Antithrombotic therapy in patients with Covid-19

Laura Norkutė1, Greta Gujytė1 

1 Lithuanian University of Health Sciences,  Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania


Since thrombosis is common in patients with severe or critical Covid-19 (Coronavirus disease 2019) and its manifestations like venous thromboembolism (VTE), both venous and arterial thrombosis are prevalent in this condition. It is usually accompanied by endothelial injuries and diffuse microvascular thrombosis which is caused by pro-inflammatory cytokines storm. Unfortunately, there is no verified and proven effective pharmacotherapy for novel SARS-CoV-2 infection. Beside observations and clinical trials, patophysiological investigations and initial epidemiological data did lead to enthusiasm for anticoagulant therapy, which seems to be associated with better outcomes in moderate and severe SARS-CoV-19 patients with signs of coagulopathy and in those requiring mechanical ventilation. It is assumed that patophiosiology of the prothrombotic state, elicited by SARS-CoV-2 presents possibly protective antithrombotic therapy mechanisms for this viral infection. The antiplatelet/anticoagulant therapy indications are guided by the clinical context and the Covid disease severity. This article suggests a practical approach on antithrombotic therapy management for SARS-CoV-2 patients from a multidisciplinary perspective.

Aim: to analyze scietific literature and provide a review of literature related to the antithrombotic treatment in patients with Covid-19.

Methods: literature review and data collection sources were selected from PubMed, UpToDate and Cochrane Library scientific databases, following dates from 2019 to 2021, using original language key words: “antithrombotic therapy and thrombosis in Covid-19”, “Covid-19 antithrombotic evaluation”, “antithrombotic therapy to complications of Covid-19”, “antiplatelets in severe Covid-19 pneumonia”, “coagulopathy ”.

Keywords: SARS-CoV-2, anticoagulant therapy, thrombosis, coagulopathy, antiplatelets.