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Review
. 2021 May;31(3):e2177.
doi: 10.1002/rmv.2177. Epub 2020 Oct 6.

Clotting disorder in severe acute respiratory syndrome coronavirus 2

Sujit Pujhari  1   2 , Sanjeeta Paul  3 , Jasmina Ahluwalia  4 , Jason L Rasgon  2
Affiliations
Review

Clotting disorder in severe acute respiratory syndrome coronavirus 2

Sujit Pujhari et al. Rev Med Virol. 2021 May.

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel human respiratory viral infection that has rapidly progressed into a pandemic, causing significant morbidity and mortality. Blood clotting disorders and acute respiratory failure have surfaced as the major complications among the severe cases of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection. Remarkably, more than 70% of deaths related to COVID-19 are attributed to clotting-associated complications such as pulmonary embolism, strokes and multi-organ failure. These vascular complications have been confirmed by autopsy. This study summarizes the current understanding and explains the possible mechanisms of the blood clotting disorder, emphasizing the role of (1) hypoxia-related activation of coagulation factors like tissue factor, a significant player in triggering coagulation cascade, (2) cytokine storm and activation of neutrophils and the release of neutrophil extracellular traps and (3) immobility and ICU related risk factors.

Keywords: COVID-19; IL-6; SARS-CoV-2; cytokine storm; pulmonary embolism; thrombosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Sujit Pujhari conceived the idea. Sujit Pujhari and Sanjeeta Paul did the literature search, drew the figures and wrote the manuscript. Sujit Pujhari, Sanjeeta Paul, Jasmina Ahluwalia and Jason L. Rasgon edited the manuscript. All the authors discussed and approved the manuscript.

Figures

FIGURE 1
FIGURE 1
Inflammation and fluid accumulation in alveoli due to severe acute respiratory syndrome coronavirus 2 infection
FIGURE 2
FIGURE 2
Mechanism of activation of coagulopathy in severe acute respiratory syndrome coronavirus 2 infection
See this image and copyright information in PMC

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