MPN and thrombosis was hard enough . . . now there ' s COVID-19 thrombosis too

Abstract

Both myeloprolifer ative neoplasms (MPNs) and coronavirus disease 2019 (COVID- 19) are char acterized by an intrinsic throm botic risk. Little is known about the inci dence and the out come of throm botic events in patients with MPN infected by severe acute respiratory syndrome coronavirus 2 (SARS- CoV - 2), but common mechanisms of coagulation activation, typ i cal of both dis or ders, sug gest that these patients can be at par tic u larly high risk. To defi ne the best thromboprophylaxis and treatment regimens in both MPN and COVID- 19, individual- and disease- specifi c thrombotic risk factors, bleed ing risk, and con com i tant spe cifi c treat ments need to be con sid ered. In this case - based review, an indi vid u al ized approach is presented in a case of SARS - CoV - 2 infec tion occur ring in a man with poly cy the mia vera (PV). A pri mary antico ag u lant thromboprophylaxis strat egy and adjust ment of his PV treat ment were implemented. However, dur ing the hos pi tal stay, he expe ri enced pul mo nary embolism and ther a peu tic anticoagulation had to be set. Then his con di tion improved, and dis charge was planned. Postdischarge deci sions had to be made about the type and dura tion of venous throm bo em bo lism treat ment as well as the man age ment of PV - spe cifi c drugs. The steps of our deci sions and rec om menda tions are presented.