Uzun Günalp, Althaus Karina, Hammer Stefanie, Bakchoul Tamam
Center for Clinical Transfusion Medicine, University Hospital of Tuebingen, Tuebingen, Germany.
Medical Faculty of Tuebingen, Institute for Clinical and Experimental Transfusion Medicine, Tuebingen, Germany.
Hamostaseologie. 2022 Dec;42(6):409-419. doi: 10.1055/a-1755-8676. Epub 2022 Apr 27.
Coagulation abnormalities are common in patients with COVID-19 and associated with high morbidity and mortality. It became a daily challenge to navigate through these abnormal laboratory findings and deliver the best possible treatment to the patients. The unique character of COVID-19-induced coagulopathy necessitates not only a dynamic follow-up of the patients in terms of hemostatic findings but also the introduction of new diagnostic methods to determine the overall function of the coagulation system in real time. After the recognition of the high risk of thromboembolism in COVID-19, several professional societies published their recommendations regarding anticoagulation in patients with COVID-19. This review summarizes common hemostatic findings in COVID-19 patients and presents the societal recommendations regarding the use of coagulation laboratory findings in clinical decision-making. Although several studies have investigated coagulation parameters in patients with COVID-19, the methodological shortcomings of published studies as well as the differences in employed anticoagulation regimens that have changed over time, depending on national and international guidelines, limit the applicability of these findings in other clinical settings. Accordingly, evidence-based recommendations for diagnostics during acute COVID-19 infection are still lacking. Future studies should verify the role of coagulation parameters as well as viscoelastic methods in the management of patients with COVID-19.
凝血异常在新型冠状病毒肺炎（COVID-19）患者中很常见，且与高发病率和死亡率相关。解读这些异常的实验室检查结果并为患者提供最佳治疗方案成为了一项日常挑战。COVID-19所致凝血病的独特特征不仅需要对患者的止血情况进行动态随访，还需要引入新的诊断方法以实时确定凝血系统的整体功能。在认识到COVID-19患者发生血栓栓塞的高风险后，多个专业学会发布了关于COVID-19患者抗凝治疗的建议。本综述总结了COVID-19患者常见的止血检查结果，并介绍了在临床决策中使用凝血实验室检查结果的学会建议。尽管已有多项研究对COVID-19患者的凝血参数进行了调查，但已发表研究的方法学缺陷以及根据国家和国际指南随时间变化的抗凝方案差异，限制了这些结果在其他临床环境中的适用性。因此，目前仍缺乏针对急性COVID-19感染期间诊断的循证建议。未来的研究应验证凝血参数以及黏弹性检测方法在COVID-19患者管理中的作用。
