Coagulopathy in COVID-19 and Its Implication for Safe and Efficacious Thromboprophylaxis

TY - JOUR

T1 - Coagulopathy in COVID-19 and Its Implication for Safe and Efficacious Thromboprophylaxis

AU - Langer, Florian

AU - Kluge, Stefan

AU - Klamroth, Robert

AU - Oldenburg, Johannes

N1 - Georg Thieme Verlag KG Stuttgart · New York.

PY - 2020/8

Y1 - 2020/8

N2 - The novel coronavirus, SARS-CoV-2, is causing a global pandemic of life-threatening multiorgan disease, called COVID-19. Accumulating evidence indicates that patients with COVID-19 are at significant risk of thromboembolic complications, mainly affecting the venous, but also the arterial vascular system. While the risk of venous thromboembolism (VTE) appears to be higher in patients requiring intensive care unit support compared to those admitted to general wards, recent autopsy findings and data on the timing of VTE diagnosis relative to hospitalization clearly suggest that thromboembolic events also contribute to morbidity and mortality in the ambulatory setting. In addition to a severe hypercoagulable state caused by systemic inflammation and viral endotheliitis, some patients with advanced COVID-19 may develop a coagulopathy, which meets established laboratory criteria for disseminated intravascular coagulation, but is not typically associated with relevant bleeding. Similar to other medical societies, the Society of Thrombosis and Haemostasis Research has issued empirical recommendations on initiation, dosing, and duration of pharmacological VTE prophylaxis in COVID-19 patients.

AB - The novel coronavirus, SARS-CoV-2, is causing a global pandemic of life-threatening multiorgan disease, called COVID-19. Accumulating evidence indicates that patients with COVID-19 are at significant risk of thromboembolic complications, mainly affecting the venous, but also the arterial vascular system. While the risk of venous thromboembolism (VTE) appears to be higher in patients requiring intensive care unit support compared to those admitted to general wards, recent autopsy findings and data on the timing of VTE diagnosis relative to hospitalization clearly suggest that thromboembolic events also contribute to morbidity and mortality in the ambulatory setting. In addition to a severe hypercoagulable state caused by systemic inflammation and viral endotheliitis, some patients with advanced COVID-19 may develop a coagulopathy, which meets established laboratory criteria for disseminated intravascular coagulation, but is not typically associated with relevant bleeding. Similar to other medical societies, the Society of Thrombosis and Haemostasis Research has issued empirical recommendations on initiation, dosing, and duration of pharmacological VTE prophylaxis in COVID-19 patients.

KW - Anticoagulants/therapeutic use

KW - Autopsy/statistics & numerical data

KW - Betacoronavirus/isolation & purification

KW - Blood Coagulation Disorders/epidemiology

KW - COVID-19

KW - Case-Control Studies

KW - China/epidemiology

KW - Coronavirus Infections/complications

KW - Disseminated Intravascular Coagulation/blood

KW - Heparin, Low-Molecular-Weight/therapeutic use

KW - Hospitalization

KW - Humans

KW - Pandemics

KW - Pneumonia, Viral/complications

KW - SARS-CoV-2

KW - Survivors/statistics & numerical data

KW - Systemic Inflammatory Response Syndrome/physiopathology

KW - Thrombophilia/etiology

KW - Venous Thromboembolism/drug therapy

U2 - 10.1055/a-1178-3551

DO - 10.1055/a-1178-3551

M3 - SCORING: Review article

C2 - 32498097

VL - 40

SP - 264

EP - 269

JO - HAMOSTASEOLOGIE

JF - HAMOSTASEOLOGIE

SN - 0720-9355

IS - 3

ER -