tetano
Editor, Senior Moderator
Acta Haematol
. 2022 Feb 8;1-15.
doi: 10.1159/000522498. Online ahead of print.
COVID-19 Coagulopathy: From Pathogenesis to Treatment
Teba Alnima[SUP] 1 [/SUP], Mark M G Mulder[SUP] 2 [/SUP], Bas C T van Bussel[SUP] 2 3 [/SUP], Hugo Ten Cate[SUP] 1 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic at the end of 2019 and continues to exert an unfavorable worldwide health impact on a large proportion of the population. A remarkable feature of COVID-19 is the precipitation of a hypercoagulable state, mainly in severe cases, leading to micro- and macrothrombosis, respiratory failure, and death. Despite the implementation of various therapeutic regimes, including anticoagulants, a large number of patients suffer from such serious complications. This review aims to describe the current knowledge on the pathophysiology of the coagulation mechanism in COVID-19. We describe the interplay between three important mediators of the disease and how this may lead to a hyperinflammatory and prothrombotic state that affects outcome, namely, the endothelium, the immune system, and the coagulation system. In line with the hypercoagulability state during COVID-19, we further review on the rare but severe vaccine-induced thrombotic thrombocytopenia. We also summarize and comment on available anticoagulant treatment options and include suggestions for some future treatment considerations for COVID-19 anticoagulation therapy.
Keywords: COVID-19; Coagulopathy; Heparin; Hyperinflammation.
. 2022 Feb 8;1-15.
doi: 10.1159/000522498. Online ahead of print.
COVID-19 Coagulopathy: From Pathogenesis to Treatment
Teba Alnima[SUP] 1 [/SUP], Mark M G Mulder[SUP] 2 [/SUP], Bas C T van Bussel[SUP] 2 3 [/SUP], Hugo Ten Cate[SUP] 1 [/SUP]
Affiliations
- PMID: 35499460
- DOI: 10.1159/000522498
Abstract
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic at the end of 2019 and continues to exert an unfavorable worldwide health impact on a large proportion of the population. A remarkable feature of COVID-19 is the precipitation of a hypercoagulable state, mainly in severe cases, leading to micro- and macrothrombosis, respiratory failure, and death. Despite the implementation of various therapeutic regimes, including anticoagulants, a large number of patients suffer from such serious complications. This review aims to describe the current knowledge on the pathophysiology of the coagulation mechanism in COVID-19. We describe the interplay between three important mediators of the disease and how this may lead to a hyperinflammatory and prothrombotic state that affects outcome, namely, the endothelium, the immune system, and the coagulation system. In line with the hypercoagulability state during COVID-19, we further review on the rare but severe vaccine-induced thrombotic thrombocytopenia. We also summarize and comment on available anticoagulant treatment options and include suggestions for some future treatment considerations for COVID-19 anticoagulation therapy.
Keywords: COVID-19; Coagulopathy; Heparin; Hyperinflammation.