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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
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Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Coagulation01:09

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The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Updated: Oct 17, 2025

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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
Summary

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.

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

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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.