Side Effects to Antithrombotic Therapy in Patients with COVID-19 – Possible Negative Implications and Understudied Factors

Abstract

Objective: To bring forth possible negative implications and side effects to antithrombotic therapy in patients with COVID-19 infection. Materials and Methods: This review was done based on existing data and utilizing resources such as books, journals and online publications using search engines. Results: The study took into account results from large studies. Inferences from ACTIV-4a, REMAP-CAP, ATTACC studies as well as ACTION, INPIRATION and RAPID were considered. Contrasting findings and understudied areas were also highlighted in the study. Conclusions: There is a need for continuous and judicious monitoring of patients on DOACs. It was revealed that there can be changes in plasma drug concentrations owing to complex drug interactions with metabolic pathways and dysregulations induced by the disease itself. The bleeding risk was one of the main concerns. Routine thromboprophylaxis should be under question. Bleeding risk had relation to whether therapeutic, subtherapeutic or prophylactic therapy was used. There are some contrasting findings across studies which needs to be clarified by further studies.