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Coagulation Dysfunction.
Fei, Yang; Tang, Ning; Liu, Hefei; Cao, Wenjing.
  • Fei Y; From the Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Fei, Tang).
  • Tang N; From the Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Fei, Tang).
  • Liu H; the Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City (Liu, Cao).
  • Cao W; the Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City (Liu, Cao).
Arch Pathol Lab Med ; 144(10): 1223-1229, 2020 10 01.
Article in English | MEDLINE | ID: covidwho-860466
ABSTRACT
CONTEXT.­ The coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coagulation dysfunction is a hallmark in patients with COVID-19. Fulminant thrombotic complications emerge as critical issues in patients with severe COVID-19. OBJECTIVE.­ To present a review of the literature and discuss the mechanisms of COVID-19 underlying coagulation activation and the implications for anticoagulant and thrombolytic treatment in the management of COVID-19. DATA SOURCES.­ We performed a systemic review of scientific papers on the topic of COVID-19, available online via the PubMed NCBI, medRxiv, and Preprints as of May 15, 2020. We also shared our experience on the management of thrombotic events in patients with COVID-19. CONCLUSIONS.­ COVID-19-associated coagulopathy ranges from mild laboratory alterations to disseminated intravascular coagulation (DIC) with a predominant phenotype of thrombotic/multiple organ failure. Characteristically, high D-dimer levels on admission and/or continuously increasing concentrations of D-dimer are associated with disease progression and poor overall survival. SARS-CoV-2 infection triggers the immune-hemostatic response. Drastic inflammatory responses including, but not limited to, cytokine storm, vasculopathy, and NETosis may contribute to an overwhelming activation of coagulation. Hypercoagulability and systemic thrombotic complications necessitate anticoagulant and thrombolytic interventions, which provide opportunities to prevent or reduce "excessive" thrombin generation while preserving "adaptive" hemostasis and bring additional benefit via their anti-inflammatory effect in the setting of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Thrombosis / Blood Coagulation Disorders / Coronavirus Infections Type of study: Prognostic study / Reviews Topics: Long Covid Limits: Humans Language: English Journal: Arch Pathol Lab Med Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Thrombosis / Blood Coagulation Disorders / Coronavirus Infections Type of study: Prognostic study / Reviews Topics: Long Covid Limits: Humans Language: English Journal: Arch Pathol Lab Med Year: 2020 Document Type: Article