Document Type : Mini Review
Department of Pharmacology, Faculty of Medicine, Assiut University, Egypt
Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
Assiut Health Directorate, Egypt
A thrombotic complication is one of the severe clinical outcomes of COVID-19. Various pathophysiological mechanisms for thrombotic events in COVID-19 have been proposed. Consistently, elevated D-dimer level has emerged as an independent risk factor for poor outcomes, including death. Several other laboratory markers and blood counts have also been associated with poor prognosis, possibly due to their relation with thrombosis. At present, the pathophysiology underlying the hypercoagulable state is poorly understood. As a result, most critically diseased COVID-19 patients are managed with prophylactic anticoagulant. The management of COVID-19 was based generally on supportive therapy and treatment that prevent respiratory failure since it's directly effects on human respiratory system. However, antiviral now and other medications alongside vaccination are used. Vaccination also found to cause thrombosis symptoms are in many COVID-19 recipients. Vaccine-induced immune thrombotic thrombocytopenia was clearly recorded with significant and awful outcomes. No clear cause for this syndrome, but many hypotheses have been established to explain the mechanism of thrombosis formation. An interaction between platelets or platelet factor 4 with anti-PF4 is a similar point in the pathogenesis of problem. Since covid19 and its vaccine induce hypercoagulability condition, it was found that anticoagulation therapy may block or slow progression of thrombosis formation.
Treatment of COVID-19 vaccines-induced hypercoagulation include many intents; as anti-inflammatory, antithrombotic and antiviral drug. This can be done by one drug like low dose aspirin or more as warfarin that use as anticoagulant. Direct oral anticoagulant can also be used. Sometimes, combination of low dose aspirin and clopidogrel may be given as they are very effective. Focusing on treatment of thrombosis in COVID-19 has increased lately, consequently, many drugs like dipyridamole, (which is significantly improved platelet and lymphocytes count and decrease D-dimer level) become use for patient and more studies about its effect are done to reach a very effective treatment.