A pilot study on the impact of congenital thrombophilia in COVID‐19

Morena‐Barrio, María Eugenia de la; Bravo-Pérez, Carlos; Morena-Barrio, Belén de la; Orlando, Christelle; Cifuentes, Rosa; Padilla, José; Miñano, Antonia; Herrero, Sonia; Marcellini, Shally; Revilla, Nuria; Bernal, Enrique; Gómez-Verdú, José-Miguel; Jochmans, Kristin; Herranz, María Teresa; Vicente, Vicente; Corral, Javier; Lozano, Marı́a Luisa

doi:10.1111/eci.13546

Cited by 22 publications

(28 citation statements)

References 16 publications

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“…They state that the possible explanation for the low incidence rate of thrombosis in thrombophilia patients may be related to the fact that these patients were already treated with anticoagulant drugs before the infection or at the very early stages of the disease. 6 Previous findings 3 also support that long-term anticoagulation at admission appears to protect COVID-19 patients from VTE.…”

Section: Introductionmentioning

confidence: 63%

High Risk of Venous Thrombosis Recurrence in Fully Anticoagulated Patient with Antithrombin Deficiency during COVID-19: A Case Report

Kovač

Marković

Lalic-Cosic

et al. 2021

IJCDW

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Coagulation dysfunction is a serious issue in patients with Coronavirus disease-19 (COVID-19). With regard to recently published studies, a high number of patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 developed life-threatening thrombotic complications despite anticoagulation. We report a case of young woman with the type-II heparin-binding site (HBS) antithrombin (AT) deficiency (Budapest 3-homozygous), who developed acute deep vein thrombosis on two occasions due to COVID-19 infection in the course of stable anticoagulation with vitamin K antagonist. The first thrombotic event was observed during mild COVID-19 infection, while the second thrombotic event she developed 2 months after she was negative for severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2). Our case highlights the complexity of the treatment in this particular type of thrombophilia and the need for precaution even in mild forms of viral infection. In the treatment of acute thrombosis, AT-deficient patients may benefit from the use of AT concentrate along with low-molecular weight heparin (LMWH), while in cases of type II-HBS, AT supplementation is mandatory.

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Section: Introductionmentioning

confidence: 63%

High Risk of Venous Thrombosis Recurrence in Fully Anticoagulated Patient with Antithrombin Deficiency during COVID-19: A Case Report

Kovač

Marković

Lalic-Cosic

et al. 2021

IJCDW

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“…[26][27][28] Although a relatively high proportion of congenital thrombophilia was previously detected in a small pilot study of 87 Covid-19 patients, the minimal sample size precluded any robust inference. 29 We analyzed rich linked data combining extensive community SARS-CoV-2 testing, well-recorded vaccination status, ambulatory and hospital-based clinical outcomes, as well as large scale genotyping data readily available for UKBB participants. The results of this analysis have many noteworthy implications.…”

Section: Discussionmentioning

confidence: 99%

“…26–28 Although a relatively high proportion of congenital thrombophilia was previously detected in a small pilot study of 87 Covid-19 patients, the minimal sample size precluded any robust inference. 29…”

Section: Discussionmentioning

confidence: 99%

Venous Thromboembolism in Ambulatory Covid-19 patients: Clinical and Genetic Determinants

Xie

Prats‐Uribe

et al. 2022

Preprint

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Background Substantial evidence suggests that severe Covid-19 leads to an increased risk of Venous Thromboembolism (VTE). We aimed to quantify the risk of VTE associated with ambulatory Covid-19, study the potential protective role of vaccination, and establish key clinical and genetic determinants of post-Covid VTE. Methods We analyzed a cohort of ambulatory Covid-19 patients from UK Biobank, and compared their 30-day VTE risk with propensity-score-matched non-infected participants. We fitted multivariable models to study the associations between age, sex, ethnicity, socio-economic status, obesity, vaccination status and inherited thrombophilia with post-Covid VTE. Results Overall, VTE risk was nearly 20-fold higher in Covid-19 vs matched non-infected participants (hazard ratio [HR] 19.49, 95% confidence interval [CI] 11.50 to 33.05). However, the risk was substantially attenuated amongst the vaccinated (HR: 2.79, 95% CI 0.82 to 9.54). Older age, male sex, and obesity were independently associated with higher risk, with adjusted HRs of 2.00 (1.61 to 2.47) per 10 years, 1.66 (1.28 to 2.15), and 1.85 (1.29 to 2.64), respectively. Further, inherited thrombophilia led to an HR 2.05, 95% CI 1.15 to 3.66. Conclusions Ambulatory Covid-19 was associated with a striking 20-fold increase in incident VTE, but no elevated risk after breakthrough infection in the fully vaccinated. Older age, male sex, and obesity were clinical determinants of Covid-19-related VTE. Additionally, inherited thrombophilia doubled risk further, comparable to the effect of 10-year ageing. These findings reinforce the need for vaccination, and call for targeted strategies to prevent VTE during outpatient care of Covid-19

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“…A study conducted by de la Morena-Barrio et al [ 99 ] on the involvement of hereditary thrombophilia in COVID-19 revealed that most patients with severe thrombophilia did not have thrombotic events during SARS-CoV-2 infection. The authors considered that the reason why the hypercoagulability condition did not lead to the development of new thrombotic episodes was related to the fact that these patients were already being treated with anticoagulant drugs before COVID-19 or at the beginning of the disease.…”

Section: A Closer Look At the Correlation With Covid-19mentioning

confidence: 99%

“…The authors considered that the reason why the hypercoagulability condition did not lead to the development of new thrombotic episodes was related to the fact that these patients were already being treated with anticoagulant drugs before COVID-19 or at the beginning of the disease. In this context, long-term anticoagulation treatment at admission appears to protect patients with COVID-19 from the development of thrombosis [ 99 ].…”

Section: A Closer Look At the Correlation With Covid-19mentioning

confidence: 99%

Hereditary Thrombophilia in the Era of COVID-19

Bădulescu

Sîrbu²,

Filip³

et al. 2022

Healthcare

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Thrombophilia, also called hypercoagulability or prothrombotic condition, usually reflects a certain imbalance that occurs either in the coagulation cascade or in the anticoagulation/fibrinolytic system. A similar imbalance may be induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thrombotic complications are associated with multiorgan failure and increased mortality. In this context, activation of coagulation and thrombocytopenia appeared as prognostic markers in COVID-19. Our work provides a structured and updated analysis of inherited thrombophilia and its involvement in COVID-19, emphasizing the importance of diagnosing and initiating thromboprophylaxis. Since the state of hypercoagulation is directly correlated with COVID-19, we consider that studies on the genetic profiles of proteins involved in thrombophilia in patients who have had COVID-19 and thrombotic events are of great importance, both in treating and in preventing deaths due to COVID-19.

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A pilot study on the impact of congenital thrombophilia in COVID‐19

Cited by 22 publications

References 16 publications

High Risk of Venous Thrombosis Recurrence in Fully Anticoagulated Patient with Antithrombin Deficiency during COVID-19: A Case Report

High Risk of Venous Thrombosis Recurrence in Fully Anticoagulated Patient with Antithrombin Deficiency during COVID-19: A Case Report

Venous Thromboembolism in Ambulatory Covid-19 patients: Clinical and Genetic Determinants

Hereditary Thrombophilia in the Era of COVID-19

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