Coagulopathy in COVID-19 and anticoagulation clinical trials

Best Pract Res Clin Haematol. 2022 Sep;35(3):101377. doi: 10.1016/j.beha.2022.101377. Epub 2022 Aug 23.

Abstract

Severe acute respiratory disease coronavirus 2 (SARS-COV-2) first emerged in Wuhan, China, in December 2019 and has caused a global pandemic of a scale unprecedented in the modern era. People infected with SARS-CoV-2 can be asymptomatic, moderate symptomatic or develop severe COVID-19. Other than the typical acute respiratory distress syndrome (ARDS), patients with moderate or severe COVID-19 also develop a distinctive systemic coagulopathy, known as COVID-19-associated coagulopathy (CAC), which is different from sepsis-related forms of disseminated intravascular coagulation (DIC). Endotheliopathy or endotheliitis are other unique features of CAC. The endothelial cell perturbation can further increase the risk of thrombotic events in COVID-19 patients. In this review, we will summarize the current knowledge on COVID-19 coagulopathy and the possible mechanisms for the condition. We also discuss the results of clinical trials testing methods for mitigating thrombosis events in COVID-19 patients.

Keywords: CAC; COVID-19; Coagulopathy; Endotheliitis; NETs.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • COVID-19* / complications
  • Humans
  • Pandemics
  • SARS-CoV-2
  • Thrombosis* / drug therapy
  • Thrombosis* / etiology

Substances

  • Anticoagulants