Association of hypercoagulation with severe acute respiratory syndrome coronavirus 2 infection

Abstract

The coronavirus disease 2019 pandemic has emerged as a major threat to all healthcare systems across the globe, and it was declared a public health emergency of international concern by the World Health Organization (WHO). The novel coronavirus affects the respiratory system, producing symptoms such as fever, cough, dyspnea, and pneumonia. The association between COVID-19 and coagulation has been previously reported. Due to several inflammatory changes that occur in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections such as alterations in the levels of clotting factors, platelet activation leads to thrombus formation in coronary and cerebral vessels, leading to myocardial infarction and cerebrovascular accidents, respectively.Unfortunately, the progression of hypercoagulability in COVID-19 is rapid in patients with and without comorbidities. Hence, the proper monitoring of thrombotic complications in patients with COVID-19 is essential to avoid further complications. The implementation of guidelines for antithrombotic treatments based on the presentation of the disease is recommended. This review discusses the symptoms and mechanisms of upregulated coagulation in patients with COVID-19.

Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

“…Viral infections lead to inflammation, initiated by the primary target such as epithelial cells and subsequently by the immune cells, also observed in SARS-CoV-2 infection. This event could stimulate the coagulation system [96] , [97] . The findings from several studies describe a dysregulated coagulation process and the relationship between dysregulated fibrinolytic factors with COVID-19 severity, ARDS development and death.…”

Resolution of acute pulmonary embolism using anticoagulation therapy alone in coronavirus disease 2019

“…COVID-19 is associated with a hypercoagulable state 15 with active inflammatory cytokines which seem to contribute to mortality in critically ill patients. 16 Both “fibrinolytic shutdown” and the formation of antiphospholipid antibodies have been described in COVID-19 associated PE.…”

Prevention and treatment of COVID-19 in patients with benign and malignant blood disorders

“…Patients with SCD have been categorized as being at higher risk for COVID-19 severe illness and complications because of concerns about their compromised immune system related to functional hyposplenism, as well as their propensity to end organ damage, such as pulmonary and renal disease. In addition, SCD and COVID-19 are both considered to be thrombophilic conditions, with increased risk of venous thromboembolism [ 15 , 16 ]. However, there is conflicting empirical evidence on whether patients with SCD experience more severe COVID-19 disease, and whether their mortality rate is greater than the general population.…”