 (COVID-19): venous thromboembolism (VTE). COVID-19 has been associated to a distinctive related coagulopathy that shows unique characteristics. The research community has risen to the challenges posed by this « evolving COVID-19 coagulopathy » and has made unprecedented efforts to promptly address its distinct characteristics. In such difficult time, both national and international societies of thrombosis and hemostasis released prompt and timely responses to guide recognition and management of COVID-19-related coagulopathy. However, latest guidelines released by the international Society on Thrombosis and Haemostasis (ISTH) on May 27, 2020, followed the American College of Chest Physicians (CHEST) on June 2, 2020 showed some discrepancies regarding thromboprophylaxis use. In this forum article, we would like to offer an updated focus on thromboprophylaxis with current incidence of VTE in ICU and non-ICU patients according to recent published studies; highlight the main differences regarding ISTH and CHEST guidelines; summarize and describe which are the key ongoing RCTs testing different anticoagulation strategies in patients with COVID-19; and finally set a proposal for COVID-19 coagulopathy specific risk factors and dedicated trials.
静脉血栓栓塞症（VTE）已成为 2019 年新型冠状病毒病（COVID-19）的一个重要问题。COVID-19 相关的凝血功能障碍具有独特的特征，这一问题已经引起了研究界的关注。研究人员针对这种“不断演变的 COVID-19 凝血功能障碍”带来的挑战做出了前所未有的努力，及时解决了其独特的特征。在这困难时期，血栓形成和止血领域的国内外学会迅速做出回应，及时发布指南，以指导 COVID-19 相关凝血功能障碍的识别和管理。然而，国际血栓形成和止血学会（ISTH）于 2020 年 5 月 27 日发布的最新指南与美国胸科医师学会（CHEST）于 2020 年 6 月 2 日发布的指南在关于抗栓治疗的应用方面存在一些差异。在本论坛文章中，我们将根据最近发表的研究，重点介绍 ICU 和非 ICU 患者中 VTE 的最新发生率，讨论 ISTH 和 CHEST 指南之间的主要差异，总结和描述正在进行的 RCT 中针对 COVID-19 患者不同抗凝策略的试验，并提出 COVID-19 凝血功能障碍的特定危险因素和专门的临床试验的建议。
