Haematological manifestations, mechanisms of thrombosis and anti-coagulation in COVID-19 disease: A review. (August 2020)

• Record Type: Journal Article
• Authors: Kasinathan, Ganesh; Sathar, Jameela
• Is Part Of: Annals of medicine and surgery. Volume 56(2020)
• Page Start: 173
• Page End: 177
• Publication Date: 2020-08
• Subjects: Coronavirus-19 disease -- Pulmonary intravascular coagulopathy -- Thromboembolism -- Bleeding episodes; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2020.06.035
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Coronavirus-19 disease (COVID-19), a zoonosis, was first reported in the city of Wuhan, province of Hubei, China in December 2019. The disease is caused by the Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2). As of 12 th of May 2020, 4, 256, 022 confirmed cases affecting 212 countries with 287, 332 deaths have been reported. The common symptoms reported in patients with COVID-19 are fever, dry cough, dyspnoea and gastrointestinal symptoms such as vomiting and diarrhoea. Non-survivors often succumb due to widespread pulmonary intravascular coagulopathy, arterial and venous thromboembolism, disseminated intravascular coagulopathy (DIC), secondary hemophagocytic lymphohistiocytosis (sHLH), and multiorgan dysfunctional syndrome (MODS). All hospitalised patients should be monitored closely for thrombotic events. Patients who develop bleeding episodes should be managed according to standard DIC guidelines. The main objectives of this review are 1) to provide a succinct background of this novel disease 2) discuss the haematological presentations and mechanisms of thrombosis 3) emphasize the role of anti-coagulation prophylaxis 4) explore the management of coagulopathy 5) provide insight on management of patients with COVID-19 disease and pre-existing bleeding disorders. Highlights: COVID-19 disease non-survivors often succumb to multiorgan dysfunctional syndrome. All hospitalised patients with COVID-19 disease are monitored closely for thrombotic events. Patients with COVID-19 disease who develop bleeding episodes are managed according to standard DIC guidelines.