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Thromb Haemost 2020; 120(12): 1654-1667
DOI: 10.1055/s-0040-1721487
Theme Issue Article

Hypercoagulopathy in Severe COVID-19: Implications for Acute Care

Alicia A. C. Waite
1   Institute for Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
2   Department of Intensive Care Medicine, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
,
David O. Hamilton
2   Department of Intensive Care Medicine, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
,
Roberto Pizzi
3   Department of Medicine and Surgery, University of Insubria, Varese, Italy
,
Walter Ageno
3   Department of Medicine and Surgery, University of Insubria, Varese, Italy
,
Ingeborg D. Welters
1   Institute for Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
2   Department of Intensive Care Medicine, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
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Abstract

COVID-19 was first described in late 2019 and has since developed into a pandemic affecting more than 21 million people worldwide. Of particular relevance for acute care is the occurrence of COVID-19-associated coagulopathy (CAC), which is characterised by hypercoagulability, immunothrombosis and venous thromboembolism, and contributes to hypoxia in a significant proportion of patients. This review describes diagnosis and treatment of CAC in the emergency department and in intensive care. We summarise the pathological mechanisms and common complications of CAC such as pulmonary thrombosis and venous thromboembolic events and discuss current strategies for thromboprophylaxis and therapeutic anti-coagulation in the acute care setting.

Keywords

anti-coagulation - coagulopathy - immunothrombosis - severe acute respiratory syndrome - venous thrombosis


Publication History

Received: 16 August 2020

Accepted: 09 November 2020

Article published online:
23 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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