Jenneke Leentjens, Saskia Middeldorp, and colleagues, published a review on the current knowledge of COVID-19 associated coagulopathy and the role of antithrombotic therapies in the Lancet Haematology.
COVID-19 is associated with a high incidence of thrombotic complications, which can be explained by the complex and unique interplay between coronaviruses and endothelial cells, the local and systemic inflammatory response, and the coagulation system. Empirically, often an intensified dose of pharmacological thrombosis prophylaxis is being used in patients admitted to hospital with COVID-19. Several guidelines on this topic have been published, with varying and weak recommendations as a result of the lack of high quality and direct evidence .
In this viewpoint they summarize the pathophysiology of COVID-19 coagulopathy in the clinical context of patients, i.e. those who are ambulant, admitted to hospital (critically ill or non-critically ill), and those post-discharge from hospital. The researchers also review data from emerging randomized controlled trials in the past year of antithrombotic therapy in COVID-19 patients, and they focus on the unique international collaboration in large platform trials that have yielded the first high quality data that guide clinicians to optimize anticoagulant prophylaxis and to treat COVID-associated coagulopathy. The first-ever trial in non-critically ill patients who were admitted to hospital has shown that a therapeutic dose of low-molecular-weight heparin might improve clinical outcomes in this population. In critically ill patients, this same treatment does not improve outcomes and prophylactic dose thromboprophylaxis is recommended. In the upcoming months they expect numerous data from the ongoing antithrombotic COVID-19 studies to guide clinicians at different stages of the disease.
Related news items
New ultra-high field MRI system available for Radboudumc and Radboud University10 June 2021
Recently, the Hahn institute in Essen has received a new heart: a 20-ton ultra-high-field MRI scanner from Siemens Healthcare with a magnetic field strength of 7 Tesla. The new CE-approved scanner is ready for business, and projects on body and brain imaging are starting up.read more
On the prevalence of cerebral amyloid angiopathy a systematic review and meta-analysis10 June 2021
Published in ‘Alzheimers and Dementia’, researchers at Radboudumc performed a systematic review and meta-analysis on the prevalence of Cerebral Amyloid Angiopathy. They scrutinized and analyzed 170 publications, comprising publications using either a neuroimaging or a neuropathological approach.read more
Retina-on-chip modeling and treating eye diseases in a dish10 June 2021
Alex Garanto, together with Anneke den Hollander and Andries van der Meer (UTwente) have received 1,17M€ to develop a retina-on-chip model to improve our understanding in eye diseases and to develop treatments against them.read more
A tipping point in cancer-immune dynamics leads to divergent immunotherapy responses8 June 2021
Jeroen Creemers and Johannes Textor published in the Journal for ImmunoTherapy of Cancer that a tipping point in cancer-immune dynamics leads to divergent immunotherapy responses and hampers biomarker discovery.read more
New method to prevent ovarian cancer increases quality of life8 June 2021
Researchers at Radboudumc have shown that quality of life is better in women with a BRCA1 or BRCA2 mutation after fallopian tube removal with delayed ovarian removal to prevent ovarian cancer.read more