• Shock · Apr 2021

    Review

    COVID-19 Associated Hypercoagulability: Manifestations, Mechanisms, and Management.

    • Michael A Mazzeffi, Jonathan H Chow, and Kenichi Tanaka.
    • Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.
    • Shock. 2021 Apr 1; 55 (4): 465471465-471.

    AbstractPatients with severe coronavirus disease-2019 (COVID-19) frequently have hypercoagulability caused by the immune response to the severe acute respiratory syndrome coronavirus-2 infection. The pathophysiology of COVID-19 associated hypercoagulability is not fully understood, but characteristic changes include: increased fibrinogen concentration, increased Factor VIII activity, increased circulating von Willebrand factor, and exhausted fibrinolysis. Anticoagulant therapy improves outcomes in mechanically ventilated patients with COVID-19 and viscoelastic coagulation testing offers an opportunity to tailor anticoagulant therapy based on an individual patient's coagulation status. In this narrative review, we summarize clinical manifestations of COVID-19, mechanisms, monitoring considerations, and anticoagulant therapy. We also review unique considerations for COVID-19 patients who are on extracorporeal membrane oxygenation.Copyright © 2020 by the Shock Society.

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