Review
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Year 2021, Volume: 7 Issue: 2, 209 - 217, 04.03.2021
https://doi.org/10.18621/eurj.830973

Abstract

References

  • 1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.
  • 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
  • 3. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020;18:844-7.
  • 4. https://www.hematology.org/COVID-19/COVID-19-and-coagulopathy (Accessed on April 20, 2020).
  • 5. Connors JM, Levy JH.. Thromboinflammation and the hypercoagulability of COVID‐19. J Thromb Haemost 2020;18;1559-61.
  • 6. Klok FA, Kruip MJHA, Van Der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res 2020;191:148-50.
  • 7. Ciceri F, Beretta L, Scandroglio AM, Colombo S, Landoni G, Ruggeri A, et al. Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis. Crit Care Resusc 2020;22:95-7.
  • 8. Krishna S, Eswaran N. Recent research progress and current understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Asian J Biol 2020;10:9-21.
  • 9. Schmaier AH. The plasma kallikrein-kinin system counterbalances the renin-angiotensin system. J Clin Invest 2002;109:1007-9.
  • 10. Van de Veerdonk F, Netea MG, van Deuren M, van der Meer JW, de Mast Q, Bruggemann R, et al. Kinins and cytokines in COVID-19: a comprehensive pathophysiological approach. Preprints 2020;2020040023
  • 11. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, et al. Hypercoagulability of COVID‐19 patients in intensive care unit. A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost 2020;18:1738-42.
  • 12. Ranucci M, Ballotta A, Di Dedda U, Bayshnikova E, Dei Poli M, Resta M, et al. The procoagulant pattern of patients with COVID‐19 acute respiratory distress syndrome. J Thromb Haemost 2020;18:1747-51.
  • 13. https://www.esicm.org/wp-content/uploads/2020/04/863_author_proof.pdf (Accessed on April 25, 2020.
  • 14. Bowles L, Platton S, Yartey N, Dave M, Lee K, Hart DP, et al. Lupus anticoagulant and abnormal coagulation tests in patients with Covid-19. N Engl J Med 2020;383:288-90.
  • 15. Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, et al. Pathogenic T cells and inflammatory monocytes incite inflammatory stroms in severe COVID-19 patients. Nat Sci Rev 2020;6:998-1002.
  • 16. Magro C, Mulvey JJ, Berlin D, Nuovo G, Salvatore S, Harp J, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res 2020;220:1-3.
  • 17. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016;315:801-10.
  • 18. Levi M, van der Poll T. Coagulation and sepsis. Thromb Res 2017;149:38-44.
  • 19. Schmitt FCF, Manolov V, Morgenstern J, Fleming T, Heitmeier S, Uhle F, et al. Acute fibrinolysis shutdown occurs early in septic shock and is associated with increased morbidity and mortality: results of an observational pilot study. Ann Intens Care 2019;9:19.
  • 20. Monteleone G, Sarzi-Puttini PC, Ardizzone S. Preventing COVID-19-induced pneumonia with anticytokine therapy. Lancet Rheumatol 2020;2:e255-6.
  • 21. Mastellos DC, Ricklin D, Lambris JD. Clinical promise of next-generation complement therapeutics. Nat Rev Drug Discov 2019;18:707-29.
  • 22. Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med 2017;377:562-72.
  • 23. Tan CW, Low JGH, Wong WH, Chua YY, Goh SL, Ng HJ. Critically ill COVID‐19 infected patients exhibit increased clot waveform analysis parameters consistent with hypercoagulability. Am J Hematol 2020;95:E156-8.
  • 24. Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D. Covid-19 does not lead to a “typical” acute respiratory distress syndrome. Am J Respir Crit Care Med 2020;201:1299-300.
  • 25. Gupta N, Zhao YY, Evans CE. The stimulation of thrombosis by hypoxia. Thromb Res 2019;181:77-83.
  • 26. Begbie M, Notley C, Tinlin S, Sawyer L, Lillicrap D. The factor VIII acute phase response requires the participation of NFκB and C/EBP. Thromb Haemost 2000;84:216-22.
  • 27. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.
  • 28. Fox SE, Akmatbekov A, Harbert JL, Li G, Brown JQ, Vander Heide RS. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med 2020;8:681-6.
  • 29. Memikoğlu O, Genç V. COVİD-19. E-Kitap, Ankara Üniversitesi Basımevi: Ankara, 2020.
  • 30. Bellosta R, Luzzani, L, Natalini G, Pegorer MA, Attisani L, Cossu LG, et al. Acute limb ischemia in patients with COVID-19 pneumonia. J Vasc Surg 2020;72:1864-72.
  • 31. Taylor FB, Toh CH, Hoots WK, Wada H, Levi M. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 2001;86:1327-30.
  • 32. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID‐19. J Thromb Haemost 2020;18:1023-6.
  • 33. Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol 2009;145:24-33.
  • 34. Di Nisio M, Baudo F, Cosmi B, D'Angelo A, De Gasperi, A, Malato A, et al. Diagnosis and treatment of disseminated intravascular coagulation: guidelines of the Italian Society for Haemostasis and Thrombosis (SISET). Thromb Res 2012;129:e177-84.
  • 35. Iba T, Di Nisio M, Levy JH, Kitamura N, Thachil J. New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: a retrospective analysis of a nationwide survey. BMJ Open 2017;7:e017046.
  • 36. Turkey Ministry of Health, General Directorate of Public Health, COVID-19 (SARS-CoV-2 Infection) Guide. April 12, 2020, pp. 64-8.
  • 37. Iba T, Levy JH, Warkentin TE, Thachil J, van der Poll T, Levi M; Scientific and Standardization Committee on DIC, and the Scientific and Standardization Committee on Perioperative and Critical Care of the International Society on Thrombosis and Haemostasis. Diagnosis and management of sepsis‐induced coagulopathy and disseminated intravascular coagulation. J Thromb Haemost 2019;17:1989-94.
  • 38. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020;18:1094-9.
  • 39. Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020;295:202-7.
  • 40. Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020;295:715-21.
  • 41. Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 2020;296:E46-54.
  • 42. Caruso D, Zerunian M, Polici M, Pucciarelli F, Polidori T, Rucci C, et al. Chest CT features of COVID-19 in Rome, Italy. Radiology 2020;296:E79-85.
  • 43. Cuker A, Peyvandi F. Coronavirus disease 2019 (COVID-19): Hypercoagulability. UpToDate 2020. https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-hypercoagulability (Accessed on November 26, 2020).
  • 44. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.
  • 45. Poterucha TJ, Libby P, Goldhaber SZ. More than an anticoagulant: Do heparins have direct anti-inflammatory effects? Thromb Haemost 2017;117:437-44.

