Proposal of the Definition for COVID-19-Associated Coagulopathy

Journal of Clinical Medicine

JerroldH. Levy¹  Toshiaki Iba²  Jecko Thachil³  Marcel Levi⁴  TheodoreE. Warkentin⁵ 

[1] Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC 27710, USA;Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan;Department of Haematology, Manchester Royal Infirmary, Manchester M13 9WL, UK;Department of Medicine, University College London Hospitals NHS Foundation Trust, and Cardio-Metabolic Programme-NIHR UCLH/UCL BRC, London NW1 2BU, UK;Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada;

关键词: COVID-19;    disseminated intravascular coagulation;    endothelial cell;    coagulopathy;    heparin;   

DOI  :  10.3390/jcm10020191

来源: DOAJ

【 摘 要 】

Thrombotic events are common complications in COVID-19 patients that include both thrombus formation in large vessels and the microvasculature of the lung and other organs. COVID-19-associated coagulopathy (CAC) and disseminated intravascular coagulation (DIC) have similarities and differences, and whether CAC is a form of DIC is the subject of debate. Reported mechanisms of CAC include activated coagulation, endotheliopathy, up-regulated innate and adaptive immunity, and activated complement system. Although the clinical features and laboratory findings of CAC and DIC seem different, there are fundamental similarities that should be considered. Basically, the pathological findings of COVID-19 fall within the scope of the definition of DIC, i.e., systemic activation of coagulation caused by or resulting from the microvascular damage. Therefore, we suggest that although CAC differs from usual infection-associated DIC, its various features indicate that it can be considered a thrombotic phenotype DIC. This review summarizes the current knowledge about CAC including differences and similarities with sepsis-associated DIC.

【 授权许可】

Unknown