In a new paper, researchers highlight the prevention, diagnosis, and treatment of complications stemming from blood clots in patients with COVID-19.
The research was conducted by a team at the University of Edinburgh.
Clinicians worldwide face this new severe infectious lung disease with no proven therapies.
Based on recent reports that demonstrated a strong association between elevated D-dimer levels and poor prognosis, concerns have risen about thrombotic complications in patients with COVID-19.
The National Institute for Public Health of the Netherlands asked a group of radiology and vascular medicine experts to provide guidance for the imaging workup and treatment of these important complications.
Their report summarizes the evidence for thromboembolic disease and potential diagnostic and preventive actions that can be taken.
The team says from the analysis of all available current medical, laboratory, and imaging data on COVID-19, it became clear that symptoms and diagnostic tests could not be explained by impaired pulmonary ventilation alone.
Recent observations suggest that respiratory failure in COVID-19 is not driven by the development of acute respiratory distress syndrome alone, but that microvascular thrombotic processes may play a role.
This may have important consequences for the diagnostic and therapeutic management of these patients.
There is a strong association between D-dimer levels, disease progression, and chest CT features suggesting venous thrombosis.
In addition, many studies have shown a very strong association between increased D-dimer levels and severe disease/poor prognosis.
The report authors stress that careful attention needs to be paid to the initial diagnosis and treatment of the prothrombotic and thrombotic state that can occur in a substantial percentage of COVID-19 patients.
Recommendations for diagnostic and therapeutic management, which vary based on patient symptoms and risk profiles, include prophylactic-dose heparin, chest CT, CT pulmonary angiography, and routine D-dimer testing.
Findings have also emerged linking COVID-19 more specifically with pulmonary embolism.
The team says COVID-19 is more than a lung infection. It affects the vasculature of the lungs and other organs and has a high thrombosis risk with acute life-threatening events that require adequate treatment with anticoagulants based on laboratory monitoring with appropriate imaging tests as required.
One author of the study is Edwin J.R. van Beek, M.D., Ph.D., the director at Edinburgh Imaging, Queens Medical Research Institute, at the University of Edinburgh, U.K.
The study is published in the journal Radiology.
Copyright © 2020 Knowridge Science Report. All rights reserved.
