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Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
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COVID-19-induced coagulopathy: Experience, achievements, prospects

Leonid Dubey1, Olga Dorosh1,2, Nataliya Dubey1

  • 1Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.

Cardiology Journal
|January 2, 2023
PubMed

Insights

Severe COVID-19 causes coagulopathy, marked by elevated D-dimer (DD), increasing thrombotic risk and mortality. Monitoring DD is crucial for guiding thromboprophylaxis and anticoagulation strategies in patients.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coagulopathy is a key feature of severe COVID-19, linked to systemic inflammation.
  • Hematological changes like elevated D-dimer (DD), prolonged activated partial thromboplastin clotting time (APTT), and prothrombin time (PT) are observed.
  • Endothelial dysfunction, hypoxia, and pulmonary congestion contribute to thrombosis and microvascular occlusion in COVID-19 patients.

Purpose of the Study:

  • To characterize the coagulopathy associated with COVID-19.
  • To investigate the relationship between hematological changes and thrombotic events.
  • To determine the prognostic value of DD levels for in-hospital mortality and guide thromboprophylaxis strategies.

Main Methods:

  • Observational study analyzing hematological parameters in hospitalized COVID-19 patients.
  • Assessment of D-dimer (DD), activated partial thromboplastin clotting time (APTT), prothrombin time (PT), and fibrinogen levels.
  • Correlation analysis between hematological markers, disseminated intravascular coagulation (DIC) syndrome, and patient outcomes (mortality, thrombotic events).

Main Results:

  • COVID-19-associated coagulopathy primarily manifests as a significant increase in DD without significant changes in platelet count, APTT, or PT.
  • Disseminated intravascular coagulation (DIC) syndrome was present in 71.4% of deceased COVID-19 patients versus 0.6% of survivors.
  • A DD increase of more than 3-4 times the normal level was associated with higher in-hospital mortality.

Conclusions:

  • COVID-19-associated coagulopathy is characterized by increased thrombin formation and local fibrinolysis, primarily indicated by elevated DD.
  • Assessment of disease severity and coagulopathy markers like DD is essential for effective thromboprophylaxis and anticoagulation management.
  • Consideration for extended thromboprophylaxis or therapeutic anticoagulation post-hospitalization, guided by imaging, is warranted for COVID-19 survivors at risk.

Keywords:
COVID-19-induced coagulopathySARS-CoV-2coronavirus disease 2019 (COVID-19) infection

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