Complement activation and coagulopathy - an ominous duo in COVID19.
Expert Rev Hematol
; 14(2): 155-173, 2021 02.
Article
in English
| MEDLINE | ID: covidwho-1044433
ABSTRACT
INTRODUCTION:
COVID-19 has similarities to the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) outbreaks, as severe patients and non-survivors have frequently shown abnormal coagulation profiles. Immune-mediated pathology is a key player in this disease; hence, the role of the complement system needs assessment. The complement system and the coagulation cascade share an intricate network, where multiple mediators maintain a balance between both pathways. Coagulopathy in COVID-19, showing mixed features of complement-mediated and consumption coagulopathy, creates a dilemma in diagnosis and management. AREAS COVERED Pathophysiology of coagulopathy in COVID-19 patients, with a particular focus on D-dimer and its role in predicting the severity of COVID-19 has been discussed. A comprehensive search of the medical literature on PubMed was done till May 30th, 2020 with the keywords 'COVID-19', 'SARS-CoV-2', 'Coronavirus', 'Coagulopathy', and 'D-dimer'. Twenty-two studies were taken for weighted pooled analysis of D-dimer. EXPERT OPINION A tailored anticoagulant regimen, including intensification of standard prophylactic regimens with low-molecular-weight heparin is advisable for COVID-19 patients. Atypical manifestations and varying D-dimer levels seen in different populations bring forth the futility of uniform recommendations for anticoagulant therapy. Further, direct thrombin inhibitors and platelet inhibitors in a patient-specific manner should also be considered.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Blood Coagulation Disorders
/
Complement Activation
/
SARS-CoV-2
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Reviews
Topics:
Long Covid
Country/Region as subject:
Asia
Language:
English
Journal:
Expert Rev Hematol
Journal subject:
Hematology
Year:
2021
Document Type:
Article
Affiliation country:
17474086.2021.1875813
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