Caging the dragon: translational approach to unravel and prevent COVID-19 associated thrombosis

In COVID-19 patients, the number of cases of venous thromboembolism (VTE), such as thrombosed leg or pulmonary embolism, is remarkably high, up to 48% in the ICU. The presence of VTE causes more serious illness and an increased number of deaths. In addition, VTE occurs despite preventive treatment with blood thinners (heparin). This may indicate heparin resistance or the possibility that treatment with heparin is not the (only) solution. Finding the best possible treatment for COVID-19 patients requires understanding the disease process and risk factors, as well as the safety and efficacy of currently prescribed thromboprophylaxis and treatment. Research The study will study the exact number of VTE cases in the Netherlands and the effect of preventive treatment with heparin, identify risk factors and predict which factors contribute to this. Laboratory research also provides insight into the development of VTE. To distinguish whether VTE in COVID-19 patients is the result of a direct effect of the virus or indirectly via the immune system, a combination of clinical cohort studies with in-depth in vivo and in vitro studies is performed. To predict the risk of VTE in admitted COVID-19 patients, patient data are collected and VTE patients are identified. Dynamic prediction models are developed and individual VTE risks are estimated. COVID-19 patients will be monitored for the long-term effects of lung and heart function, functional status and quality of life. The project is carried out by the Dutch COVID & Thrombosis Coalition consortium . All UMCs and Sanquin participate in this. In addition, we collaborate with several general hospitals. The research is partly financed by the Netherlands Thrombosis Foundation.