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Coagulation abnormalities & thromboprophylaxis in COVID-19

Aditya Jandial1, Anunay Gupta2, Amit Malviya3

  • 1Department of Hematology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

The Indian Journal of Medical Research
|October 13, 2021
PubMed

Insights

Novel coronavirus 2019 (COVID-19) causes unique coagulopathy with elevated D-dimers and fibrinogen. Antithrombotic therapy is crucial for improving outcomes in sick patients with COVID-19-associated thrombotic complications.

Area of Science:

  • Internal Medicine
  • Hematology
  • Infectious Diseases

Background:

  • The novel coronavirus 2019 (COVID-19) pandemic presents with evolving organ-specific manifestations.
  • Thrombotic complications and coagulopathy are frequently observed in severe COVID-19 cases.

Purpose of the Study:

  • To characterize the unique coagulopathy associated with COVID-19.
  • To differentiate COVID-19-associated coagulopathy from other known coagulation disorders.
  • To highlight the clinical correlates and potential pathogenetic mechanisms.

Main Methods:

  • Observational analysis of clinical data from COVID-19 patients.
  • Comparison of coagulation profiles in COVID-19 patients with other conditions.
  • Review of emerging evidence on pathogenesis and treatment.

Main Results:

  • COVID-19 coagulopathy is distinct from sepsis-induced coagulopathy and disseminated intravascular coagulation.
  • Key features include elevated D-dimers and fibrinogen early in the disease, with minimally deranged prothrombin time and platelet counts.
  • Venous and arterial thromboses are more common than bleeding events.

Conclusions:

  • COVID-19-associated coagulopathy involves mechanisms overlapping with thrombotic microangiopathy, hemophagocytic syndrome, and antiphospholipid syndrome, exacerbated by endothelial damage.
  • Antithrombotic therapy plays a significant role in improving outcomes for critically ill COVID-19 patients.

Keywords:
AnticoagulantsCOVID-19SARS-CoV-2coagulopathycoronavirusesdisseminated intravascular coagulationpulmonary embolism

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