Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations–State-of-the-Art - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue (Article De Synthèse) Anticancer Research Année : 2022

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

Evangelos Dimakakos
  • Fonction : Auteur
Georgia Gomatou
  • Fonction : Auteur
Mariella Catalano
  • Fonction : Auteur
Dan-Mircea Olinic
  • Fonction : Auteur
Alex Spyropoulos
  • Fonction : Auteur
Anna Falanga
  • Fonction : Auteur
Anthony Maraveyas
  • Fonction : Auteur
Aaron Liew
  • Fonction : Auteur
Sam Schulman
  • Fonction : Auteur
Jill Belch
  • Fonction : Auteur
Peter Marschang
  • Fonction : Auteur
Benilde Cosmi
  • Fonction : Auteur
Jonas Spaak
  • Fonction : Auteur
Konstantinos Syrigos
  • Fonction : Auteur

Résumé

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.

Dates et versions

hal-03992559 , version 1 (16-02-2023)

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Citer

Evangelos Dimakakos, Georgia Gomatou, Mariella Catalano, Dan-Mircea Olinic, Alex Spyropoulos, et al.. Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations–State-of-the-Art. Anticancer Research, 2022, 42 (7), pp.3261-3274. ⟨10.21873/anticanres.15815⟩. ⟨hal-03992559⟩
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