Status of major hemostatic components in the setting of COVID-19: the effect on endothelium, platelets, coagulation factors, fibrinolytic system, and complement

Ann Hematol. 2023 Jun;102(6):1307-1322. doi: 10.1007/s00277-023-05234-1. Epub 2023 Apr 19.

Abstract

The coagulation, fibrinolytic, anticoagulation, and complement systems are in delicate balance with the vessel wall endothelium ensuring appropriate hemostasis. Coagulopathy in coronavirus disease 2019 (COVID-19) is not a simple disorder of one hemostatic component but a complicated process affecting most of the hemostasis system. COVID-19 disturbs the balance between the procoagulant systems and the regulatory mechanisms. Here, we investigate the effect of COVID-19 on key hemostatic components, including platelets, endothelial cells, coagulation factors, fibrinolytic system, anticoagulant protein system, and complement system, to improve our understanding of the pathophysiological processes underlying COVID-19 coagulopathy based on evidence.

Keywords: Blood platelets; COVID-19; Endothelium; Fibrinolysis; Hemostasis; Thrombosis.

Publication types

  • Review

MeSH terms

  • Blood Coagulation Disorders*
  • Blood Coagulation Factors / metabolism
  • Blood Platelets / metabolism
  • COVID-19*
  • Endothelial Cells / metabolism
  • Endothelium, Vascular / metabolism
  • Fibrinolysis
  • Hemostasis
  • Hemostatics* / pharmacology
  • Humans

Substances

  • Hemostatics
  • Blood Coagulation Factors