Open AccessCOVID-19 Coagulopathy: From Pathogenesis to Treatment
Author(s) -
Teba Alnima,
Marlies Mulder,
Bas C.T. van Bussel,
Hugo Ten Cate
Publication year - 2022
Publication title -
acta haematologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 56
eISSN - 1421-9662
pISSN - 0001-5792
DOI - 10.1159/000522498
Subject(s) - coagulopathy , medicine , intensive care medicine , pandemic , disease , covid-19 , coronavirus , population , immunology , infectious disease (medical specialty) , environmental health
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic at the end of 2019 and continues to exert an unfavourable worldwide health impact on a large proportion of the population. A remarkable feature of COVID-19 disease is the precipitation of a hypercoagulable state, mainly in severe cases, leading to micro- and macrothrombosis, respiratory failure and death. Despite the implementation of various therapeutic regimes, including anticoagulants, a large number of patients suffer from such serious complications. This review aims to describe the current knowledge on the pathophysiology of the coagulation mechanism in COVID-19. We describe the interplay between three important mediators of the disease and how this may lead to a hyperinflammatory and pro-thrombotic state that affects outcome; namely, the endothelium, the immune system and the coagulation system. In line with the hypercoagulability state during COVID-19, we further review on the rare but severe vaccine-induced thrombotic thrombocytopenia. We also summarize and comment on available anticoagulant treatment options and include suggestions for some future treatment considerations for COVID-19 anti-coagulation therapy.