Anticoagulation in Patients With COVID-19: JACC Review Topic of the Week.
Anticoagulation in Patients With COVID-19: JACC Review Topic of the Week.
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DOI：
10.1016/j.jacc.2021.12.023
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发表时间：
2022-03-08
影响因子：
24
通讯作者：
Fuster V
中科院分区：
文献类型：
--
作者：
Farkouh ME;Stone GW;Lala A;Bagiella E;Moreno PR;Nadkarni GN;Ben-Yehuda O;Granada JF;Dressler O;Tinuoye EO;Granada C;Bustamante J;Peyra C;Godoy LC;Palacios IF;Fuster V
临床、实验室和尸检结果支持2019冠状病毒病（COVID-19）和血栓栓塞性疾病之间的关联。急性COVID-19感染的特征是单核细胞反应性和泛内皮细胞炎，导致动脉和静脉的大小血管血栓形成的发生率很高。观察性研究和随机试验已经调查了与预防性剂量肝素相比，全剂量抗凝是否可以改善结局。尽管在因COVID-19住院的重症患者中未发现治疗性肝素的益处，但一些研究支持治疗性抗凝在尚不需要重症监护室支持的患者中可能发挥作用。我们总结了在COVID-19患者中使用抗凝治疗的病理学、原理和当前证据，并描述了正在进行的FREEDOM COVID-19抗凝试验的主要设计要素，在该试验中，3，600名不需要重症监护病房护理的COVID-19住院患者被随机分配至单次剂量依诺肝素、治疗剂量依诺肝素和治疗剂量阿哌沙班。（FREEDOM COVID-19抗凝策略[FREEDOM COVID]; NCT 04512079）
Clinical, laboratory, and autopsy findings support an association between coronavirus disease-2019 (COVID-19) and thromboembolic disease. Acute COVID-19 infection is characterized by mononuclear cell reactivity and pan-endothelialitis, contributing to a high incidence of thrombosis in large and small blood vessels, both arterial and venous. Observational studies and randomized trials have investigated whether full-dose anticoagulation may improve outcomes compared with prophylactic dose heparin. Although no benefit for therapeutic heparin has been found in patients who are critically ill hospitalized with COVID-19, some studies support a possible role for therapeutic anticoagulation in patients not yet requiring intensive care unit support. We summarize the pathology, rationale, and current evidence for use of anticoagulation in patients with COVID-19 and describe the main design elements of the ongoing FREEDOM COVID-19 Anticoagulation trial, in which 3,600 hospitalized patients with COVID-19 not requiring intensive care unit level of care are being randomized to prophylactic-dose enoxaparin vs therapeutic-dose enoxaparin vs therapeutic-dose apixaban. (FREEDOM COVID-19 Anticoagulation Strategy [FREEDOM COVID]; NCT04512079)
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影响因子：
20.3
作者：
Giannis D;Allen SL;Tsang J;Flint S;Pinhasov T;Williams S;Tan G;Thakur R;Leung C;Snyder M;Bhatia C;Garrett D;Cotte C;Isaacs S;Gugerty E;Davidson A;Marder GS;Schnitzer A;Goldberg B;McGinn T;Davidson KW;Barish MA;Qiu M;Zhang M;Goldin M;Matsagkas M;Arnaoutoglou E;Spyropoulos AC
通讯作者：
Spyropoulos AC
影响因子：
50.3
作者：
Cordon-Cardo C;Pujadas E;Wajnberg A;Sebra R;Patel G;Firpo-Betancourt A;Fowkes M;Sordillo E;Paniz-Mondolfi A;Gregory J;Krammer F;Simon V;Isola L;Soon-Shiong P;Aberg JA;Fuster V;Reich DL
通讯作者：
Reich DL
影响因子：
158.5
作者：
Ackermann, Maximilian;Verleden, Stijn E.;Jonigk, Danny
通讯作者：
Jonigk, Danny
影响因子：
19.7
作者：
Bhayana R;Som A;Li MD;Carey DE;Anderson MA;Blake MA;Catalano O;Gee MS;Hahn PF;Harisinghani M;Kilcoyne A;Lee SI;Mojtahed A;Pandharipande PV;Pierce TT;Rosman DA;Saini S;Samir AE;Simeone JF;Gervais DA;Velmahos G;Misdraji J;Kambadakone A
通讯作者：
Kambadakone A
影响因子：
9.6
作者：
Jiménez D;García-Sanchez A;Rali P;Muriel A;Bikdeli B;Ruiz-Artacho P;Le Mao R;Rodríguez C;Hunt BJ;Monreal M
通讯作者：
Monreal M