Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cancer Research Center, Department of General Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cell Biol Int. 2021 Sep;45(9):1832-1850. doi: 10.1002/cbin.11623. Epub 2021 May 16.
December 2019 will never be forgotten in the history of medicine when an outbreak of pneumonia of unknown etiology in Wuhan, China sooner or later prompted the World Health Organization to issue a public health warning emergency. This is not the first nor will it be the last time that a member of β-coronaviruses (CoVs) is waging a full-scale war against human health. Notwithstanding the fact that pneumonia is the primary symptom of the novel coronavirus (2019nCoV; designated as SARS-CoV-2), the emergence of severe disease mainly due to the injury of nonpulmonary organs at the shadow of coagulopathy leaves no choice, in some cases, rather than a dreadful death. Multiple casual factors such as inflammation, endothelial dysfunction, platelet and complement activation, renin-angiotensin-aldosterone system derangement, and hypoxemia play a major role in the pathogenesis of coagulopathy in coronavirus disease 2019 (COVID-19) patients. Due to the undeniable role of coagulation dysfunction in the initiation of several complications, assessment of coagulation parameters and the platelet count would be beneficial in early diagnosis and also timely prediction of disease severity. Although low-molecular-weight heparin is considered as the first-line of treatment in COVID-19-associated coagulopathy, several possible therapeutic options have also been proposed for better management of the disease. In conclusion, this review would help us to gain insight into the pathogenesis, clinical manifestation, and laboratory findings associated with COVID-19 coagulopathy and would summarize management strategies to alleviate coagulopathy-related complications.
2019 年 12 月,在中国武汉爆发了一种病因不明的肺炎疫情,世界卫生组织(WHO)很快发布了公共卫生紧急事件警告。这不是β冠状病毒(CoVs)第一次也不会是最后一次对人类健康发动全面战争。尽管新型冠状病毒(2019nCoV;被指定为 SARS-CoV-2)的主要症状是肺炎,但主要由于凝血功能障碍导致的非肺部器官损伤,在某些情况下,除了可怕的死亡,别无选择。多种偶然因素如炎症、内皮功能障碍、血小板和补体激活、肾素-血管紧张素-醛固酮系统紊乱和低氧血症在 2019 冠状病毒病(COVID-19)患者的凝血功能障碍发病机制中起主要作用。由于凝血功能障碍在引发多种并发症方面的不可否认的作用,评估凝血参数和血小板计数将有助于早期诊断,也有助于及时预测疾病的严重程度。尽管低分子量肝素被认为是 COVID-19 相关凝血功能障碍的一线治疗药物,但也提出了几种可能的治疗选择,以更好地管理这种疾病。总之,这篇综述将帮助我们深入了解 COVID-19 凝血功能障碍的发病机制、临床表现和实验室发现,并总结减轻与凝血功能障碍相关的并发症的管理策略。