Strength of Anticoagulation in Moderate to Severe COVID-19 Illness: In Medio Stat Virtus?

Lippi, Giuseppe; Favaloro, Emmanuel J.

doi:10.1055/s-0042-1756186

Cited by 4 publications

(4 citation statements)

References 39 publications

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“…Thus, the evidence that patients with severe/critical influenza illness may be at an increased risk of developing thrombotic episodes necessitates another focused consideration. Similar to COVID-19, 37 a specific thromboprophylaxis protocol must be established for these patients, based on their clinical severity, as recent data suggest that systemic anticoagulation, although empirically administered, may be effective to significantly reduce the risk of VTE in critical patients with Influenza H1N1 infection. 33 Further research is needed to clarify this critical therapeutic aspect in the managed care of influenza patients.…”

Section: Discussionmentioning

confidence: 99%

Venous Thrombosis in Airborne Viral Infections: Is Coronavirus Disease 2019 now Any Different from Influenza?

Lippi,

Favaloro,

Nocini

2024

Semin Thromb Hemost

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One of the hallmarks of coronavirus disease 2019 (COVID-19), particularly in complicated cases (i.e., requiring hospitalization or intensive care support), is persistent hemostasis activation, which may be associated with a vast array of thrombotic episodes involving both the arterial and venous systems. The renewed emphasis on the relationship between viral infections and venous thrombosis paves the way for determining whether a more common and often underestimated infection disease, such as influenza, may also be associated with a significant burden of venous thrombotic episodes, and how this eventual thrombotic risk compares to that seen in COVID-19, both in the past and with newer variants. Our review of studies comparing the burden of venous thromboembolism (VTE) in patients with COVID-19 or influenza revealed that the thrombotic risk appears to be significantly higher in patients with COVID-19 but remains certainly not meaningless in those with influenza, particularly in subjects infected by highly virulent strains (i.e., H1N1), in those who develop pneumonia and require intensive care support. In these specific clinical settings, the adoption of tailored thromboprophylaxis may be indicated though more studies are compellingly needed on this matter. As COVID-19 variants emerge, there is a possibility that the VTE burden of COVID-19 will decrease, and progress to that of other respiratory viruses.

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Section: Discussionmentioning

confidence: 99%

Venous Thrombosis in Airborne Viral Infections: Is Coronavirus Disease 2019 now Any Different from Influenza?

Lippi,

Favaloro,

Nocini

2024

Semin Thromb Hemost

Self Cite

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“…Thus, aPL may be present in COVID-19 patients, just as a chance event. Second, many patients with moderate to severe COVID-19 are given anticoagulant therapy to treat and/or prevent thrombosis [ 83 , 84 , 85 , 86 ]. Typically, this treatment encompasses heparin (for short term, hospital patients), or possibly one of direct oral anticoagulants (DOACs) (for longer term, post hospital discharge).…”

Section: Autoantibodies Interfering With Hemostasis In Covid-19 and A...mentioning

confidence: 99%

Autoimmune Diseases Affecting Hemostasis: A Narrative Review

Favaloro

Pasalic

Lippi

2022

IJMS

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Hemostasis reflects a homeostatic mechanism that aims to balance out pro-coagulant and anti-coagulant forces to maintain blood flow within the circulation. Simplistically, a relative excess of procoagulant forces can lead to thrombosis, and a relative excess of anticoagulant forces can lead to bleeding. There are a wide variety of congenital disorders associated with bleeding or thrombosis. In addition, there exist a vast array of autoimmune diseases that can also lead to either bleeding or thrombosis. For example, autoantibodies generated against clotting factors can lead to bleeding, of which acquired hemophilia A is the most common. As another example, autoimmune-mediated antibodies against phospholipids can generate a prothrombotic milieu in a condition known as antiphospholipid (antibody) syndrome (APS). Moreover, there exist various autoimmunity promoting environments that can lead to a variety of antibodies that affect hemostasis. Coronavirus disease 2019 (COVID-19) represents perhaps the contemporary example of such a state, with potential development of a kaleidoscope of such antibodies that primarily drive thrombosis, but may also lead to bleeding on rarer occasions. We provide here a narrative review to discuss the interaction between various autoimmune diseases and hemostasis.

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“…The remainder of this issue contains several Commentaries as well as Letters to the Editor ("correspondence"). [19][20][21][22][23][24][25][26][27][28][29] Such material permits publication of various "smaller" COVID-19 vignettes. First comes a Commentary related to heparin anticoagulation in COVID-19 by Lippi et al 19 The authors discuss the benefits of heparin use from the perspectives of pleiotropic antiviral activity beyond anticoagulant and anti-inflammatory properties.…”

mentioning

confidence: 99%

“…Next comes a series of Commentaries on the strength of anticoagulation in various categories of COVID-19 severity. [20][21][22] The final commentary in this issue of the journal is managing drugdrug interactions with oral anticoagulants and nirmatrelvir/ritonavir in COVID-19 outpatients by Rizk et al The remainder of the issue contains some correspondence (i.e., Letters to the Editor), [24][25][26][27][28][29] around the possibility of acquired thrombotic thrombocytopenic purpura (aTTP) after COVID-19 mRNA vaccination, aspirin use reducing platelet hyperreactivity and degranulation in COVID-19 patients, antiphospholipid syndrome in COVID-19, and molecular mimicry between human PF4 and SARS-CoV-2 spike protein as potential basis for autoimmune responses in vaccinated and naturally infected patients. For aTTP post-COVID-19 mRNA vaccination and antiphospholipid syndrome in COVID-19, the real questions are whether these events are caused by or coincidental to vaccination or COVID-19.…”

mentioning

confidence: 99%

Maintaining Hemostasis and Preventing Thrombosis in Coronavirus Disease 2019 (COVID-19)—Part IV

Favaloro

Pasalic

Lippi

2023

Semin Thromb Hemost

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Strength of Anticoagulation in Moderate to Severe COVID-19 Illness: In Medio Stat Virtus?

Cited by 4 publications

References 39 publications

Venous Thrombosis in Airborne Viral Infections: Is Coronavirus Disease 2019 now Any Different from Influenza?

Venous Thrombosis in Airborne Viral Infections: Is Coronavirus Disease 2019 now Any Different from Influenza?

Autoimmune Diseases Affecting Hemostasis: A Narrative Review

Maintaining Hemostasis and Preventing Thrombosis in Coronavirus Disease 2019 (COVID-19)—Part IV

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