COVID-19 相关凝血病：目前已知的情况

Title:COVID-19 Related Coagulopathy: What is Known Up to Now

Volume: 28 Issue: 21

关键词: COVID-19、凝血、凝血病、急性呼吸窘迫综合征、血管紧张素转换酶 2、SARS-CoV-2。

摘要: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has been a global challenge. The complicated forms of the Coronavirus Disease 2019 (COVID- 19) can evolve to multiple-organ failure, including several coagulopathies related to a sudden worsening of respiratory status. This article aimed to review studies about hematological and hemostatic laboratory disorders directly related to COVID-19 and to discuss how SARS-CoV- 2 causes these abnormalities. The coagulation cascade model is associated with both COVID- 19 and pulmonary involvement. Laboratory changes are relevant to evaluate the coagulation state - D-dimer, prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), platelet count and fibrinogen. Pregnant women and patients in Extracorporeal Membrane Oxygenation (ECMO) need special attention. Prophylactic interventions for COVID-19 coagulopathy should consider patients at risk for thrombotic events and potential contraindications. The mechanisms exerted by SARS-CoV-2 that impairs hemostatic balance include endothelial injury, inflammation, and activation of the immune and complement systems. For diagnosis of coagulopathy, mainly D-dimer, but also PT, APTT and FDP, should be evaluated in COVID-19 patients. Intervention possibilities vary between low-molecular-weight heparin (LMWH) and Unfractionated Heparin (UFH). Until now, there is sufficient evidence that acutely-ill patients with risk factors for coagulopathies will benefit from thrombophylaxis during hospitalization and post-discharge, but not all patients.

Cite this article as:

COVID-19 Related Coagulopathy: What is Known Up to Now, Current Medicinal Chemistry 2021; 28 (21) . https://dx.doi.org/10.2174/0929867327666201005112231