PDF | Long COVID describes an array of often debilitating symptoms in the aftermath of SARS-CoV-2 infection, with similar symptomatology affecting some... | Find, read and cite all the research you need on ResearchGate
Whilst in many patients polypharmacy is needed to tackle the co-pathology(ies) (not all of which are outlined herein), targeting coagulopathy seems essential to mitigate thrombotic risks and help mitigate other immunogenic cascades.
We contend that Long COVID patients (those with SITV) will not be ready to rehabilitate until the underlying illness and its complications have been effectively treated.
The treatment targets for SITV are microclots, hyperactive platelets, and endotheliitis. It has been proposed that treating this multifaceted inflammatory coagulopathy with a single drug will be insufficient and a combination of anticoagulant and antiplatelet drugs are required to achieve synergistic and superior outcomes [81,114,156], with early intervention recommended.
As Long COVID microclots are resistant to fibrinolysis [36,69,78], dabigatran may be superior as it increases clot susceptibility to fibrinolysis more than other anticoagulants [174,175]. Heparin inhibits spike protein ACE2 binding meaning it has antiviral and anticoagulant properties [60,176–178]. Heparin has been utilised to effectively treat pathology such as Long COVID-related perfusion defects [139], as well as microclots in the context of pulmonary emboli [179]. Further, obstetric patients (n = 291) with Long COVID who received enoxaparin antenatally to six weeks postnatally reported ongoing Long COVID symptoms less frequently than those who did not [180].
Thromboelastography can be utilised to mitigate bleeding risk.
Case study used aspirin, clopidogrel, dabigatran, and omeprazole.