Pharmacotherapy for Prevention and Management of Thrombosis in COVID-19

Coronavirus disease-2019 (COVID-19) is an acute viral syndrome caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has resulted in a global pandemic.[ 1 ] [ 2 ] The disease can affect a multitude of organ systems in the body.[ 3 ] Dysregulation of hemostatic pathways, evidenced by laboratory and clinical data, plays an important role in morbidity and mortality related to COVID-19. Various forms of thrombosis, from thrombotic microangiopathy to large-vessel thrombosis in the venous system (deep vein thrombosis, splanchnic vein thrombosis, pulmonary embolism) or the arterial system (including acute myocardial infarction, ischemic stroke, and acute limb ischemia), have been described.[ 4 ] However, existing epidemiological studies suggest that venous thromboembolism (VTE) is the predominant form of thrombotic events, with reported rates in the literature being variable between 7% up to more than 80% (upon routine screening of critically ill patients).[ 5 ] [ 6 ] [ 7 ] In this setting, the optimal strategies for prevention of thrombotic events and choice of antithrombotic agents for management of pre-existing or new thrombotic events in patients with COVID-19 are of utmost importance. Herein, we provide a succinct summary of potential pharmacological options for the treatment and prevention of thrombosis in patients with COVID-19. Publication History Article published online: 20 August 2020 © 2020. Thieme. All rights reserved. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.