Springer Reference Medizin, Год журнала: 2023, Номер unknown, С. 1 - 11
Опубликована: Ноя. 14, 2023
Journal of Thrombosis and Haemostasis, Год журнала: 2024, Номер 22(6), С. 1779 - 1797
Опубликована: Март 18, 2024
Based on emerging evidence from the COVID-19 pandemic, International Society Thrombosis and Haemostasis (ISTH) guidelines for antithrombotic treatment in were published 2022. Since then, at least 16 new randomized controlled trials have contributed additional evidence, which necessitated a modification of most previous recommendations. We used again American College Cardiology Foundation/American Heart Association methodology assessment level (LOE) class recommendation (COR). Five recommendations had LOE upgraded to A 2 patients with added. Furthermore, section was added answer questions about vaccination vaccine-induced immune thrombotic thrombocytopenia (VITT), studies provided some evidence. only included or B. Panelists agreed 19 recommendations, 4 nonhospitalized, 5 noncritically ill hospitalized, 3 critically postdischarge patients, as well VITT. strong (COR 1) given (a) use prophylactic dose low-molecular-weight heparin unfractionated hospitalized COVID-19, (b) select this group, therapeutic-dose heparin/unfractionated preference dose, (c) antiplatelet factor enzyme immunoassays diagnosing against 3) addition an agent patients. These international provide countries diverse healthcare resources vaccine availability.
Язык: Английский
Процитировано
21
International Journal of Surgery, Год журнала: 2024, Номер unknown
Опубликована: Март 28, 2024
There was controversy surrounding the optimal thromboprophylaxis strategy for coronavirus disease 2019 (COVID-19) patients. This included debates on dosage of anticoagulants thromboembolism prophylaxis, requirement additional antiplatelet therapy, and necessity prophylaxis outpatients postdischarge. To explore this, authors performed a meta-analysis randomized controlled trials.
Язык: Английский
Процитировано
12
Thrombosis Research, Год журнала: 2024, Номер 238, С. 141 - 150
Опубликована: Май 1, 2024
Thromboembolic events are common complications of COVID-19. Clinical study results on safety and efficacy anticoagulation in COVID-19 controversial.
Язык: Английский
Процитировано
6
Seminars in Thrombosis and Hemostasis, Год журнала: 2023, Номер 50(04), С. 527 - 536
Опубликована: Сен. 25, 2023
Abstract Soon after the outbreak of coronavirus disease 2019 (COVID-19), unexplained sustained fatigue, cognitive disturbance, and muscle ache/weakness were reported in patients who had recovered from acute COVID-19 infection. This abnormal condition has been recognized as “long COVID (postacute sequelae [PASC])” with a prevalence estimated to be 10 20% convalescent patients. Although pathophysiology PASC studied, exact mechanism remains obscure. Microclots circulation can represent one possible causes PASC. hypercoagulability thrombosis are critical mechanisms COVID-19, recent studies have that thromboinflammation continues some patients, even virus cleared. Viral spike proteins RNA detected months recovered, findings may responsible for persistent development microclots. Despite this theory, long-term results anticoagulation, antiplatelet therapy, vascular endothelial protection inconsistent, could not always show beneficial treatment effects. In summary, reflects heterogeneous condition, microclots cannot explain all presenting symptoms. After clarification pathomechanisms each symptom, symptom- or biomarker-based stratified approach should considered future studies.
Язык: Английский
Процитировано
13
Опубликована: Июнь 20, 2024
Non-Vitamin K Oral Anticoagulants (NOACs) have revolutionized anticoagulant therapy, offering improved safety and efficacy over traditional agents like warfarin. This review comprehensively examines the dual roles of NOACs—Apixaban, Rivaroxaban, Edoxaban, Dabigatran—not only as anticoagulants but also modulators inflammation via Protease-Activated Receptor (PAR) signaling. We highlight unique pharmacotherapeutic properties each NOAC, supported by key clinical trials demonstrating their effectiveness in preventing thromboembolic events. Beyond established roles, emerging research suggests that NOACs influence through PAR signaling pathways, implicating factors such FXa Thrombin modulation inflammatory responses. synthesizes current evidence on anti-inflammatory potential NOACs, exploring impact markers conditions atherosclerosis diabetes. By delineating mechanisms which mediate effects, this work aims to expand therapeutic utility, new perspectives for managing diseases. Our findings underscore broader implications advocating consideration strategies aimed at addressing inflammation-related pathologies. comprehensive synthesis not enhances understanding NOACs' multifaceted paves way future applications cardiovascular health
Язык: Английский
Процитировано
5
International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(16), С. 8727 - 8727
Опубликована: Авг. 10, 2024
Non-vitamin K oral anticoagulants (NOACs) have revolutionized anticoagulant therapy, offering improved safety and efficacy over traditional agents like warfarin. This review comprehensively examines the dual roles of NOACs—apixaban, rivaroxaban, edoxaban, dabigatran—not only as anticoagulants, but also modulators inflammation via protease-activated receptor (PAR) signaling. We highlight unique pharmacotherapeutic properties each NOAC, supported by key clinical trials demonstrating their effectiveness in preventing thromboembolic events. Beyond established roles, emerging research suggests that NOACs influence through PAR signaling pathways, implicating factors such factor Xa (FXa) thrombin modulation inflammatory responses. synthesizes current evidence on anti-inflammatory potential NOACs, exploring impact markers conditions atherosclerosis diabetes. By delineating mechanisms which mediate effects, this work aims to expand therapeutic utility, new perspectives for managing diseases. Our findings underscore broader implications advocating consideration strategies aimed at addressing inflammation-related pathologies. comprehensive synthesis not enhances understanding NOACs’ multifaceted paves way future applications cardiovascular health.
