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Heart Science JournalHeart Science Journal

COVID-19 has become a major public health problem, with new cases and deaths growing around the world. COVID-19 has been reported to associate with a hypercoagulable state, which may lead to venous thromboembolism (VTE) formation. This condition is also associated with worse outcomes in COVID-19 patients. It is, therefore, critical for clinicians to identify this condition and manage accordingly. VTE formation in COVID-19 occurs through several mechanisms, such as inflammatory reaction leading to a hypercoagulable state and vascular dysfunction and direct vascular injury by the virus. The rate of VTE formation was as high as 31% in Intensive Care Unit (ICU) patients and 9.2% in general wards patients. It was also associated with poor prognosis. Thromboprophylaxis with heparin, particularly low molecular weight heparin (LMWH), has been shown to improve these patients prognosis. A careful individual assessment is required to determine which patients will benefit from this therapy. There are still no sufficient prospective trials to establish guidelines for VTE thrombo-prophylaxis in COVID-19. The assessment includes laboratory parameters such as PT, platelet count, D-dimer, fibrinogen, and other risk factors incorporated in the PADUA risk assessment model (RAM), versus the risk of bleeding incorporated in IMPROVE bleeding RAM.

Patients with COVID-19 are at increased risk of VTE due to inflammatory reactions, vascular dysfunction, and direct viral injury.Thromboprophylaxis with heparin, especially LMWH, can improve patient outcomes.A thorough individual assessment, considering both VTE risk factors and bleeding risks, is crucial for determining appropriate therapy.

Penelitian lebih lanjut perlu dilakukan untuk mengidentifikasi biomarker yang lebih akurat untuk memprediksi risiko VTE pada pasien COVID-19, sehingga memungkinkan stratifikasi risiko yang lebih tepat dan personalisasi terapi antikoagulan. Studi prospektif yang terkontrol dengan baik sangat dibutuhkan untuk mengevaluasi efektivitas dan keamanan berbagai strategi tromboprofilaksis, termasuk dosis LMWH yang optimal, pada populasi pasien COVID-19 yang beragam, dengan mempertimbangkan faktor-faktor seperti tingkat keparahan penyakit, komorbiditas, dan risiko perdarahan. Selain itu, penelitian juga perlu menyelidiki peran potensial terapi anti-inflamasi sebagai pendekatan tambahan untuk mencegah VTE pada pasien COVID-19, karena peradangan yang berlebihan merupakan pendorong utama hiperkoagulasi dalam konteks ini. Studi-studi ini dapat membantu menyempurnakan pedoman klinis dan meningkatkan hasil bagi pasien yang terinfeksi COVID-19.

  1. Venous Thromboembolism Prevention in COVID-19: A Review of Latest Evidences | Heart Science Journal.... heartscience.ub.ac.id/index.php/heartscience/article/view/106Venous Thromboembolism Prevention in COVID 19 A Review of Latest Evidences Heart Science Journal heartscience ub ac index php heartscience article view 106
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