COVID-19 Related Coagulopathy: What is Known Up to Now

Author(s): Ana Luísa Batista Pena, Rafael Arantes Oliveira, Renata Gomes Severo, Ana Cristina Simões e Silva*

Journal Name: Current Medicinal Chemistry

Volume 28 , Issue 21 , 2021


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Abstract:

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has been a global challenge. The complicated forms of the Coronavirus Disease 2019 (COVID- 19) can evolve to multiple-organ failure, including several coagulopathies related to a sudden worsening of respiratory status. This article aimed to review studies about hematological and hemostatic laboratory disorders directly related to COVID-19 and to discuss how SARS-CoV- 2 causes these abnormalities. The coagulation cascade model is associated with both COVID- 19 and pulmonary involvement. Laboratory changes are relevant to evaluate the coagulation state - D-dimer, prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), platelet count and fibrinogen. Pregnant women and patients in Extracorporeal Membrane Oxygenation (ECMO) need special attention. Prophylactic interventions for COVID-19 coagulopathy should consider patients at risk for thrombotic events and potential contraindications. The mechanisms exerted by SARS-CoV-2 that impairs hemostatic balance include endothelial injury, inflammation, and activation of the immune and complement systems. For diagnosis of coagulopathy, mainly D-dimer, but also PT, APTT and FDP, should be evaluated in COVID-19 patients. Intervention possibilities vary between low-molecular-weight heparin (LMWH) and Unfractionated Heparin (UFH). Until now, there is sufficient evidence that acutely-ill patients with risk factors for coagulopathies will benefit from thrombophylaxis during hospitalization and post-discharge, but not all patients.

Keywords: COVID-19, Coagulation, Coagulopathy, Acute respiratory distress syndrome, Angiotensin-converting enzyme 2, SARS-CoV-2.

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Article Details

VOLUME: 28
ISSUE: 21
Year: 2021
Published on: 04 October, 2020
Page: [4207 - 4225]
Pages: 19
DOI: 10.2174/0929867327666201005112231
Price: $65

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