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International Angiology 2020 Sep 07

DOI: 10.23736/S0392-9590.20.04539-3


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 Angiology Unit, Cardiotoracovascular Department, San Marco Hospital, A.O.U. “Policlinico-San Marco”, University of Catania, Catania, Italy; 2 Vascular Centre, Nuova Villa Claudia, Rome, Italy; 3 Hemostasis & Thrombosis Research, Laboratories at Loyola, University Medical Center, Maywood, IL, USA; 4 Vascular Surgery Department of 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, Concord Hospital, Sydney, 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 is to summarize current evidence about vascular involvement in COVID-19 disease and potential antithrombotic therapy.

KEY WORDS: COVID-19; Thrombosis; Coagulopathy; D-dimer; Low molecular weight heparin

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