COVID-19 and coagulative axis: review of emerging aspects in a novel disease

Monaldi Archives for Chest Disease

Roberto Parrella¹  Fabio Perrotta²  Tullio Valente³  Benito Celia⁴  Matilde Boccia⁴  Luigi Aronne⁴  Maria Ceparano⁴  Vito D'Agnano⁴  Andrea Bianco⁴  Grazia Mazzeo⁴ 

[1] Department of Infectious Diseases, COVID Unit D, Cotugno Hospital, A.O.R.N. dei Colli, Naples;Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso;Department of Radiology, Monaldi Hospital, A.O.R.N. dei Colli, Naples;Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples;

关键词: COVID-19;    SARS-CoV-2;    sepsis;    disseminated intravascular coagulation;    coagulopathy;   

DOI  :  10.4081/monaldi.2020.1300

来源: DOAJ

【 摘 要 】

Latest evidences from literature suggest that SARS-CoV-2 disease 2019 (COVID-19) is commonly complicated with coagulopathy and that disseminated intravascular coagulation is present in the majority of deceased patients. Particularly, conventional coagulation parameters appear to be significantly altered in patients with poor prognosis. A wide-ranging cross- talk between coagulative haemostasis and inflammation, as well as the activation of coagulation cascade during viral infections, are well established. Another important evidence which may explain coagulation disorders in COVID-19 is the increase of thrombus formation under conditions of hypoxia. Despite the exact pathophysiological mechanism of coronavirus-induced thromboembolism needs to be further investigated, this finding suggests that it is good practice to assess the risk of thrombosis in COVID-19 patients to improve the clinical management in terms of anticoagulation therapy. Anticoagulants, mainly low-molecular-weight heparin (LMWH), should be tailored in patients meeting sepsis induced coagulopathy (SIC) criteria or with markedly elevated D-dimer. In this context, further studies are needed to optimise the decision making in therapeutic approach.

【 授权许可】

Unknown