Cytokine storm associated coagulation complications in COVID-19 patients: Pathogenesis and Management.
Expert Rev Anti Infect Ther
; 19(11): 1397-1413, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1174805
ABSTRACT
INTRODUCTION:
SARS-CoV-2, the causative agent of COVID-19, attacks the immune system causing an exaggerated and uncontrolled release of pro-inflammatory mediators (cytokine storm). Recent studies propose an active role of coagulation disorders in disease progression. This hypercoagulability has been displayed by marked increase in D-dimer in hospitalized patients. AREAS COVERED This review summarizes the pathogenesis of SARS-CoV-2 infection, generation of cytokine storm, the interdependence between inflammation and coagulation, its consequences and the possible management options for coagulation complications like venous thromboembolism (VTE), microthrombosis, disseminated intravascular coagulation (DIC), and systemic and local coagulopathy. We searched PubMed, Scopus, and Google Scholar for relevant reports using COVID-19, cytokine storm, and coagulation as keywords. EXPERT OPINION A prophylactic dose of 5000-7500 units of low molecular weight heparin (LMWH) has been recommended for hospitalized COVID-19 patients in order to prevent VTE. Treatment dose of LMWH, based on disease severity, is being contemplated for patients showing a marked rise in levels of D-dimer due to possible pulmonary thrombi. Additionally, targeting PAR-1, thrombin, coagulation factor Xa and the complement system may be potentially useful in reducing SARS-CoV-2 infection induced lung injury, microvascular thrombosis, VTE and related outcomes like DIC and multi-organ failure.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Blood Coagulation Disorders
/
Venous Thromboembolism
/
Cytokine Release Syndrome
/
COVID-19
Type of study:
Prognostic study
/
Reviews
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Expert Rev Anti Infect Ther
Journal subject:
Communicable Diseases
Year:
2021
Document Type:
Article
Affiliation country:
14787210.2021.1915129
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