COVID-19 and hypercoagulability

Year 2021, Volume: 7 Issue: 2, 209 - 217, 04.03.2021
https://doi.org/10.18621/eurj.830973

Abstract

It has been observed that patients with COVID-19 infection may develop acute pulmonary embolism (APE), acute myocardial infarction, limb thrombosis, and venous and / or arterial thrombosis, including central nervous system. Thrombosis formation in COVID-19 patients can be explained by the virchow triad. Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) can directly attack vascular endothelial cells, causing excessive activation of the immune system and cytokine storm, causing thrombosis. Increased prothrombotic factors such as antiphospholipid antibodies, elevated factor VIII, high fibrinogen, circulating prothrombotic microparticles, neutrophil extracellular traps have been reported in COVID-19 infection. It has been argued that complement-mediated endothelial damage, increase in pro-inflammatory cytokines such as interleukin (IL)-1, IL-6, IL-8 and interferon-γ may be the cause of thrombosis. Autopsies of patients with COVID-19 revealed that the causes of death were pneumonia and pulmonary embolism. When monitoring COVID-19 patients, platelet, prothrombin time (PT) and activated partial thromboplastin time (aPTT), fibrinogen and D-dimer monitoring should be initiated every 1-2 days, especially in critically ill patients. High D-dimer levels are associated with high mortality; may indicate infection/sepsis, cytokine storm, and impending organ failure. Disseminated intravascular coagulation (DIC) may be seen in COVID-19 patients, but unlike DIC, fibrinogen is usually high. Clotting times and platelet counts are usually normal. Therefore, it is appropriate to use sepsis-induced coagulopathy (SIC) criteria in the follow-up of COVID-19 patients. Infected areas related to pulmonary embolism can be seen as radiological appearance. Some patients may have enlarged subsegmental pulmonary vessels. Treatment of the underlying disease is the most important treatment for all coagulopathies. Patients with venous thromboembolism, inpatient medical, surgical, and COVID-19 therapy should receive anticoagulant therapy unless there is a contraindication to anticoagulation (for example, active bleeding or severe bleeding within the previous 24 to 48 hours).

