Nuts and bolts of COVID-19 associated coagulopathy: the essentials for management and treatment

Postgrad Med. 2021 Nov;133(8):899-911. doi: 10.1080/00325481.2021.1974212. Epub 2021 Sep 11.

Abstract

Introduction: COVID-19-associated coagulopathy (CAC) is a well-recognized hematologic complication among patients with severe COVID-19 disease, where macro- and micro-thrombosis can lead to multiorgan injury and failure. Major societal guidelines that have published on the management of CAC are based on consensus of expert opinion, with the current evidence available. As a result of limited studies, there are many clinical scenarios that are yet to be addressed, with expert opinion varying on a number of important clinical issues regarding CAC management.

Methods: In this review, we utilize current societal guidelines to provide a framework for practitioners in managing their patients with CAC. We have also provided three clinical scenarios that implement important principles of anticoagulation in patients with COVID-19.

Conclusion: Overall, decisions should be made on acase by cases basis and based on the providers understanding of each patient's medical history, clinical course and perceived risk.

Keywords: COVID-19; anticoagulation; coronavirus; hematologic monitoring; therapeutic anticoagulation; thrombosis; venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Biomarkers / blood
  • Blood Coagulation Disorders / diagnosis
  • Blood Coagulation Disorders / therapy*
  • Blood Coagulation Disorders / virology
  • COVID-19 / complications*
  • Drug Monitoring
  • Fibrinolytic Agents / therapeutic use
  • Hemorrhage / chemically induced
  • Hemorrhage / therapy
  • Heparin / therapeutic use
  • Humans
  • Practice Guidelines as Topic*
  • Prevalence
  • Thromboembolism / diagnosis
  • Thromboembolism / epidemiology
  • Thromboembolism / therapy*
  • Thromboembolism / virology
  • Thrombosis / diagnosis
  • Thrombosis / epidemiology
  • Thrombosis / therapy*
  • Thrombosis / virology

Substances

  • Anticoagulants
  • Biomarkers
  • Fibrinolytic Agents
  • Heparin