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Biomarkers and thrombotic risk in COVID-19 patients: what is the current status of knowledge?

It has been previously well-established that infection with novel Coronavirus (SARS-CoV-2) is associated with a significantly increased propensity for microvascular and macrovascular thrombotic and thromboembolic events due to thromboinflammation, endothelial cell activation, and injury, platelet activation, and hypercoagulability. Since thrombotic events are linked to poor clinical prognosis, particularly among hospitalized and ICU-treated COVID-19 patients, there is an unmet need in developing effective strategies that would prevent thrombosis or aid in the early diagnosis and treatment of thrombotic complications in this vulnerable patient population. Therefore, readily available, as well as novel and experimental circulating biomarkers, might be one of the feasible and effective approaches to facilitate this endeavor. In the comprehensive consensus statement, issued by the International COVID-19 Thrombosis Biomarkers Colloquium, an aggregate of seventeen international experts in thrombosis provide practical information on the use of various biomarkers for thrombosis risk stratification among patients with COVID-19. In their review paper, the authors discuss and evaluate several laboratory biomarkers and diagnostic platforms that reflect distinct mechanistic pathways and pathophysiological processes that are postulated to be operative in COVID-19-provoked thrombosis. They go on by evaluating biomarkers that are implicated in platelet activation and aggregation, endothelial cell activation and injury, as well as haemostasis regulation, coagulation, and fibrinolysis. The authors also include a section on a vaccine- induced immune thrombotic thrombocytopenia (VITT) that is recently recognized as a rare but potentially fatal side-effect of adenoviral vector vaccines that are used against SARS-CoV-2. Finally, useful formal recommendations with the level of evidence (LoE) grading are given concerning the usefulness of a particular biomarker in the prognosis, diagnosis, and management of COVID-19-related thrombosis.

biomarkers ; circulation ; coronavirus ; COVID-19 ; thrombosis ; thromboembolism ; SARS-CoV-2 ; VTE

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