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COVID-19 Coagulopathy: Current knowledge and guidelines on anticoagulation.
Joshua K Salabei1, Troy J Fishman1, Zekarias T Asnake1
1University of Central Florida, School of Medicine/North Florida Regional Medical Center, 6500W Newberry Rd, Gainesville, FL, 32605, USA.
Heart & Lung : the Journal of Critical Care
|February 1, 2021
Summary
COVID-19-associated coagulopathy (CAC) involves SARS-CoV-2, inflammation, and endothelial dysfunction, leading to thrombotic risks. Prophylactic anticoagulation is vital for hospitalized COVID-19 patients, with tailored institutional guidelines recommended.
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- COVID-19-associated coagulopathy (CAC) is a serious complication of SARS-CoV-2 infection.
- CAC can result in severe thrombotic events and mortality.
- Understanding CAC mechanisms is crucial for effective patient management.
Purpose of the Study:
- To review the etiologies of COVID-19-associated coagulopathy.
- To differentiate CAC from other coagulopathies like DIC, sepsis-associated coagulopathy, and ARDS-associated coagulopathy.
- To emphasize the role of endothelial dysfunction and inflammatory markers in CAC.
Main Methods:
- Literature review focusing on SARS-CoV-2 infection and coagulopathy.
- Analysis of proposed mechanisms including viral cytotoxicity and cytokine storm.
- Examination of hematological parameters indicative of coagulopathy.
Main Results:
- Key etiologies include direct SARS-CoV-2 effects, cytokine activation, and endothelial dysfunction.
- Distinctive features of CAC compared to other coagulopathies were identified.
- Elevated d-dimers and prolonged coagulation times (PT/aPTT) are significant indicators.
Conclusions:
- Prophylactic anticoagulation is recommended for all hospitalized COVID-19 patients.
- Institution-specific guidelines are necessary due to varying patient demographics and risk factors.
- Management of CAC requires careful consideration of hematological parameters and patient-specific factors.
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