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01-11-2020 | Septicemia | IM - REVIEW

COVID-19, coagulopathy and venous thromboembolism: more questions than answers

Authors: Marco Marietta, Valeria Coluccio, Mario Luppi

Published in: Internal and Emergency Medicine | Issue 8/2020

Abstract

The acute respiratory illnesses caused by severe acquired respiratory syndrome corona Virus-2 (SARS-CoV-2) is a global health emergency, involving more than 8.6 million people worldwide with more than 450,000 deaths. Among the clinical manifestations of COVID-19, the disease that results from SARS-CoV-2 infection in humans, a prominent feature is a pro-thrombotic derangement of the hemostatic system, possibly representing a peculiar clinicopathologic manifestation of viral sepsis. The severity of the derangement of coagulation parameters in COVID-19 patients has been associated with a poor prognosis, and the use of low molecular weight heparin (LMWH) at doses registered for prevention of venous thromboembolism (VTE) has been endorsed by the World Health Organization and by Several Scientific societies. However, some relevant issues on the relationships between COVID-19, coagulopathy and VTE have yet to be fully elucidated. This review is particularly focused on four clinical questions: What is the incidence of VTE in COVID-19 patients? How do we frame the COVID-19 associated coagulopathy? Which role, if any, do antiphospolipid antibodies have? How do we tackle COVID-19 coagulopathy? In the complex scenario of an overwhelming pandemic, most everyday clinical decisions have to be taken without delay, although not yet supported by a sound scientific evidence. This review discusses the most recent findings of basic and clinical research about the COVID-associated coagulopathy, to foster a more thorough knowledge of the mechanisms underlying this compelling disease.

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Title: COVID-19, coagulopathy and venous thromboembolism: more questions than answers
Authors: Marco Marietta
Valeria Coluccio
Mario Luppi
Publication date: 01-11-2020
Publisher: Springer International Publishing
Keywords: Septicemia
Disseminated Intravascular Coagulation
Septicemia
Phlebothrombosis
COVID-19
Heparin
Low Molecular Weight Heparin
Fondaparinux
Published in: Internal and Emergency Medicine / Issue 8/2020
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-020-02432-x

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