Coagulopathy in COVID-19: Manifestations and management

Cleve Clin J Med. 2020 Jul 31;87(8):461-468. doi: 10.3949/ccjm.87a.ccc024.

Abstract

Severe COVID-19 illness is associated with intense inflammation, leading to high rates of thrombotic complications that increase morbidity and mortality. Markedly elevated levels of D-dimer with normal fibrinogen levels are the hallmark laboratory findings of severe COVID-19- associated coagulopathy. Prophylaxis against venous thromboembolism is paramount for all hospitalized patients, with more aggressive prophylaxis and screening recommended for patients with D-dimer levels above 3.0 μg/mL. Point-of-care ultrasonography is the imaging method of choice for patients at high risk, as it entails minimal risk of exposing providers to the virus.

MeSH terms

  • Anticoagulants / pharmacology*
  • Betacoronavirus* / pathogenicity
  • Betacoronavirus* / physiology
  • Blood Coagulation / drug effects
  • Blood Coagulation / physiology
  • Blood Coagulation Disorders* / blood
  • Blood Coagulation Disorders* / etiology
  • Blood Coagulation Disorders* / therapy
  • Blood Coagulation Tests / methods
  • COVID-19
  • Chemoprevention / methods
  • Coronavirus Infections* / blood
  • Coronavirus Infections* / physiopathology
  • Coronavirus Infections* / therapy
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Monitoring, Physiologic / methods*
  • Pandemics*
  • Pneumonia, Viral* / blood
  • Pneumonia, Viral* / physiopathology
  • Pneumonia, Viral* / therapy
  • SARS-CoV-2
  • Thrombosis / etiology
  • Thrombosis / prevention & control

Substances

  • Anticoagulants
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D