Diagnosis and Management of Thrombosis in COVID-19
A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".
Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 352
Special Issue Editor
Special Issue Information
Dear Colleagues,
COVID-19, the disease caused by novel SARS-CoV2 virus, was initially considered a respiratory illness, but soon after a high incidence of thromboembolic events was reported, it became associated with a worse prognosis.
Clinical studies revealed that up to one third of COVID-19 patients developed thrombotic events, mainly venous thromboembolism (VTE). Autopsy studies showed a prevalence of 50% VTE, emphasizing a direct correlation between the disease severity and the risk for thrombosis. It is noteworthy that VTE appears despite prophylactic anticoagulation that is usually administered in hospitalized medically ill patients. This suggests additional mechanisms involved in COVID-19 thrombosis.
A COVID-19-associated coagulopathy has been described. It is characterized by elevated D-Dimers, mild thrombocytopenia, slightly prolonged prothrombin time, and increased fibrinogen. Endothelial dysfunction caused by viral invasion and host inflammatory effects plays an important role in thrombosis. It generates a proinflammatory and procoagulant state and the consequences are worse in patients with pre-existent endothelial dysfunction. This process predominantly affects the micro vessels. The interaction between the damaged endothelium and the immune system results in immunothrombosis, a host defense mechanism against pathogens that is exacerbated in COVID-19. Additional factors such as hypoxia, which causes endothelial dysfunction and hypercoagulability, and genetic predisposition towards thrombosis are augmenting the risk.
Many issues are still unclarified: what is the best preventive treatment, if anti-inflammatory (e.g., Dexamethasone) or immunomodulatory (eg. Tocilizumab) treatments reduce immunothrombosis, if small pulmonary thrombi are markers for VTE, immunothrombosis, or both, and if diagnosing tests (biomarkers and radiological) can differentiate between VTE and immunothrombosis?
The purpose of this Special Issue is to bring together novel and relevant studies related to
medical imaging, biomarkers and other methods useful to identifying this pathology, including comprehensive reviews that will aid the clinicians in tackling this disease.
Dr. Mihaela Hostiuc
Guest Editor
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Keywords
- venous thromboembolism
- COVID-19
- immunothrombosis
- low molecular weight heparins
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