tetano
Editor, Senior Moderator
Shock
. 2020 Sep 2.
doi: 10.1097/SHK.0000000000001660. Online ahead of print.
COVID-19 Associated Hypercoagulability: Manifestations, Mechanisms, and Management
Michael A Mazzeffi[SUP] 1 [/SUP], Jonathan H Chow, Kenichi Tanaka
Affiliations
Abstract
Patients with severe coronavirus disease-2019 (COVID-19) frequently have hypercoagulability caused by the immune response to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The pathophysiology of COVID-19 associated hypercoagulability is not fully understood, but characteristic changes include: increased fibrinogen concentration, increased Factor VIII activity, increased circulating von Willebrand factor, and exhausted fibrinolysis. Anticoagulant therapy improves outcomes in mechanically ventilated patients with COVID-19 and viscoelastic coagulation testing offers an opportunity to tailor anticoagulant therapy based on an individual patient's coagulation status. In this narrative review, we summarize clinical manifestations of COVID-19, mechanisms, monitoring considerations, and anticoagulant therapy. We also review unique considerations for COVID-19 patients who are on extracorporeal membrane oxygenation.
. 2020 Sep 2.
doi: 10.1097/SHK.0000000000001660. Online ahead of print.
COVID-19 Associated Hypercoagulability: Manifestations, Mechanisms, and Management
Michael A Mazzeffi[SUP] 1 [/SUP], Jonathan H Chow, Kenichi Tanaka
Affiliations
- PMID: 32890309
- DOI: 10.1097/SHK.0000000000001660
Abstract
Patients with severe coronavirus disease-2019 (COVID-19) frequently have hypercoagulability caused by the immune response to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The pathophysiology of COVID-19 associated hypercoagulability is not fully understood, but characteristic changes include: increased fibrinogen concentration, increased Factor VIII activity, increased circulating von Willebrand factor, and exhausted fibrinolysis. Anticoagulant therapy improves outcomes in mechanically ventilated patients with COVID-19 and viscoelastic coagulation testing offers an opportunity to tailor anticoagulant therapy based on an individual patient's coagulation status. In this narrative review, we summarize clinical manifestations of COVID-19, mechanisms, monitoring considerations, and anticoagulant therapy. We also review unique considerations for COVID-19 patients who are on extracorporeal membrane oxygenation.