In this article by the Global COVID-19 Thrombosis Collaborative Group, we describe novel dosing approaches for commonly used antithrombotic agents (especially heparin-based regimens) and the potential use of less widely used antithrombotic drugs in the absence of confirmed thrombosis. Although these therapies may have direct antithrombotic effects, other mechanisms of action, including anti-inflammatory or antiviral effects, have been postulated. Based on survey results from this group of authors, we suggest research priorities for specific agents and subgroups of patients with COVID-19. Further, we review other agents, including immunomodulators, that may have antithrombotic properties. It is our hope that the present document will encourage and stimulate future prospective studies and randomized trials to study the safety, efficacy, and optimal use of these agents for prevention or management of thrombosis in COVID-19.
Future Directions and Conclusion
Despite the efforts of the international medical and scientific communities and recent declines in hospitalizations, COVID-19 continues to pose an unprecedented challenge. The prognosis for hospitalized patients with COVID-19, especially in the setting of critical illness, continues to be poor. While contributing factors to poor outcomes in patients with COVID-19 are likely multifactorial, thrombotic complications play a major role in the prognosis of these patients. The development of safe and effective thromboprophylaxis and treatment strategies for thrombotic disease is contingent on an improved understanding of the mechanistic and pathophysiologic basis for such complications in COVID-19 patients. In this document, we have outlined several agents and mechanisms of action for potential for use as antithrombotic agents in the setting of COVID-19. Survey results from group of authors may be helpful for research priority settings for various agents and patient subgroups with COVID-19 (►Table 3). High-quality research investigations into the optimal drug, dose, and duration of therapies to prevent and treat thrombotic complications of COVID-19 offer the potential to improve outcomes of infected patients.
Reference & Source information: https://www.researchgate.net/
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