Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations-State-of-the-Art.
[en] Cancer and COVID-19 are both well-established risk factors predisposing to thrombosis. Both disease entities are correlated with increased incidence of venous thrombotic events through multifaceted pathogenic mechanisms involving the interaction of cancer cells or SARS-CoV2 on the one hand and the coagulation system and endothelial cells on the other hand. Thromboprophylaxis is recommended for hospitalized patients with active cancer and high-risk outpatients with cancer receiving anticancer treatment. Universal thromboprophylaxis with a high prophylactic dose of low molecular weight heparins (LMWH) or therapeutic dose in select patients, is currentlyindicated for hospitalized patients with COVID-19. Also, prophylactic anticoagulation is recommended for outpatients with COVID-19 at high risk for thrombosis or disease worsening. However, whether there is an additive risk of thrombosis when a patient with cancer is infected with SARS-CoV2 remains unclear In the current review, we summarize and critically discuss the literature regarding the epidemiology of thrombotic events in patients with cancer and concomitant COVID-19, the thrombotic risk assessment, and the recommendations on thromboprophylaxis for this subgroup of patients. Current data do not support an additive thrombotic risk for patients with cancer and COVID-19. Of note, patients with cancer have less access to intensive care unit care, a setting associated with high thrombotic risk. Based on current evidence, patients with cancer and COVID-19 should be assessed with well-established risk assessment models for medically ill patients and receive thromboprophylaxis, preferentially with LMWH, according to existing recommendations. Prospective trials on well-characterized populations do not exist.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Dimakakos, Evangelos; Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece
Gomatou, Georgia; Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece, georgiagom@med.uoa.gr
Catalano, Mariella; Research Center on Vascular Disease & Angiology Unit, Department of Biomedical Science, L Sacco Hospital, University of Milan, Milan, Italy
Olinic, Dan-Mircea; Medical Clinic No. 1, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
Spyropoulos, Alex C; Feinstein Institutes for Medical Research and The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, Hempstead, NY, U.S.A ; Department of Medicine Northwell Health at Lenox Hill Hospital, New York, NY, U.S A
Falanga, Anna; University of Milan Bicocca, School of Medicine, Milan, Italy ; Department of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
Maraveyas, Anthony; Queens Centre Oncology & Hematology Faculty of Health Sciences Hull York Medical School Cottingham, Hull, U.K
Liew, Aaron; School of Medicine, College of Medicine Nursing and Health Sciences, National University of Ireland Galway (NUIG), and Portiuncula University Hospital & Galway University Hospital, Saolta University Health Care Group, Galway, Ireland
Schulman, Sam; Department of Medicine and Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
Belch, Jill; Institute of Cardiovascular Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, U.K
Gerotziafas, Grigorios; Sorbonne University, Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 938, Research Group Cancer, Biology and Therapeutics, Centre de Recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France ; Thrombosis Center, Tenon-Saint Antoine, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
Marschang, Peter; Department of Internal Medicine, Central Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy
Cosmi, Benilde; Division of Angiology and Blood Coagulation, Department of Specialty, Diagnostics and Experimental Medicine, University of Bologna, IRCCS S.Orsola Malpighi Research Institute, Bologna, Italy
Spaak, Jonas; Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
Syrigos, Konstantinos; Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, "Sotiria" General Hospital, Athens, Greece
CANCER-COVID-19 THROMBOSIS COLLABORATIVE GROUP, endorsed by VAS-European Independent Foundation in Angiology/Vascular Medicine, UEMS Vascular Medicine/Angiology and European Society of Vascular Medicine, and supported by the Balkan Working Group for Prevention and Treatment of Venous Thromboembolism and Hellenic Association of Lung Cancer
Sprynger, Muriel ; Université de Liège - ULiège > Département des sciences cliniques
Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations-State-of-the-Art.
Publication date :
July 2022
Journal title :
Anticancer Research
ISSN :
0250-7005
eISSN :
1791-7530
Publisher :
International Institute of Anticancer Research, Greece
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