Page, EM and Ariëns, RAS (2021) Mechanisms of thrombosis and cardiovascular complications in COVID-19. Thrombosis Research, 200. pp. 1-8. ISSN 0049-3848
Abstract
Background
The novel coronavirus SARS-CoV-2, responsible for the 2019–2020 global (COVID-19) pandemic, is a respiratory virus associated with the development of thromboembolic complications and respiratory failure in severe cases. Increased risk of pulmonary embolism and thrombosis has been identified in COVID-19 patients, alongside accompanying elevations in potential prognostic biomarkers, including D-dimer, IL-6 and cardiac specific troponins. Our aim was to provide a scoping review of the available literature regarding thrombosis risk, other cardiovascular implications, and their biomarkers in COVID-19 to highlight potential disease mechanisms.
Methods
Authors conducted a literature search in PubMed using MeSH headings “disseminated intravascular coagulation”, “pulmonary embolism”, “thromb*”, “stroke”, “myocardial infarction” and “acute lung injury”, as well as terms “COVID-19”, “SARS-CoV-2”, “2019 novel coronavirus” and “2019-nCoV”.
Results and conclusions
COVID-19 disease is characterised by the interactions between hyperactive coagulation and complement systems – induced by hyper-inflammatory conditions, resulting in a pro-thrombotic state and diffuse tissue injury. There are several promising prognostic markers of disease severity, with D-dimer the most significant. The presence of thrombocytopenia appears to be a key indicator of patient deterioration.
Further research is required to understand the underlying pathophysiology in COVID-19 and its implications in disease progression and patient management. Randomised trials are urgently needed to determine the safety of proposed therapeutic anticoagulation with heparin and the role for anti-platelet agents, such as Ticagrelor, in patient management.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 Elsevier Ltd. All rights reserved. This is an author produced version of an article published in Thrombosis Research. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | SARS-CoV-2; COVID-19; Thromboembolism; Cardiovascular complications; D-dimer |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Discovery & Translational Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 23 Jun 2021 15:19 |
Last Modified: | 17 Jan 2022 01:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.thromres.2021.01.005 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:175487 |