Potential use of plants and their extracts in the treatment of coagulation disorders in COVID-19 disease: a narrative review

Coronavirus disease, i.e., COVID-19, is caused by the virus called “severe acute respiratory coronavirus 2 (SARS-CoV-2)”. Infection induces predominantly respiratory illness but is associated with coagulation disorders which play an important role in the pathogenesis, clinical , and outcome of the disease. The treatment of hemostasis disorders of COVID-19 patients a difficult problem to solve. For example, heparin is quite effective drug in reducing mortality in severe -19 forms but not able to prevent venous and arterial thromboembolic complications. Moreover, therapy with heparin is associated with several adverse reactions, such as thrombocytopenia, , hypoaldosteronism and hypersensitivity reactions. New alternative anticoagulant molecules be obtained from plants which are rich in polyphenols and flavonoids. These compounds, besides being antioxidants, also possess anti-inflammatory effect and, because able to inhibit the activity of many , including serine proteases, also anticoagulant properties. The purpose of this narrative review to provide an overview of current literature data on coagulation disorders associated with COVID-19 and of the anticoagulant activity of plants and their extracts in order to evaluate their possible clinical as alternative sources of novel molecules with anticoagulant and antithrombotic activity for the of coagulation disorders in patients with COVID-19.