The unique characteristics of COVID-19 coagulopathy

Critical Care - 2020
Toshiaki Iba1, Jerrold H. Levy2, Jean M. Connors3, Theodore E. Warkentin4, Jecko Thachil5, Marcel Levi6
1Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
2Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, USA
3Hematology Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
4Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, Hamilton, Canada
5Department of Haematology, Manchester Royal Infirmary, Manchester, UK
6Department of Medicine, University College London Hospitals NHS Foundation Trust, and Cardio-Metabolic Programme-NIHR UCLH/UCL BRC London, London, UK

Tóm tắt

AbstractThrombotic complications and coagulopathy frequently occur in COVID-19. However, the characteristics of COVID-19-associated coagulopathy (CAC) are distinct from those seen with bacterial sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC), with CAC usually showing increased D-dimer and fibrinogen levels but initially minimal abnormalities in prothrombin time and platelet count. Venous thromboembolism and arterial thrombosis are more frequent in CAC compared to SIC/DIC. Clinical and laboratory features of CAC overlap somewhat with a hemophagocytic syndrome, antiphospholipid syndrome, and thrombotic microangiopathy. We summarize the key characteristics of representative coagulopathies, discussing similarities and differences so as to define the unique character of CAC.

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