Caging the dragon: Research approach to COVID‐19–related thrombosis

Abstract

The incidence of venous thrombosis, mostly pulmonary embolism (PE), ranging from local immunothrombosis to central emboli, but also deep vein thrombosis (DVT) in people with coronavirus disease 2019 (COVID‐19) is reported to be remarkably high. The relevance of better understanding, predicting, treating, and preventing COVID‐19–associated venous thrombosis meets broad support, as can be concluded from the high number of research, review, and guideline papers that have been published on this topic. The Dutch COVID & Thrombosis Coalition (DCTC) is a multidisciplinary team involving a large number of Dutch experts in the broad area of venous thrombosis and hemostasis research, combined with experts on virology, critically ill patients, pulmonary diseases, and community medicine, across all university hospitals and many community hospitals in the Netherlands. Within the consortium, clinical data of at least 5000 admitted COVID‐19–infected individuals are available, including substantial collections of biobanked materials in an estimated 3000 people. In addition to considerable experience in preclinical and clinical thrombosis research, the consortium embeds virology‐hemostasis research models within unique biosafety facilities to address fundamental questions on the interaction of virus with epithelial and vascular cells, in relation to the coagulation and inflammatory system. The DCTC has initiated a comprehensive research program to answer many of the current questions on the pathophysiology and best anticoagulant treatment of COVID‐19–associated thrombotic complications. The research program was funded by grants of the Netherlands Thrombosis Foundation and the Netherlands Organization for Health Research and Development. Here, we summarize the design and main aims of the research program.

Altered fibrin network structure and fibrinolysis in intensive care unit patients with COVID‐19, not entirely explaining the increased risk of thrombosis

“…This study was a case‐control study conducted in the Erasmus Medical Center in Rotterdam, the Netherlands, as part of The Dutch COVID & Thrombosis Coalition 9 . Between April 2020 and December 2020, we collected plasma samples of COVID‐19 patients admitted to the ICU.…”

“…This study was a case‐control study conducted in the Erasmus Medical Center in Rotterdam, the Netherlands, as part of The Dutch COVID & Thrombosis Coalition. 9 Between April 2020 and December 2020, we collected plasma samples of COVID‐19 patients admitted to the ICU. We included patients with and without a diagnosis of thrombosis during their stay at the ICU, confirmed using computed tomography pulmonary angiography or compression ultrasound (see Supplemental Methods for details).…”

Stability of vitamin K antagonist anticoagulation after COVID‐19 diagnosis

“…As part of the research program initiated by the Dutch COVID & Thrombosis Coalition, 18 we collected patient characteristics from two anticoagulation clinics in the Netherlands (Leiden, Amsterdam) from their computerized patient records, consisting of year of birth, sex, co‐medication, year of VKA initiation, indication for VKA treatment and INR target range.…”

Ruling out Pulmonary Embolism in Patients with (Suspected) COVID-19—A Prospective Cohort Study

“…This study was approved by the Institutional Review Board of the LUMC for observational studies, a decision endorsed by all other Dutch study sites, and institutional approval was also granted at the study site in Dublin (Ireland), and was performed on behalf of the Dutch COVID & Thrombosis Coalition (DCTC). 18…”