Catholic Health System, SUNY at Buffalo, Buffalo, New York, United States.
Medical Radiation Sciences Research Group, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Med Sci. 2021 Jan;46(1):1-14. doi: 10.30476/ijms.2020.87233.1730.
Since the emergence of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic, an increasing number of reports and studies have tried to warn the medical community about the thrombotic complications of coronavirus disease 2019 (COVID-19). It is suggested that the hyperinflammatory response and endothelial injury, especially in patients with severe disease, lead to a hypercoagulable state. Sudden deaths occurring in some patients also point to fulminant arrhythmias and massive pulmonary embolism (PE). Several expert panels have published recommendations regarding the prophylaxis and treatment of such complications. Nonetheless, there are limited high-quality studies for evidence-based decision-making, and most of these recommendations have arisen from descriptive studies, and optimal anticoagulant agents and dosages are yet to be designated. The coagulopathy persists after the acute phase of the illness, and some panels recommend the continuation of deep vein thrombosis prophylaxis for several days after regaining the normal daily activities by the patient. Here, we review the incidence and possible mechanisms of thrombotic complications, and present a summary of the considerations for the prophylaxis and treatment of such complications in the adult population.
自严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）大流行出现以来，越来越多的报告和研究试图警告医学界注意 2019 年冠状病毒病（COVID-19）的血栓并发症。据认为，过度炎症反应和内皮损伤，特别是在重症患者中，导致高凝状态。一些患者的突然死亡也表明存在暴发性心律失常和大量肺栓塞（PE）。几个专家小组已经发布了关于此类并发症预防和治疗的建议。然而，由于缺乏高质量的研究来进行循证决策，因此大多数建议都是基于描述性研究提出的，并且尚未指定最佳的抗凝剂和剂量。在疾病的急性期后，凝血功能障碍仍然存在，一些小组建议在患者恢复正常日常活动后，继续进行深静脉血栓形成预防几天。在这里，我们回顾了血栓并发症的发生率和可能的发生机制，并总结了在成年人群中预防和治疗此类并发症的注意事项。
