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This is a short review that focuses on the coagulation abnormalities in patients with COVID-19. Summarizing the latest data, the authors suggest that the coagulopathy associated with COVID-19 is a combination of low-grade disseminated intravascular coagulation and localized pulmonary thrombotic microangiopathy.
The authors suggest routine monitoring of prothrombin time, platelet count, and D-dimer levels every 2–3 days and encourage the use of thromboprophylaxis.
– Derrick Tao, MD
This abstract is available on the publisher's site.
Although most patients with coronavirus disease 2019 (COVID-19) predominantly have a respiratory tract infection, a proportion of patients progress to a more severe and systemic disease, characterised by treatment-resistant pyrexia, acute lung injury with acute respiratory distress syndrome (ARDS), shock, and multiple organ dysfunction, associated with substantial mortality.1 Many patients with severe COVID-19 present with coagulation abnormalities that mimic other systemic coagulopathies associated with severe infections, such as disseminated intravascular coagulation (DIC) or thrombotic microangiopathy, but COVID-19 has distinct features.2 Coagulopathy in patients with COVID-19 is associated with an increased risk of death.3 Furthermore, the relevance of COVID-19-coagulation abnormalities are becoming increasingly clear as a substantial proportion of patients with severe COVID-19 develop, sometimes unrecognised, venous and arterial thromboembolic complications.4,5 In this Comment we summarise the characteristics of COVID-19 coagulopathy, coagulation laboratory findings in affected patients, the prohaemostatic state and incidence of thromboembolic events, and potential therapeutic interventions.