Abstract

ANTICOAGULANTS ROLE IN MANAGEMENT OF COVID 19 INDUCING HYPERCOAGULANILITY

Ch. Vamsi*, V. Pravallika, V. Lekhya Tejaswi, U. Amala, Debojyoti Bhowmik, Sovan Maji, Sourav Pramanik

ABSTRACT

Background: Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), is associated with a significant risk of thrombotic complications resulting from a hypercoagulable state. The inflammatory response, endothelial dysfunction, platelet activation, and coagulation cascade dysregulation contribute to the development of venous and arterial thromboembolism, which are major causes of morbidity and mortality in affected patients. Objective: This review aims to evaluate the role of anticoagulant therapy in the management of COVID-19-induced hypercoagulability and to summarize the current evidence regarding its efficacy, safety, and clinical outcomes. Methods: A comprehensive review of published literature, clinical trials, and international guidelines was conducted using electronic databases including PubMed, Scopus, and Google Scholar. Studies investigating the pathophysiology of COVID-19-associated coagulopathy and the therapeutic use of anticoagulants such as low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), and direct oral anticoagulants (DOACs) were analyzed. Results: Evidence indicates that anticoagulant therapy, particularly LMWH and UFH, plays a crucial role in reducing thrombotic events and improving clinical outcomes in hospitalized COVID-19 patients. Prophylactic anticoagulation has been shown to decrease the incidence of venous thromboembolism, while therapeutic-dose anticoagulation may benefit selected patients with severe disease and elevated coagulation markers. However, the risk of bleeding necessitates careful patient selection and individualized treatment strategies. Current guidelines recommend routine thromboprophylaxis for hospitalized patients, with dosing adjusted according to disease severity and thrombotic risk. Conclusion: Anticoagulants constitute an essential component of the management of COVID-19-associated hypercoagulability. Their timely administration can reduce thrombotic complications and improve patient outcomes. Further large-scale studies are required to optimize anticoagulant selection, dosing regimens, and treatment duration across different patient populations.

Keywords: COVID-19, SARS-CoV-2, Hypercoagulability, Anticoagulants, Thrombosis, Low-Molecular-Weight Heparin, Venous Thromboembolism, Coagulopathy.