4.6 Review

Coronavirus Disease 2019-Associated Coagulopathy

Journal

MAYO CLINIC PROCEEDINGS
Volume 96, Issue 1, Pages 203-217

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.mayocp.2020.10.031

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Severe cases of COVID-19 often involve arterial and venous thrombotic events due to a hypercoagulable state, known as COVID-19-associated coagulopathy, which is a major component of the disease's pathophysiology. Vascular insults may initially be limited to the pulmonary microvasculature but progress to systemic involvement, leading to distant organ thrombosis and multiorgan dysfunction syndrome.
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, 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 multiorgan dysfunction syndrome. In this review article, we discuss recent insights into the pathophysiologic mechanisms of COVID-19-associated coagulopathy and review the clinical, histopathologic, and laboratory evidence, which leads us to conclude that COVID-19 is both a pulmonary and vascular disorder. (C) 2020 Mayo Foundation for Medical Education and Research

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