COVID-19 infection and thrombosis

• Published in: Clinica chimica acta 2020-11, Vol.510, p.344-346
• Main Authors: Srivastava, Swati, Garg, Iti, Bansal, Anju, Kumar, Bhuvnesh
• Format: Article
• Language: English
• Subjects: Anticoagulants - therapeutic use; Coagulopathy; Coronavirus Infections - complications; Coronavirus Infections - drug therapy; Coronavirus Infections - epidemiology; COVID-19; Humans; Hypercoagulability; Letter to the Editor; LMWH; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - drug therapy; Pneumonia, Viral - epidemiology; Thrombosis; Thrombosis - complications
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2020.07.046

•Coagulation parameters such should be checked at the time of admission of COVID-19 patient.•Measurement of these parameters should continue at regular intervals during entire treatment.•Prophylactic anticoagulation therapy, with LMWH or unfractionated heparin is recommended.•Anticoagulation therapy is strongly recommended patients at high-risk for coagulopathy.•Dose and duration of anti-coagulation therapy should be decided on case to case basis. Recent reports on outbreak of SARS-CoV-2 coronavirus (COVID-19) have shown its association with abnormal blood clots. The viral infection initiates inflammatory responses leading to endothelial damage and coagulation cascade dysfnction. Spread of COVID-19 has been associated with disseminated intravascular coagulation (DIC) and subsequent coagulopathy. Initially coagulopathy in COVID-19 patients result in significant elevation of D-dimer, fibrin/fibrinogen degradation products (FDP), and abnormalities in coagulatory parameters, which resulting in formation of thrombus and eventually death. Present report intends to summarize the information of the research reports available so far on the complications of formation of unusal blood clots (thrombosis) during COVID-19 infection and its therapeutic strategies. Extensive web search was done for various reports associating COVID-19 infection with increased coagulopathy and abnormal coagulatory parameters such as PT, PTT, and platelet counts; along with increased D-dimer and fibrinogen levels. Findings of these research reports were summarized to recommend cautions for clinicians while treating COVID-19 patient. Screening of coagulatory parameters upon admission and during entire course of treatment is recommended, especially those who are at increased risk of thrombosis. Also, anticoagulant treatment can be used as thromboprophylaxis measure. Dose and duration of anticoagulation treatment requirement may vary and thus regular monitoring is needed.