2020
DOI: 10.1002/rth2.12406
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Antiviral anticoagulation

Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a novel envelope virus that causes coronavirus disease 2019 (COVID‐19). Hallmarks of COVID‐19 are a puzzling form of thrombophilia that has elevated D‐dimer but only modest effects on other parameters of coagulopathy. This is combined with severe inflammation, often leading to acute respiratory distress and possible lethality. Coagulopathy and inflammation are interconnected by the transmembrane receptor, tissue factor (TF), which initiates blood … Show more

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Cited by 13 publications
(11 citation statements)
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References 177 publications
(336 reference statements)
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“…In this direction, factor Xa (FXa), a serine protease in the common coagulation pathway, is known to play a crucial role in coagulation by inducing the formation of thrombin, which eventually leads to the formation of cross-linked blood clots [ 9 11 ]. FXa has also been linked to inflammation [ 12 ] and viral infections [ 13 ]. In fact, direct FXa inhibitors have been reported to promote a host of pharmacological effects, including anticoagulant activity, anti-inflammatory activity, and antiviral activity (Fig.…”
Section: Introductionmentioning
confidence: 99%
“…In this direction, factor Xa (FXa), a serine protease in the common coagulation pathway, is known to play a crucial role in coagulation by inducing the formation of thrombin, which eventually leads to the formation of cross-linked blood clots [ 9 11 ]. FXa has also been linked to inflammation [ 12 ] and viral infections [ 13 ]. In fact, direct FXa inhibitors have been reported to promote a host of pharmacological effects, including anticoagulant activity, anti-inflammatory activity, and antiviral activity (Fig.…”
Section: Introductionmentioning
confidence: 99%
“…Therefore, for patients regularly assuming DOACs, clinicians have recommended to replace DOACs with heparin to avoid drug–drug interactions (Testa et al, 2020 ). However, in COVID-19 patients, the coagulation function is heavily unbalanced leading to hypercoagulation and the development of life-threatening coagulopathies, which may negatively affect the prognosis (Han et al, 2020 ; Pryzdial et al, 2020 ). Indeed, the alteration of blood clotting and inflammation are two frequently coupled manifestations of viral infections.…”
Section: Resultsmentioning
confidence: 99%
“…Indeed, the alteration of blood clotting and inflammation are two frequently coupled manifestations of viral infections. Therefore, DOACs such as apixaban have shown an antiviral activity on herpes simplex virus type 1 and have been proposed as a possible therapeutic strategy to control COVID-19 (Pryzdial et al, 2020 ).…”
Section: Resultsmentioning
confidence: 99%
“…35 The thrombopathy may be a response to direct virus-induced damage to vascular endothelial cells 64 and/or the virus acquiring TF from host cells, both triggering coagulation activation. 50,52,53,71…”
Section: Does Complement Activation Trigger Venous Thromboembolism mentioning
confidence: 99%
“…Although many of these patients have elevated D‐dimer and fibrinogen, they also commonly have increased C‐reactive protein and IL‐6, consistent with a vigorous inflammatory response 35 . The thrombopathy may be a response to direct virus‐induced damage to vascular endothelial cells 64 and/or the virus acquiring TF from host cells, both triggering coagulation activation 50,52,53,71 . However, it is also possible that complement contributes.…”
Section: Other Considerationsmentioning
confidence: 99%