A Review of Pathophysiology, Clinical Features, and Management Options of COVID-19 Associated Coagulopathy

Julie Goswami, Taleen A. Macarthur, Meera Sridharan, Rajiv K. Pruthi, Robert D. McBane, Thomas E. Witzig, Myung S. Park

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

There is increasing evidence that novel coronavirus disease 2019 (COVID-19) leads to a significant coagulopathy, a phenomenon termed "COVID-19 associated coagulopathy." COVID-19 has been associated with increased rates of both venous and arterial thromboembolic events, a source of significant morbidity and mortality in this disease. Further evidence suggests a link between the inflammatory response and coagulopathy associated with COVID-19. This presents a unique set of challenges for diagnosis, prevention, and treatment of thrombotic complications. In this review, we summarize and discuss the current literature on laboratory coagulation disruptions associated with COVID-19 and the clinical effects of thromboembolic events including pulmonary embolism, deep vein thrombosis, peripheral arterial thrombosis, and acute ischemic stroke in COVID-19. Endothelial injury and augmented innate immune response are implicated in the development of diffuse macro- and microvascular thrombosis in COVID-19. The pathophysiology of COVID-19 associated coagulopathy is an important determinant of appropriate treatment and monitoring of these complications. We highlight the importance of diagnosis and management of dysregulated coagulation in COVID-19 to improve outcomes in COVID-19 patients with thromboembolic complications.

Original languageEnglish (US)
Pages (from-to)700-716
Number of pages17
JournalShock
Volume55
Issue number6
DOIs
StatePublished - Jun 1 2021

Keywords

  • COVID-19
  • Coagulation
  • DVT
  • coagulopathy
  • pulmonary embolism
  • thromboembolism
  • thrombosis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Emergency Medicine

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