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. 2021 Mar;113(3):320-329.
doi: 10.1007/s12185-021-03084-z. Epub 2021 Feb 7.

Diagnosis and treatment of disseminated intravascular coagulation in COVID-19 patients: a scoping review

Hirotaka Mori  1 , Hiroshi Ohkawara  1 , Ryuichi Togawa  2 , Mami Rikimaru  2 , Yoko Shibata  2 , Takayuki Ikezoe  3
Affiliations

Diagnosis and treatment of disseminated intravascular coagulation in COVID-19 patients: a scoping review

Hirotaka Mori et al. Int J Hematol. 2021 Mar.

Abstract

Background: Disseminated intravascular coagulation (DIC) is noted in severe cases of coronavirus disease 2019 (COVID-19). Recently, a number of studies evaluating the diagnosis and treatment of DIC in COVID-19 patients have been reported.

Objective: The aim of this study is to identify existing gaps where further research is needed on the diagnosis and treatment of DIC complicated by COVID-19.

Methods: We used the PRISMA Extension for Scoping Reviews. MEDLINE, CENTRAL, WHO-ICTRP, ClinicalTrial.gov and PROSPERO were searched from their inception to 6 October 2020.

Results: Seven studies were selected; five were already published and two are ongoing. DIC was diagnosed using the International Society on Thrombosis and Hemostasis (ISTH) DIC score (n = 4) and the sepsis-induced coagulopathy (SIC) DIC score (n = 5). Seven studies examined the effectiveness of low molecular weight heparin (LMWH); of these, four studies used a prophylactic dose and five used a therapeutic dose of LMWH. A prophylactic dose of unfractionated heparin (UFH) was investigated in two studies.

Conclusion: Studies on DIC diagnostic criteria and anticoagulants were limited to the ISTH or SIC scores and heparinoids, particularly LMWH. Further studies are needed to compare these with other available DIC scoring systems and anticoagulants.

Keywords: Anticoagulants; COVID-19; Coagulopathy; Disseminated intravascular coagulation; Scoping review.

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Conflict of interest statement

All of the authors declare that they have no conflicts of interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram. PRISMA preferred reporting items for systematic reviews and meta-analyses
Fig. 2
Fig. 2
Characteristics of the sources of evidence. CR case report, CS case series, CC case control, pros prospective cohort study, retro retrospective cohort study, ISTH International Society on Thrombosis and Haemostasis, JAAM Japanese Association for acute medicine, JMHW Japanese Ministry of Health and Welfare, SIC sepsis-induced coagulopathy, P-UFH prophylactic dose of unfractionated heparin, T-UFH therapeutic dose of unfractionated heparin, P-LMWH prophylactic dose of low molecular weight heparin, T-LMWH therapeutic dose of low molecular weight heparin, rTM recombinant thrombomodulin, SE side effects, No. number
See this image and copyright information in PMC

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