Plasma Antithrombin Values Are Significantly Decreased in Coronavirus Disease 2019 (COVID-19) Patients with Severe Illness

Lippi, Giuseppe; Henry, Brandon Michael; Sanchís-Gomar, Fabián

doi:10.1055/s-0040-1716873

Cited by 19 publications

(16 citation statements)

References 21 publications

(16 reference statements)

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“…77 Importantly, the severe pro-inflammatory condition is then associated with a remarkable associated increase in the circulating levels of many acute-phase proteins, including fibrinogen, vWF, and FVIII, 78,79 and which may hence contribute to amplify the thrombotic process. Evidence has also been provided that the ongoing thrombotic process would contribute to sustain or even amplify the prothrombotic state, as mirrored by a progressive decline in the activity of the major endogenous anticoagulants such as antithrombin, tissue factor pathway inhibitor, and anticoagulation proteins C and S. 75 In fact, Lippi et al 80 recently found in a metaanalysis that low antithrombin levels were significantly associated with COVID-19 severity.…”

Section: Derangement Of Secondary Hemostasismentioning

confidence: 99%

Coronavirus Disease 2019–Associated Coagulopathy

Lippi

Sanchís-Gomar

Favaloro

et al. 2021

Mayo Clinic Proceedings

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Patients with the severe form of coronavirus disease 2019 (COVID-19) have been frequently found to suffer from both arterial and venous thrombotic events due to the perpetuation of a hypercoagulable state. This phenomenon, termed COVID-19-associated coagulopathy (CC), is now considered a major component of the pathophysiology of this novel infectious disease, leading to widespread thrombosis. While at first, the vascular insults may be limited to the pulmonary microvasculature, as the disease progresses, systemic involvement occurs, culminating in distant organ thrombosis and multi-organ dysfunction syndrome. In this review article, we discuss recent insights into the pathophysiologic mechanisms of CC and review the clinical, histopathologic, and laboratory evidence, which leads us to conclude that COVID-19 is both a pulmonary and vascular disorder.

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Section: Derangement Of Secondary Hemostasismentioning

confidence: 99%

Coronavirus Disease 2019–Associated Coagulopathy

Lippi

Sanchís-Gomar

Favaloro

et al. 2021

Mayo Clinic Proceedings

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“…Concerning the changes in plasma levels of antithrombin, a systematic review and meta-analysis of 471 patients calculated the weighted mean difference (WMD) of antithrombin levels in these patients with or without severe illness. 104 It was shown that WMD of antithrombin levels in the gravely ill (n ¼ 197, 41.8%), compared with those with a milder course, was -10 IU/dL (95% confidence interval: -3 to -17 IU/dL; I2: 86%). This study indicated that antithrombin levels are significantly reduced in severe illness.…”

Section: Antithrombinmentioning

confidence: 97%

The Impact of SARS-CoV-2 Infection on Blood Coagulation and Fibrinolytic Pathways: A Review of Prothrombotic Changes Caused by COVID-19

Bahraini

Dorgalaleh

2021

Semin Thromb Hemost

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The cardinal pathology of coronavirus disease 2019 (COVID-19) is a primary infection of pulmonary tract cells by severe acute respiratory syndrome coronavirus 2, provoking a local inflammatory response, often accompanied by cytokine storm and acute respiratory distress syndrome, especially in patients with severe disease. Systemic propagation of the disease may associate with thrombotic events, including deep vein thrombosis, pulmonary embolism, and thrombotic microangiopathy, which are important causes of morbidity and mortality in patients with COVID-19. This narrative review describes current knowledge of the pathophysiological mechanisms of COVID-19-associated coagulopathy, with focus on prothrombotic changes in hemostatic mediators, including plasma levels of clotting factors, natural anticoagulants, components of fibrinolytic system, and platelets. It will also highlight the central role of endothelial cells in COVID-19-associated coagulopathy. This narrative review discusses also potential therapeutic strategies for managing thrombotic complications. Awareness by medical experts of contributors to the pathogenesis of thrombotic events in COVID-19 is imperative to develop therapeutics not limited to regular anticoagulants. Instituting cooperation among medical personnel and researchers may lessen this novel virus' impact now, and in the event of recurrence.

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“…Hyperinflammation can markedly decrease AT levels and glycosaminoglycan synthesis, which is associated with coagulation (124). Additionally, several recent studies have shown that plasma antithrombin values are significantly decreased in COVID-19, which is strongly associated with mortality in COVID-19 (125)(126)(127). At supplementation, using fresh frozen plasma (FFP) in COVID-19 patients may improve thrombosis prophylaxis and thus have an impact on their survival (126).…”

Section: Antithrombinmentioning

confidence: 99%

Immunothrombosis in Acute Respiratory Dysfunction of COVID-19

Fang

Wang

et al. 2021

Front. Immunol.

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COVID-19 is an acute, complex disorder that was caused by a new β-coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Based on current reports, it was surprising that the characteristics of many patients with COVID-19, who fulfil the Berlin criteria for acute respiratory distress syndrome (ARDS), are not always like those of patients with typical ARDS and can change over time. While the mechanisms of COVID-19–related respiratory dysfunction in COVID-19 have not yet been fully elucidated, pulmonary microvascular thrombosis is speculated to be involved. Considering that thrombosis is highly related to other inflammatory lung diseases, immunothrombosis, a two-way process that links coagulation and inflammation, seems to be involved in the pathophysiology of COVID-19, including respiratory dysfunction. Thus, the current manuscript will describe the proinflammatory milieu in COVID-19, summarize current evidence of thrombosis in COVID-19, and discuss possible interactions between these two.

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Plasma Antithrombin Values Are Significantly Decreased in Coronavirus Disease 2019 (COVID-19) Patients with Severe Illness

Abstract: Letter to the Editor 460This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Cited by 19 publications

References 21 publications

Coronavirus Disease 2019–Associated Coagulopathy

Coronavirus Disease 2019–Associated Coagulopathy

The Impact of SARS-CoV-2 Infection on Blood Coagulation and Fibrinolytic Pathways: A Review of Prothrombotic Changes Caused by COVID-19

Immunothrombosis in Acute Respiratory Dysfunction of COVID-19

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