TY - JOUR
T1 - Proposal of the definition for covid-19-associated coagulopathy
AU - Iba, Toshiaki
AU - Warkentin, Theodore E.
AU - Thachil, Jecko
AU - Levi, Marcel
AU - Levy, Jerrold H.
N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/1/2
Y1 - 2021/1/2
N2 - Thrombotic events are common complications in COVID-19 patients that include both thrombus formation in large vessels and the microvasculature of the lung and other organs. COVID-19-associated coagulopathy (CAC) and disseminated intravascular coagulation (DIC) have similarities and differences, and whether CAC is a form of DIC is the subject of debate. Reported mechanisms of CAC include activated coagulation, endotheliopathy, up-regulated innate and adaptive immunity, and activated complement system. Although the clinical features and laboratory findings of CAC and DIC seem different, there are fundamental similarities that should be considered. Basically, the pathological findings of COVID-19 fall within the scope of the definition of DIC, i.e., systemic activation of coagulation caused by or resulting from the microvascular damage. Therefore, we suggest that although CAC differs from usual infection-associated DIC, its various features indicate that it can be considered a thrombotic phenotype DIC. This review summarizes the current knowledge about CAC including differences and similarities with sepsis-associated DIC.
AB - Thrombotic events are common complications in COVID-19 patients that include both thrombus formation in large vessels and the microvasculature of the lung and other organs. COVID-19-associated coagulopathy (CAC) and disseminated intravascular coagulation (DIC) have similarities and differences, and whether CAC is a form of DIC is the subject of debate. Reported mechanisms of CAC include activated coagulation, endotheliopathy, up-regulated innate and adaptive immunity, and activated complement system. Although the clinical features and laboratory findings of CAC and DIC seem different, there are fundamental similarities that should be considered. Basically, the pathological findings of COVID-19 fall within the scope of the definition of DIC, i.e., systemic activation of coagulation caused by or resulting from the microvascular damage. Therefore, we suggest that although CAC differs from usual infection-associated DIC, its various features indicate that it can be considered a thrombotic phenotype DIC. This review summarizes the current knowledge about CAC including differences and similarities with sepsis-associated DIC.
KW - COVID-19
KW - Coagulopathy
KW - Disseminated intravascular coagulation
KW - Endothelial cell
KW - Heparin
UR - http://www.scopus.com/inward/record.url?scp=85104656759&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/jcm10020191
DO - https://doi.org/10.3390/jcm10020191
M3 - Review article
C2 - 33430431
SN - 2077-0383
VL - 10
SP - 1
EP - 9
JO - Journal of clinical medicine
JF - Journal of clinical medicine
IS - 2
M1 - 191
ER -