TY - JOUR
T1 - Thromboembolic Disease in Patients With Cancer and COVID-19
T2 - Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations–State-of-the-Art
AU - 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 Preve
AU - Dimakakos, Evangelos
AU - Gomatou, Georgia
AU - Catalano, Mariella
AU - Olinic, Dan Mircea
AU - Spyropoulos, Alex C.
AU - Falanga, Anna
AU - Maraveyas, Anthony
AU - Liew, Aaron
AU - Schulman, Sam
AU - Belch, Jill
AU - Gerotziafas, Grigorios
AU - Marschang, Peter
AU - Cosmi, Benilde
AU - Spaak, Jonas
AU - Syrigos, Konstantinos
AU - Antic, Darko
AU - Blinc, Ales
AU - Boc, Vinko
AU - Boccardo, Francesco
AU - Brodmann, Marianne
AU - Carpentier, Patrick
AU - Celovska, Denisa
AU - De Marchi, Sergio
AU - Dimitrov, Gabriel
AU - Farkas, Katalin
AU - Fionik, Olga
AU - Fyta, Eleni
AU - Gkiozos, Ioannis
AU - Gottsater, Anders
AU - Gresele, Paolo
AU - Hamade, Amer
AU - Heiss, Christian
AU - Karahan, Oguz
AU - Karakatsanis, Stamatis
AU - Kavousi, Maryam
AU - Kollias, Anastasios
AU - Kolossvary, Endre
AU - Kotteas, Elias
AU - Kozak, Matija
AU - Kroon, Abraham
AU - Kubat, Emre
AU - Lefkou, Eleftheria
AU - Lessani, Gianfranco
AU - Manu, Chris
AU - Mazzolai, Lucia
AU - Milic, Dragan
AU - Nancheva, Jasminka
AU - Pantazopoulos, Kosmas
AU - Patriarcheas, Vasileios
AU - Pazvanska, Evelina
AU - Pecsvarady, Zsolt
AU - Pillon, Sergio
AU - Prior, Manilo
AU - Ptohis, Nikolaos
AU - Quere, Isabelle
AU - Righini, Marc
AU - Roztocil, Karel
AU - Schernthaner, Gerit Holger
AU - Schlager, Oliver
AU - Sieron, Aleksander
AU - Sprynger, Muriel
AU - Stanek, Agata
AU - Stojkovski, Igor
AU - Stvrtinova, Viera
AU - Suput, Dusan
AU - Syrigos, Nikolaos
AU - Trontzas, Ioannis
AU - Vasic, Dragan
AU - Visona, Adriana
AU - Xhepa, Sokol
N1 - Publisher Copyright:
© 2022 International Institute of Anticancer Research. All rights reserved.
PY - 2022/7
Y1 - 2022/7
N2 - 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 currently indicated 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 SARSCoV2 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.
AB - 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 currently indicated 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 SARSCoV2 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.
KW - Anticoagulation
KW - CAT
KW - COVID-19
KW - review
KW - thromboprophylaxis
UR - https://www.scopus.com/pages/publications/85133288196
U2 - 10.21873/anticanres.15815
DO - 10.21873/anticanres.15815
M3 - Review article
C2 - 35790272
AN - SCOPUS:85133288196
SN - 0250-7005
VL - 42
SP - 3261
EP - 3274
JO - Anticancer Research
JF - Anticancer Research
IS - 7
ER -
SDG 3 Good Health and Well-being