COVID-19 and its implications for thrombosis and anticoagulation

Abstract

Severe acute respiratory syndrome coronavirus 2, Coagulation test screening, including the measurement of coronavirus disease 2019 (COVID-19)-induced infection D-dimer and fibrinogen levels, is suggested. COVID-can be associated with a coagulopathy, findings consis-19–associated coagulopathy should be managed as it tent with infection-induced inflammatory changes as would be for any critically ill patient, following the estabobserved in patients with disseminated intravascular lished practice of using thromboembolic prophylaxis for coagulopathy (DIC). The lack of prior immunity to COVID-critically ill hospitalized patients, and standard supportive 19 has resulted in large numbers of infected patients care measures for those with sepsis-induced coagulopathy across the globe and uncertainty regarding management or DIC. Although D-dimer, sepsis physiology, and con-of the complications that arise in the course of this viral sumptive coagulopathy are indicators of mortality, current illness. The lungs are the target organ for COVID-19; data do not suggest the use of full-intensity anticoagulation patients develop acute lung injury that can progress to doses unless otherwise clinically indicated. Even though respiratory failure, although multiorgan failure can also there is an associated coagulopathy with COVID-19, occur. The initial coagulopathy of COVID-19 presents bleeding manifestations, even in those with DIC, have not with prominent elevation of D-dimer and fibrin/fibrinogen-been reported. If bleeding does occur, standard guidelines degradation products, whereas abnormalities in pro-for the management of DIC and bleeding should be thrombin time, partial thromboplastin time, and platelet followed. (Blood. 2020;135(23):2033-2040) counts are relatively uncommon in initial presentations.