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Journal of Thrombosis and Thrombolysis
Published in: Journal of Thrombosis and Thrombolysis 2/2022

01-02-2022 | Computed Tomography

Cellular and molecular mechanisms in COVID-19 coagulopathy: role of inflammation and endotheliopathy

Authors: Rossella Cacciola, Elio Gentilini Cacciola, Veronica Vecchio, Emma Cacciola

Published in: Journal of Thrombosis and Thrombolysis | Issue 2/2022

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Abstract

Introduction

Coronavirus 2 (CoV-2) infection or coronavirus disease 2019 (COVID-19) is frequently associated with microvascular thrombosis.The microthrombosis in COVID-19 is the result of the interplay between inflammation and endotheliopathy. Elevated interleukin-6 (IL-6) characterizes COVID-19 inflammation resulting in endotheliopathy and coagulopathy marked by elevated D-dimer (DD). Aim of this study is to identify and to describe the coagulation changes in 100 moderate COVID-19 patients having lung involvement and to determine the association of coagulopathy with the severity and prognosis.

Methods

Inflammation, endothelial and coagulation molecules were measured in moderate and mild disease.

Results

IL-6 and tumor necrosis factor-α (TNF-α) and tissue factor (TF), von Willebrand factor (VWF), and tissue factor pathway inhibitor (TFPI) significantly increased in moderate disease as well as D-dimer, thrombin antithrombin complex (TAT), Fibrinogen (Fib), platelet factor-4 (PF4), β-thromboglobulin (β-TG), P-selectin, and platelet adhesion. Shortened clotting time (CT) and clot formation time (CFT), high maximum clot firmness (MCF) and low LY at 30 min were present in 100% of moderate COVID-19 patients compared with mild COVID-19 patients.

Conclusions

These findings demonstrate that moderate COVID-19 has a profound inflammation associated with severee ndotheliopathy and intense coagulation activation uncontrolled by TFPI.
Attention should be paid to coagulopathy in COVID-19. Closely monitoring of coagulation and application of appropriate anticoagulation may improve the prognosis of moderate COVID-19 and to prevent the progression to severe COVID-19 disease.
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Metadata
Title
Cellular and molecular mechanisms in COVID-19 coagulopathy: role of inflammation and endotheliopathy
Authors
Rossella Cacciola
Elio Gentilini Cacciola
Veronica Vecchio
Emma Cacciola
Publication date
01-02-2022
Publisher
Springer US
Published in
Journal of Thrombosis and Thrombolysis / Issue 2/2022
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI
https://doi.org/10.1007/s11239-021-02583-4

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