Emerging evidence of a COVID-19 thrombotic syndrome has treatment implications.
Nat Rev Rheumatol
; 16(10): 581-589, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-690837
ABSTRACT
Reports of widespread thromboses and disseminated intravascular coagulation (DIC) in patients with coronavirus disease 19 (COVID-19) have been rapidly increasing in number. Key features of this disorder include a lack of bleeding risk, only mildly low platelet counts, elevated plasma fibrinogen levels, and detection of both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and complement components in regions of thrombotic microangiopathy (TMA). This disorder is not typical DIC. Rather, it might be more similar to complement-mediated TMA syndromes, which are well known to rheumatologists who care for patients with severe systemic lupus erythematosus or catastrophic antiphospholipid syndrome. This perspective has critical implications for treatment. Anticoagulation and antiviral agents are standard treatments for DIC but are gravely insufficient for any of the TMA disorders that involve disorders of complement. Mediators of TMA syndromes overlap with those released in cytokine storm, suggesting close connections between ineffective immune responses to SARS-CoV-2, severe pneumonia and life-threatening microangiopathy.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Thrombosis
/
Coronavirus Infections
/
Betacoronavirus
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Language:
English
Journal:
Nat Rev Rheumatol
Journal subject:
Rheumatology
Year:
2020
Document Type:
Article
Affiliation country:
S41584-020-0474-5
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