Thromboembolic Disease in Patients With Cancer and COVID-19 : Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations-State-of-the-Art
(2022) In Anticancer research 42(7). p.3261-3274- Abstract
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... (More)
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.
(Less)
- author
- contributor
- Gottsäter, Anders LU
- author collaboration
- organization
- publishing date
- 2022-07
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Anticoagulants/therapeutic use, COVID-19/complications, Endothelial Cells, Heparin, Low-Molecular-Weight/therapeutic use, Humans, Neoplasms/complications, Prospective Studies, RNA, Viral, Risk Factors, SARS-CoV-2, Thrombosis/drug therapy, Venous Thromboembolism/drug therapy
- in
- Anticancer research
- volume
- 42
- issue
- 7
- pages
- 3261 - 3274
- publisher
- International Institute of Cancer Research
- external identifiers
-
- scopus:85133288196
- pmid:35790272
- ISSN
- 1791-7530
- DOI
- 10.21873/anticanres.15815
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
- id
- 872fd14a-8be0-4f5c-80ad-9148e0dc0446
- date added to LUP
- 2023-08-31 09:18:19
- date last changed
- 2024-04-20 02:16:50
@article{872fd14a-8be0-4f5c-80ad-9148e0dc0446,
abstract = {{<p>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.</p>}},
author = {{Dimakakos, Evangelos and Gomatou, Georgia and Catalano, Mariella and Olinic, Dan-Mircea and Spyropoulos, Alex C and Falanga, Anna and Maraveyas, Anthony and Liew, Aaron and Schulman, Sam and Belch, Jill and Gerotziafas, Grigorios and Marschang, Peter and Cosmi, Benilde and Spaak, Jonas and Syrigos, Konstantinos}},
issn = {{1791-7530}},
keywords = {{Anticoagulants/therapeutic use; COVID-19/complications; Endothelial Cells; Heparin, Low-Molecular-Weight/therapeutic use; Humans; Neoplasms/complications; Prospective Studies; RNA, Viral; Risk Factors; SARS-CoV-2; Thrombosis/drug therapy; Venous Thromboembolism/drug therapy}},
language = {{eng}},
number = {{7}},
pages = {{3261--3274}},
publisher = {{International Institute of Cancer Research}},
series = {{Anticancer research}},
title = {{Thromboembolic Disease in Patients With Cancer and COVID-19 : Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations-State-of-the-Art}},
url = {{http://dx.doi.org/10.21873/anticanres.15815}},
doi = {{10.21873/anticanres.15815}},
volume = {{42}},
year = {{2022}},
}