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. 2021 Jun 1;55(6):700-716.
doi: 10.1097/SHK.0000000000001680.

A Review of Pathophysiology, Clinical Features, and Management Options of COVID-19 Associated Coagulopathy

Julie Goswami  1 , Taleen A MacArthur  1 , Meera Sridharan  2 , Rajiv K Pruthi  2 , Robert D McBane 2nd  2   3 , Thomas E Witzig  2 , Myung S Park  1
Affiliations

A Review of Pathophysiology, Clinical Features, and Management Options of COVID-19 Associated Coagulopathy

Julie Goswami et al. Shock. .

Abstract

There is increasing evidence that novel coronavirus disease 2019 (COVID-19) leads to a significant coagulopathy, a phenomenon termed "COVID-19 associated coagulopathy." COVID-19 has been associated with increased rates of both venous and arterial thromboembolic events, a source of significant morbidity and mortality in this disease. Further evidence suggests a link between the inflammatory response and coagulopathy associated with COVID-19. This presents a unique set of challenges for diagnosis, prevention, and treatment of thrombotic complications. In this review, we summarize and discuss the current literature on laboratory coagulation disruptions associated with COVID-19 and the clinical effects of thromboembolic events including pulmonary embolism, deep vein thrombosis, peripheral arterial thrombosis, and acute ischemic stroke in COVID-19. Endothelial injury and augmented innate immune response are implicated in the development of diffuse macro- and microvascular thrombosis in COVID-19. The pathophysiology of COVID-19 associated coagulopathy is an important determinant of appropriate treatment and monitoring of these complications. We highlight the importance of diagnosis and management of dysregulated coagulation in COVID-19 to improve outcomes in COVID-19 patients with thromboembolic complications.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1:
Figure 1:
Description of Methods
Figure 2:
Figure 2:
Proposed mechanisms by which SARS Cov-2 infection leads to micro- and macrovascular thrombosis
See this image and copyright information in PMC

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