Coagulation disorder in COVID-19 (Lancet, 10th July)
https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(20)30218-0/fulltext
In severe COVID cases
Severe acute respiratory syndrome
Severe dyspnoea and hypoxaemia
Sepsis or septic shock
Life-threatening organ dysfunction
Mild, moderate, severe, and critical COVID-19 infection
Increases blood clotting
COVID-19 infection is associated with coagulopathy of varying degrees
Similar to the changes observed in sepsis induced coagulopathy (SIC) or disseminated intravascular coagulopathy (DIC).
Severity of coagulopathy was associated with the severity of COVID-19 and mortality
Coagulopathy is associated with an endotheliopathy that causes a thrombotic microangiopathy and microcirculatory impairment.
Post-mortem findings of microvascular platelet-rich thrombotic depositions in small vessels of the lungs and other organs
Plausible explanation of sudden cerebrovascular complications
Myocardial ischaemia
Increasing reports of both micro-circulatory and macro-circulatory thromboembolic complications
https://onlinelibrary.wiley.com/doi/abs/10.1111/jth.14929
High incidence of VTE in hospitalized COVID‐19 patients
Particularly those with severe illness
Similar to the high VTE rates observed in patients with other viral pneumonias
Including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS‐CoV)
Implications for patient management
Thrombosis prophylaxis
Scientific and Standardization Committee of the International Society on Thrombosis and
Haemostasis
“a change of anticoagulant regimen from prophylactic low molecular weight heparin or intermediate-dose to treatment-dose regimen can be considered in patients without established venous thromboembolism, but deteriorating pulmonary status or acute respiratory distress syndrome”
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