PMID- 32556875
OWN - NLM
STAT- MEDLINE
DCOM- 20200911
LR  - 20231112
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 35
IP  - 9
DP  - 2020 Sep
TI  - Antithrombotic Therapies in COVID-19 Disease: a Systematic Review.
PG  - 2698-2706
LID - 10.1007/s11606-020-05906-y [doi]
AB  - 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.
FAU - Maldonado, Edward
AU  - Maldonado E
AD  - Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
FAU - Tao, Derrick
AU  - Tao D
AD  - Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
FAU - Mackey, Katherine
AU  - Mackey K
AD  - Department of Veterans Affairs Evidence Synthesis Program (ESP), VA Portland 
      Healthcare System, Portland, OR, USA. katherine.mackey@va.gov.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20200617
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Anticoagulants/therapeutic use
MH  - *Betacoronavirus
MH  - COVID-19
MH  - Coronavirus Infections/*drug therapy/*epidemiology
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Observational Studies as Topic/methods
MH  - Pandemics
MH  - Pneumonia, Viral/*drug therapy/*epidemiology
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - SARS-CoV-2
MH  - Venous Thromboembolism/*drug therapy/*epidemiology
PMC - PMC7299557
OTO - NOTNLM
OT  - COVID-19
OT  - anticoagulants
OT  - sepsis
OT  - thromboembolism
COIS- The authors declare that they do not have a conflict of interest.
EDAT- 2020/06/20 06:00
MHDA- 2020/09/12 06:00
PMCR- 2021/09/01
CRDT- 2020/06/20 06:00
PHST- 2020/04/29 00:00 [received]
PHST- 2020/05/04 00:00 [accepted]
PHST- 2020/06/20 06:00 [pubmed]
PHST- 2020/09/12 06:00 [medline]
PHST- 2020/06/20 06:00 [entrez]
PHST- 2021/09/01 00:00 [pmc-release]
AID - 10.1007/s11606-020-05906-y [pii]
AID - 5906 [pii]
AID - 10.1007/s11606-020-05906-y [doi]
PST - ppublish
SO  - J Gen Intern Med. 2020 Sep;35(9):2698-2706. doi: 10.1007/s11606-020-05906-y. Epub 
      2020 Jun 17.