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Review
. 2021 Feb;42(2):93-100.
doi: 10.1016/j.revmed.2020.12.014. Epub 2021 Jan 5.

[COVID-19: Coagulopathy and thrombosis]

[Article in French]
Z Tazi Mezalek  1
Affiliations
Review

[COVID-19: Coagulopathy and thrombosis]

[Article in French]
Z Tazi Mezalek. Rev Med Interne. 2021 Feb.

Abstract
in English, French

The SARS-CoV-2 virus caused a global pandemic within weeks. Many patients with severe COVID-19 present with coagulation abnormalities, including increase D-dimers. This coagulopathy is associated with an increased risk of death. Furthermore, a substantial proportion of patients with severe COVID-19 develop sometimes unrecognized, venous thromboembolic complications. A better understanding of COVID-19 pathophysiology, in particular hemostatic disorders, will help to choose appropriate treatment strategies. A rigorous thrombotic risk assessment and the implementation of a suitable anticoagulation strategy are required. We review here the characteristics of COVID-19 coagulation laboratory findings in affected patients, the incidence of thromboembolic events and their specificities, and potential therapeutic interventions.

Le virus SARS-CoV-2 a provoqué une pandémie mondiale en quelques semaines, causant l’infection de plus de 20 millions de sujets. Près du 15 % des patients atteints de la maladie à coronavirus 2019 (COVID-19) et plus de 70 % des formes graves présentent des anomalies de coagulation. Cet état « d’hypercoagulabilité » incluant essentiellement une élévation marquée des D-Dimères est associé à un risque accru de décès. En outre, une proportion substantielle de patients atteints de COVID-19 sévère développent des complications thromboemboliques veineuses, incidence d’autant plus élevée que les patients sont admis en unités de soins intensifs ou en réanimation. Une meilleure compréhension de la physiopathologie de la COVID-19, en particulier des troubles de l’hémostase, permettra d’adapter des stratégies thérapeutiques, notamment anti-thrombotiques. La mise en évidence de ces anomalies doit être associée à une évaluation rigoureuse du risque thrombotique permettant la mise en place d’une stratégie anti-thrombotique adaptée. Nous passons en revue les caractéristiques des données biologiques de la « coagulopathie » associée à la COVID-19, l’incidence des événements thromboemboliques et leurs spécificités ainsi que les interventions thérapeutiques potentielles.

Keywords: COVID-19; Coagulopathie; Coagulopathy; Embolie pulmonaire; Pulmonary embolism; Thromboprophylaxie; Thromboprophylaxis; Thrombose veineuse; Venous thrombosis.

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