SPECIAL ARTICLE   Editor’s choice • Free access

International Angiology 2020 December;39(6):445-51

DOI: 10.23736/S0392-9590.20.04539-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

The vascular side of COVID-19 disease. Position paper of the International Union of Angiology

Luca COSTANZO ¹ ✉, Giacomo FAILLA ¹, Pier L. ANTIGNANI ², Jawied FAREED ³, Yongquan GU ⁴, Jan PITHA ⁵, Leonardo ALUIGI ⁶, Thomas KARPLUS ⁷, Armando MANSILHA ⁸

¹ Unit of Angiology, Department of Cardio-Thoraco-Vascular, Policlinico-San Marco University Hospital, University of Catania, Catania, Italy; ² Vascular Center, Nuova Villa Claudia Nursing Home, Rome, Italy; ³ Hemostasis and Thrombosis Research Laboratories, Loyola University Medical Center, Maywood, IL, USA; ⁴ Department of Vascular Surgery, XuanWu Hospital, Capital Medical University, Beijing, China; ⁵ Laboratory for Atherosclerosis Research, Center for Clinical and Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; ⁶ Angiology Care Unit, Private Villalba Hospital (GVM), Bologna, Italy; ⁷ Department of Vascular Medicine, Sydney Local Health District, Concord Hospital, Sidney, Australia; ⁸ Faculty of Medicine, University of Porto, Porto, Portugal

The SARS-CoV-2 infection (COVID-19) is causing an ongoing pandemic and potentially fatal disease. Development of coagulopathy with thrombotic complications such as deep vein thrombosis and pulmonary embolism are emerging as factors for progression to severe disease and death. Also, a markedly increased level of D-dimer, a protein product of fibrin degradation, has been associated to mortality. Furthermore, activation of immune response due to virus infection may led to uncontrolled severe inflammation with damage to host cells and induction of endotheliitis and cellular apoptosis and pyroptosis. The use of low molecular weight heparin in early stage of the disease could prevent vascular complications and reduce the progression to severe stage of the disease. Aim of this paper was to summarize current evidence about vascular involvement in COVID-19 disease and potential antithrombotic therapy.

KEY WORDS: COVID-19; Thrombosis; Blood coagulation disorders