References

  • 1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.
  • 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
  • 3. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020;18:844-7.
  • 4. https://www.hematology.org/COVID-19/COVID-19-and-coagulopathy (Accessed on April 20, 2020).
  • 5. Connors JM, Levy JH.. Thromboinflammation and the hypercoagulability of COVID‐19. J Thromb Haemost 2020;18;1559-61.
  • 6. Klok FA, Kruip MJHA, Van Der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res 2020;191:148-50.
  • 7. Ciceri F, Beretta L, Scandroglio AM, Colombo S, Landoni G, Ruggeri A, et al. Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis. Crit Care Resusc 2020;22:95-7.
  • 8. Krishna S, Eswaran N. Recent research progress and current understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Asian J Biol 2020;10:9-21.
  • 9. Schmaier AH. The plasma kallikrein-kinin system counterbalances the renin-angiotensin system. J Clin Invest 2002;109:1007-9.
  • 10. Van de Veerdonk F, Netea MG, van Deuren M, van der Meer JW, de Mast Q, Bruggemann R, et al. Kinins and cytokines in COVID-19: a comprehensive pathophysiological approach. Preprints 2020;2020040023
  • 11. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, et al. Hypercoagulability of COVID‐19 patients in intensive care unit. A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost 2020;18:1738-42.
  • 12. Ranucci M, Ballotta A, Di Dedda U, Bayshnikova E, Dei Poli M, Resta M, et al. The procoagulant pattern of patients with COVID‐19 acute respiratory distress syndrome. J Thromb Haemost 2020;18:1747-51.
  • 13. https://www.esicm.org/wp-content/uploads/2020/04/863_author_proof.pdf (Accessed on April 25, 2020.
  • 14. Bowles L, Platton S, Yartey N, Dave M, Lee K, Hart DP, et al. Lupus anticoagulant and abnormal coagulation tests in patients with Covid-19. N Engl J Med 2020;383:288-90.
  • 15. Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, et al. Pathogenic T cells and inflammatory monocytes incite inflammatory stroms in severe COVID-19 patients. Nat Sci Rev 2020;6:998-1002.
  • 16. Magro C, Mulvey JJ, Berlin D, Nuovo G, Salvatore S, Harp J, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res 2020;220:1-3.
  • 17. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016;315:801-10.
  • 18. Levi M, van der Poll T. Coagulation and sepsis. Thromb Res 2017;149:38-44.
  • 19. Schmitt FCF, Manolov V, Morgenstern J, Fleming T, Heitmeier S, Uhle F, et al. Acute fibrinolysis shutdown occurs early in septic shock and is associated with increased morbidity and mortality: results of an observational pilot study. Ann Intens Care 2019;9:19.
  • 20. Monteleone G, Sarzi-Puttini PC, Ardizzone S. Preventing COVID-19-induced pneumonia with anticytokine therapy. Lancet Rheumatol 2020;2:e255-6.
  • 21. Mastellos DC, Ricklin D, Lambris JD. Clinical promise of next-generation complement therapeutics. Nat Rev Drug Discov 2019;18:707-29.
  • 22. Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med 2017;377:562-72.
  • 23. Tan CW, Low JGH, Wong WH, Chua YY, Goh SL, Ng HJ. Critically ill COVID‐19 infected patients exhibit increased clot waveform analysis parameters consistent with hypercoagulability. Am J Hematol 2020;95:E156-8.
  • 24. Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D. Covid-19 does not lead to a “typical” acute respiratory distress syndrome. Am J Respir Crit Care Med 2020;201:1299-300.
  • 25. Gupta N, Zhao YY, Evans CE. The stimulation of thrombosis by hypoxia. Thromb Res 2019;181:77-83.
