Four years into the pandemic, managing COVID-19 patients with acute coagulopathy: what have we learned?

Toshiaki Iba, Jerrold H. Levy, Cheryl L. Maier, Jean M. Connors, Marcel Levi

Research output: Contribution to journalReview articleAcademicpeer-review


Coagulopathy alongside micro- and macrovascular thrombotic events were frequent characteristics of patients presenting with acute COVID-19 during the initial stages of the pandemic. However, over the past 4 years, the incidence and manifestations of COVID-19-associated coagulopathy have changed due to immunity from natural infection and vaccination and the appearance of new SARS-CoV-2 variants. Diagnostic criteria and management strategies based on early experience and studies for COVID-19-associated coagulopathy thus require reevaluation. As many other infectious disease states are also associated with hemostatic dysfunction, the coagulopathy associated with COVID-19 may be compounded, especially throughout the winter months, in patients with diverse etiologies of COVID-19 and other infections. This commentary examines what we have learned about COVID-19-associated coagulopathy throughout the pandemic and how we might best prepare to mitigate the hemostatic consequences of emerging infection agents.
Original languageEnglish
Pages (from-to)1541-1549
Number of pages9
JournalJournal of thrombosis and haemostasis
Issue number6
Early online date2024
Publication statusPublished - Jun 2024


  • COVID-19
  • anticoagulation
  • coagulopathy
  • critical illness
  • hyperviscosity
  • immunity
  • thromboembolism
  • thrombosis

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