Thrombosis in Covid-19 Patients and Dilemma of Antithrombotic Choice: A Systematic Review

Background: Coronavirus Disease 2019 (COVID-19) potentially deteriorates the immune system and triggers prothrombotic states in many patient scenarios. Clinical studies so far do not stratify the risk of thromboembolism in COVID-19 cases. Objective: This systematic review investigates the risks of thromboembolism and outcomes of anticoagulation therapy in COVID-19 patients. Methods: We searched PubMed, Cochrane Library, Embase, Web of Science, and Google Scholar to identify relevant studies assessing thromboembolism and anticoagulant therapy in COVID-19 patients. Study Selection, Data Extraction, and Synthesis: Two reviewers screened the titles and abstracts of the included studies in the context of COVID-19, thrombosis, and anticoagulant therapy. The reviewers also ascertained the elimination of duplicate articles. Results: We included eight studies based on the thromboembolism predisposition of COVID-19 (adult/elderly) patients with the status/history of cardiovascular disease, diabetes, hypertension, obesity, and hospital admission. Conclusion: Prospective studies need to explore the risks of thromboembolism in patients with COVID-19. The current body of evidence does not substantiate antithrombotic treatment for managing thromboembolism in the setting of COVID-19. The physicians must take preventive measures for reducing the incidence rate of thromboembolism in COVID-19 scenarios until the availability of definitive treatment.