Details

Autor(en) / Beteiligte

• Tomo, Sojit
• Kumar, Kiran Pvsn
• Roy, Dipayan
• Sankanagoudar, Shrimanjunath
• Purohit, Purvi
• Yadav, Dharamveer
• Banerjee, Mithu
• Sharma, Praveen
• Misra, Sanjeev

Titel

Complement activation and coagulopathy - an ominous duo in COVID19

Ist Teil von

• Expert review of hematology, 2021-02, Vol.14 (2), p.155-173

Ort / Verlag

England: Taylor & Francis

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• COVID-19 has similarities to the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) outbreaks, as severe patients and non-survivors have frequently shown abnormal coagulation profiles. Immune-mediated pathology is a key player in this disease; hence, the role of the complement system needs assessment. The complement system and the coagulation cascade share an intricate network, where multiple mediators maintain a balance between both pathways. Coagulopathy in COVID-19, showing mixed features of complement-mediated and consumption coagulopathy, creates a dilemma in diagnosis and management. Pathophysiology of coagulopathy in COVID-19 patients, with a particular focus on D-dimer and its role in predicting the severity of COVID-19 has been discussed. A comprehensive search of the medical literature on PubMed was done till May 30th, 2020 with the keywords 'COVID-19', 'SARS-CoV-2', 'Coronavirus', 'Coagulopathy', and 'D-dimer'. Twenty-two studies were taken for weighted pooled analysis of D-dimer. A tailored anticoagulant regimen, including intensification of standard prophylactic regimens with low-molecular-weight heparin is advisable for COVID-19 patients. Atypical manifestations and varying D-dimer levels seen in different populations bring forth the futility of uniform recommendations for anticoagulant therapy. Further, direct thrombin inhibitors and platelet inhibitors in a patient-specific manner should also be considered.