en
Scientific article
Review
Open access
English

Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations-State-of-the-Art

ContributorsDimakakos, Evangelos; Gomatou, Georgia; Catalano, Mariella; Olinic, Dan-Mircea; Spyropoulos, Alex C; Falanga, Anna; Maraveyas, Anthony; Liew, Aaron; Schulman, Sam; Belch, Jill; Gerotziafas, Grigorios; Marschang, Peter; Cosmi, Benilde; Spaak, Jonas; Syrigos, Konstantinos; 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
Published inAnticancer Research, vol. 42, no. 7, p. 3261-3274
Publication date2022-07
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 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.

eng
Keywords
  • Anticoagulation
  • CAT
  • COVID-19
  • Review
  • Thromboprophylaxis
  • Anticoagulants / therapeutic use
  • COVID-19 / complications
  • Endothelial Cells
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Prospective Studies
  • RNA, Viral
  • Risk Factors
  • SARS-CoV-2
  • Thrombosis / drug therapy
  • Thrombosis / etiology
  • Thrombosis / prevention & control
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control
Citation (ISO format)
DIMAKAKOS, Evangelos et al. Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations-State-of-the-Art. In: Anticancer Research, 2022, vol. 42, n° 7, p. 3261–3274. doi: 10.21873/anticanres.15815
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal0250-7005
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