How to Manage the Thrombotic Complications in COVID-19?

Coronavirus disease is caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health problem. The infection has taken a great toll on the death rates. The pathophysiology and the management of the global pandemic are ever-evolving. There is multisystem involvement in the COVID 19 disease spectrum.  Endothelial injury and cytokines in the COVID19 infection may lead to activation of the coagulation pathways leading to thromboembolic events. Here is the need to discuss the pathophysiology, diagnosis, and management of Thromboembolism complications in COVID19. This preprint article discusses the symptoms, diagnosis, and treatment of VTE in COVID 19 patients.

Studies have reported a higher incidence of thrombotic complications in critically ill patients. Venous thromboembolism (VTE) is a condition in which the blood clots most often in the deep veins of the body and travels in circulation lodging in lungs known as Pulmonary Embolism. All patients admitted with severe or moderate COVID19 have a higher clinical suspicion of Venous Thromboembolism (VTE). The symptoms to look for in the COVID patients are as follows: worsening tachypnea decreased O2 concentration saturation <90%, Increasing supplementation O2 requirement, worsening of COVID 19 pneumonia, unilateral worsening limb pain, or edema. I

maging studies are required for a definitive diagnosis of VTE. This needs further diagnostic tests as follows: CBC, D-dimer PT, PTT, fibrinogen, ferritin, LDH, CPK, CK. Imaging can also be taken into consideration DVT and CT pulmonary angiography (CT-PA). Prophylactic anticoagulation is recommended for all patients(critical or noncritical) admitted with moderate or severe COVID 19. Heparin has protective effects on the endothelium. The use of heparin not only has an anticoagulant effect but also an anti-inflammatory effect which may be beneficial to COVID19 patients.

Ref link: https://pubmed.ncbi.nlm.nih.gov/32803670/