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Erschienen in: Journal of General Internal Medicine 9/2020

17.06.2020 | COVID-19 | Review Paper Zur Zeit gratis

Antithrombotic Therapies in COVID-19 Disease: a Systematic Review

verfasst von: MD Edward Maldonado, MD Derrick Tao, MD, MPP Katherine Mackey

Erschienen in: Journal of General Internal Medicine | Ausgabe 9/2020

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Abstract

Background

Infection with coronavirus SARS-CoV-2, causing COVID-19 disease, leads to inflammation and a prothrombotic state.

Objective

This rapid systematic review aims to synthesize evidence on thromboembolism incidence and outcomes with antithrombotic therapies in COVID-19.

Data Sources

We searched MEDLINE (Ovid), Cochrane Rapid Reviews, PROSPERO, and the WHO COVID-19 Database from January 1, 2003, to April 22, 2020, for studies meeting pre-specified inclusion criteria.

Study Selection, Data Extraction, and Synthesis

One investigator identified articles for inclusion, abstracted data, and performed quality assessment, with second reviewer checking.

Results

Incidence of thromboembolism among hospitalized patients with COVID-19 ranged from 25 to 53% in 4 retrospective series. We identified 3 studies (1 retrospective cohort study, 1 prospective uncontrolled observational study, and 1 case series) examining outcomes among COVID-19 patients who received antithrombotic therapies. These studies all included different interventions (thromboprophylaxis with unfractionated heparin (UFH) or low molecular-weight heparin (LMWH); an intensive thromboprophylaxis protocol with LMWH, antithrombin, and clopidogrel; and salvage therapy with tissue plasminogen activator and heparin). These studies are overall poor quality due to methodological limitations including unclear patient selection protocols, lack of reporting or adjustment for patient baseline characteristics, inadequate duration of follow-up, and partial reporting of outcomes.

Conclusions

New evidence on thromboembolism in COVID-19 does not warrant a change in current guidance on thromboprophylaxis among hospitalized patients. Prospective trials of antithrombotic treatment strategies among patients with COVID-19 are urgently needed.
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Metadaten
Titel
Antithrombotic Therapies in COVID-19 Disease: a Systematic Review
verfasst von
MD Edward Maldonado
MD Derrick Tao
MD, MPP Katherine Mackey
Publikationsdatum
17.06.2020
Verlag
Springer International Publishing
Erschienen in
Journal of General Internal Medicine / Ausgabe 9/2020
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-020-05906-y

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