Язык: Английский
Процитировано
3
Journal of Thrombosis and Thrombolysis, Год журнала: 2024, Номер unknown
Опубликована: Авг. 23, 2024
Abstract A heightened risk for thrombosis is a hallmark of COVID-19. Expansive clinical experience and medical literature have characterized small ( micro ) large (macro vessel involvement the venous arterial circulatory systems. Most events occur in patients with serious or critical illness hyperacute (first 1–2 weeks) acute phases (2–4 SARS-CoV-2 infection. However, involving venous, arterial, microcirculatory systems has been reported subacute (4–8 weeks), convalescent (> 8–12 chronic 12 among mild-to-moderate illness. The purpose current focused review to highlight distinguishing features, pathological components, potential mechanisms microvascular overarching objective better understand proclivity thrombosis, laying solid foundation screening surveillance modalities, preventive strategies, optimal patient management. Graphical abstract Thrombosis COVID-19 contributing organ injury, morbidity, mortality. thrombus unique distinct characteristics. Among them are highly inflammatory signature on endothelial cell inflammation neutrophil extracellular traps (NETs). While virus resulting host immunoinflammatory response this pathogen provide an underpinning vascular events, spike protein necessary likely sufficient acute, subacute, potentially latent form harbored adipocytes, cells, circulating monocytes post-infectious atherothrombotic phenotypes.
Язык: Английский
Процитировано
3
Elsevier eBooks, Год журнала: 2025, Номер unknown, С. 543 - 568
Опубликована: Янв. 1, 2025
Язык: Английский
Процитировано
0
BMJ, Год журнала: 2025, Номер 389, С. e081165 - e081165
Опубликована: Май 29, 2025
Abstract Objective To compare the effects of treatments for mild or moderate (that is, non-severe) coronavirus disease 2019 (covid-19). Design Systematic review and network meta-analysis. Data sources Covid-19 Living Overview Evidence Repository (covid-19 L-OVE) by Epistemonikos Foundation, a public, living repository covid-19 articles, from 1 January 2023 to 19 May 2024. The search also included WHO database (up 17 February 2023) six Chinese databases 20 2021). analysis studies identified between December 28 June 2023. Study selection Randomised clinical trials in which people with suspected, probable, confirmed were allocated drug treatment standard care placebo. Pairs reviewers independently screened potentially eligible articles. Methods After duplicate data abstraction, bayesian meta-analysis was conducted. Risk bias assessed use modification Cochrane risk 2.0 tool, certainty evidence using grading recommendations assessment, development, evaluation (GRADE) approach. For each outcome, following GRADE guidance, classified groups most least beneficial harmful. Results Of 259 enrolling 166 230 patients, 187 (72%) analysis. Compared care, two drugs probably reduce hospital admission: nirmatrelvir-ritonavir (25 fewer per 1000 (95% confidence interval fewer), certainty) remdesivir (21 (28 7 certainty). Molnupiravir systemic corticosteroids may admission (low azithromycin reduces time symptom resolution (mean difference 4 days (5 3 corticosteroids, favipiravir, molnupiravir, umifenovir duration symptoms (moderate high only lopinavir-ritonavir increased adverse leading discontinuation. Conclusion Nirmatrelvir-ritonavir hospital, molnupiravir hospital. Several medications including resolution. registration This not registered. protocol is publicly available supplementary material.
Язык: Английский
Процитировано
0
Thrombosis Research, Год журнала: 2024, Номер 237, С. 209 - 215
Опубликована: Апрель 6, 2024
IntroductionPregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the these events, although is relatively limited among outpatients. We sought determine whether outpatient pregnant women with are at a high for events.Materials & methodsWe analyzed outpatients from multicenter CORONA-VTE-Network registry. The main study outcomes were composite adjudicated venous arterial and Events assessed 90 days after diagnosis reported non-pregnant ≤45 years, men as points reference.ResultsAmong 6585 outpatients, 169 diagnosis. By 90-day follow-up, two during third trimester had lower extremity thrombosis, one deep superficial vein thrombosis. cumulative incidence events was 1.20 % (95 confidence interval [CI]: 0.0 2.84 %). Respective rates 0.47 CI: 0.14 0.79 %) women, 0.49 0.06 0.91 years. No non-thrombotic occurred in women. 0.53 0.18 0.87) 0.68 1.18) aged years.ConclusionsThrombotic rare COVID-19. Although higher event rate cannot be excluded, absolute low do not warrant population-wide interventions optimize outcomes.
Язык: Английский
Процитировано
2