Emergency Department, Chun'an First People's Hospital (Zhejiang Provincial People's Hospital Chun'an Branch), Hangzhou, 311700, Zhejiang, China.
Department of Pharmacy, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.
Mol Cell Biochem. 2021 Jul;476(7):2877-2885. doi: 10.1007/s11010-021-04122-4. Epub 2021 Mar 19.
Coronavirus disease 2019 (COVID-19) induced by SARS-Cov-2 can be related to coagulopathy. Also, the infection-induced inflammatory changes are found in patients with disseminated intravascular coagulopathy (DIC). The lack of previous immunity to COVID-19 has caused infection of a large number of patients worldwide and unpredictability regarding the management of the complications that appear in the course of this viral illness. Lungs are the most important target organ of the SARS-COV-2. In COVID-19 patients, acute lung injury leads to respiratory failure. However, multiorgan failure can also occur in these patients. The primary coagulopathy of COVID-19 is marked by a considerable elevation of D-dimer, ferritin, and fibrinogen degradation products. In comparison, abnormalities in platelet count, prothrombin time, and partial thromboplastin time are partly uncommon in initial presentations. Inflammatory biomarkers including CRP, LDH, and IL-6 are significantly elevated in the early stages of the disease. In this regard, inflammation-associated biomarkers and coagulation test screening, including the assessment of IL-6, CRP, LDH, D-dimer, platelet count, PT&PTT time, ferritin, and fibrinogen levels are suggested for detecting infection by this virus. Overall, COVID-19-associated coagulopathy should be managed like other patients with critical conditions, and supportive care and thromboembolic prophylaxis should be used for severe patients.
由 SARS-CoV-2 引起的 2019 年冠状病毒病 (COVID-19) 可与凝血功能障碍有关。此外,感染诱导的炎症变化见于弥散性血管内凝血 (DIC) 患者。由于 COVID-19 以前没有免疫力,导致全球大量患者感染,并且对这种病毒性疾病过程中出现的并发症的处理不可预测。肺部是 SARS-COV-2 的最重要靶器官。在 COVID-19 患者中,急性肺损伤导致呼吸衰竭。然而,这些患者也可能发生多器官衰竭。COVID-19 的主要凝血功能障碍表现为 D-二聚体、铁蛋白和纤维蛋白原降解产物的显著升高。相比之下,血小板计数、凝血酶原时间和部分凝血活酶时间的异常在初始表现中部分不常见。炎症生物标志物包括 CRP、LDH 和 IL-6 在疾病的早期阶段明显升高。在这方面,建议对感染这种病毒进行炎症相关生物标志物和凝血试验筛查,包括评估 IL-6、CRP、LDH、D-二聚体、血小板计数、PT 和 PTT 时间、铁蛋白和纤维蛋白原水平。总的来说,COVID-19 相关的凝血功能障碍应像其他危重症患者一样进行管理,并对重症患者进行支持性护理和血栓预防。