Related Experiment Video
Updated: Dec 1, 2025
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
COVID-19-associated coagulopathy and disseminated intravascular coagulation
Hidesaku Asakura1, Haruhiko Ogawa2
1Department of Hematology, Kanazawa University Hospital, Takaramachi 13-1, Kanazawa, Ishikawa, 920-8640, Japan. hasakura@staff.kanazawa-u.ac.jp.
Insights
COVID-19 complications include thrombosis and disseminated intravascular coagulation (DIC), with D-dimer monitoring having limitations. Regular coagulation/fibrinolytic examinations are crucial for managing COVID-19 patients due to fluctuating conditions.
Area of Science:
- Pathology
- Hematology
- Infectious Diseases
Background:
- COVID-19 pathology involves thrombosis, disseminated intravascular coagulation (DIC), and cytokine storms.
- Increased D-dimer is a common finding in COVID-19, linked to prognosis.
- Limitations exist in using D-dimer alone for evaluating coagulation abnormalities.
Observation:
- COVID-19-associated DIC pathophysiology differs from septic DIC, presenting both thrombotic and hemorrhagic risks.
- COVID-19 thrombosis encompasses macro- and microthrombosis, with microthrombosis diagnosis relying on coagulation/fibrinolysis markers.
- Coagulation/fibrinolytic status can change rapidly, necessitating frequent monitoring.
Findings:
- D-dimer elevation is frequent but insufficient for comprehensive assessment.
- COVID-19-induced DIC has unique features compared to other DIC types.
- Effective COVID-19 management requires tailored treatment based on disease severity and stage.
Implications:
- Regular coagulation and fibrinolysis monitoring is essential for COVID-19 patient management.
- Understanding COVID-19's distinct DIC pathophysiology is critical for appropriate treatment.
- Personalized treatment strategies, potentially including combination therapies like heparin and nafamostat, are key for managing COVID-19 complications.
Abstract:
The pathology of coronavirus disease 2019 (COVID-19) is exacerbated by the progression of thrombosis, and disseminated intravascular coagulation (DIC), and cytokine storms. The most frequently reported coagulation/fibrinolytic abnormality in COVID-19 is the increase in D-dimer, and its relationship with prognosis has been discussed. However, limits exist to the utility of evaluation by D-dimer alone. In addition, since the coagulation/fibrinolytic condition sometimes fluctuates within a short period of time, regular examinations in recognition of the significance of the examination are desirable. The pathophysiology of disseminated intravascular coagulation (DIC) associated with COVID-19 is very different from that of septic DIC, and both thrombotic and hemorrhagic pathologies should be noted. COVID-19 thrombosis includes macro- and microthrombosis, with diagnosis of the latter depending on markers of coagulation and fibrinolysis. Treatment of COVID-19 is classified into antiviral treatment, cytokine storm treatment, and thrombosis treatment. Rather than providing uniform treatment, the treatment method most suitable for the severity and stage should be selected. Combination therapy with heparin and nafamostat is expected to develop in the future. Fibrinolytic therapy and adsorption therapy require further study.
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