Hemostatic Abnormalities in COVID-19: An Update

被引:0
|
作者
Mukul Aggarwal
Jasmita Dass
Manoranjan Mahapatra
机构
[1] All India Institute of Medical Sciences,Department of Hematology
[2] New Delhi,undefined
来源
Indian Journal of Hematology and Blood Transfusion | 2020年 / 36卷
关键词
COVID-19; COVID associated coagulopathy; D-dimer; Thrombosis; Pulmonary intravascular coagulopathy;
D O I
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学科分类号
摘要
COVID-19 has emerged as a pandemic with lung being the primarily afflicted organ. Deranged hemostasis has been observed in patients with COVID-19 with scales tipped towards a prothrombotic state. The pathogenesis differs from disseminated intravascular coagulation with a primary pulmonary localization. This is referred to as pulmonary intravascular coagulopathy with strong component of thrombo-inflammation. This is reflected in the lab tests with an increase in D-dimer which correlates with severity and outcomes of disease. Common coagulation tests such as prothrombin time, activated partial thromboplastin time are only mildly prolonged while most patients have normal to increased fibrinogen and marginal thrombocytopenia. Overall, the patients have an increase in venous and arterial thrombotic events especially in ICU patients. Routine thromboprophylaxis with low molecular weight heparin is recommended in all hospitalized patients to reduce the incidence of thrombosis. Bleeding is uncommon and treated with blood products transfusion. This review shall discuss the hemostatic abnormalities in COVID-19 patients and their impact on prognosis. In addition, strategy of thromboprophylaxis and various academic society guidelines are discussed in detail.
引用
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页码:616 / 626
页数:10
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