  • 26. Begbie M, Notley C, Tinlin S, Sawyer L, Lillicrap D. The factor VIII acute phase response requires the participation of NFκB and C/EBP. Thromb Haemost 2000;84:216-22.
  • 27. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.
  • 28. Fox SE, Akmatbekov A, Harbert JL, Li G, Brown JQ, Vander Heide RS. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med 2020;8:681-6.
  • 29. Memikoğlu O, Genç V. COVİD-19. E-Kitap, Ankara Üniversitesi Basımevi: Ankara, 2020.
  • 30. Bellosta R, Luzzani, L, Natalini G, Pegorer MA, Attisani L, Cossu LG, et al. Acute limb ischemia in patients with COVID-19 pneumonia. J Vasc Surg 2020;72:1864-72.
  • 31. Taylor FB, Toh CH, Hoots WK, Wada H, Levi M. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 2001;86:1327-30.
  • 32. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID‐19. J Thromb Haemost 2020;18:1023-6.
  • 33. Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol 2009;145:24-33.
  • 34. Di Nisio M, Baudo F, Cosmi B, D'Angelo A, De Gasperi, A, Malato A, et al. Diagnosis and treatment of disseminated intravascular coagulation: guidelines of the Italian Society for Haemostasis and Thrombosis (SISET). Thromb Res 2012;129:e177-84.
  • 35. Iba T, Di Nisio M, Levy JH, Kitamura N, Thachil J. New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: a retrospective analysis of a nationwide survey. BMJ Open 2017;7:e017046.
  • 36. Turkey Ministry of Health, General Directorate of Public Health, COVID-19 (SARS-CoV-2 Infection) Guide. April 12, 2020, pp. 64-8.
  • 37. Iba T, Levy JH, Warkentin TE, Thachil J, van der Poll T, Levi M; Scientific and Standardization Committee on DIC, and the Scientific and Standardization Committee on Perioperative and Critical Care of the International Society on Thrombosis and Haemostasis. Diagnosis and management of sepsis‐induced coagulopathy and disseminated intravascular coagulation. J Thromb Haemost 2019;17:1989-94.
  • 38. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020;18:1094-9.
  • 39. Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020;295:202-7.
  • 40. Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020;295:715-21.
  • 41. Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 2020;296:E46-54.
  • 42. Caruso D, Zerunian M, Polici M, Pucciarelli F, Polidori T, Rucci C, et al. Chest CT features of COVID-19 in Rome, Italy. Radiology 2020;296:E79-85.
  • 43. Cuker A, Peyvandi F. Coronavirus disease 2019 (COVID-19): Hypercoagulability. UpToDate 2020. https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-hypercoagulability (Accessed on November 26, 2020).
  • 44. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.
  • 45. Poterucha TJ, Libby P, Goldhaber SZ. More than an anticoagulant: Do heparins have direct anti-inflammatory effects? Thromb Haemost 2017;117:437-44.
There are 45 citations in total.

Details

Primary Language English
Subjects Respiratory Diseases
Journal Section Reviews
Authors

Hasan Ölmez 0000-0003-4153-9953

Mustafa Tosun 0000-0003-4153-9953

Edhem Ünver 0000-0002-0322-8102

Mehmet Doğan This is me

Nurten Arslan Işık 0000-0002-5192-6263

Publication Date March 4, 2021
Submission Date November 26, 2020
Acceptance Date February 5, 2021
Published in Issue Year 2021 Volume: 7 Issue: 2

Cite

AMA Ölmez H, Tosun M, Ünver E, Doğan M, Arslan Işık N. COVID-19 and hypercoagulability. Eur Res J. March 2021;7(2):209-217. doi:10.18621/eurj.830973

e-ISSN: 2149-3189 


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