Shortly after the emergence of coronavirus disease 2019 (COVID-19) in late 2019, clinicians rapidly recognized an apparent association between the disease and both arterial and venous thrombotic complications, which was confirmed in epidemiologic studies. Based on these data, hospitals empirically developed and implemented protocols with different strategies for anticoagulation of hospitalized COVID-19 patients. Subsequent randomized controlled trials (RCTs) clarified the role of anticoagulation in patients hospitalized with COVID-19 and recently discharged from the hospital. In this review, we discuss the epidemiology and pathophysiology of thrombosis in patients with COVID-19, observational comparative effectiveness analyses that provided hints of a benefit from anticoagulation, and finally the RCTs that established which patients with COVID-19 benefit from treatment-dose anticoagulation. These RCTs have demonstrated that hospitalized, noncritically ill patients with COVID-19 benefit from treatment-dose anticoagulation, but patients who are hospitalized and critically ill, discharged from the hospital, or not hospitalized do not benefit.

中文翻译：

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COVID-19 血栓并发症和治疗策略

2019 年末 2019 冠状病毒病 (COVID-19) 出现后不久，临床医生迅速认识到该疾病与动脉和静脉血栓并发症之间存在明显关联，这一点在流行病学研究中得到了证实。根据这些数据，医院根据经验制定并实施了针对住院 COVID-19 患者的不同抗凝策略的方案。随后的随机对照试验 (RCT) 阐明了抗凝治疗对住院并最近出院的 COVID-19 患者的作用。在这篇综述中，我们讨论了 COVID-19 患者血栓形成的流行病学和病理生理学、观察性比较有效性分析（提供了抗凝治疗获益的线索），以及最终确定哪些 COVID-19 患者从治疗剂量抗凝治疗中受益的随机对照试验。这些随机对照试验表明，住院的非重症 COVID-19 患者可从治疗剂量抗凝治疗中受益，但住院重症、出院或未住院的患者则不会受益。