REVIEW   Free access

Italian Journal of Vascular and Endovascular Surgery 2022 March;29(1):28-33

DOI: 10.23736/S1824-4777.21.01463-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Current evidence on COVID-19 and coagulopathy

Domenico CECERE ✉, Enrico CAPPELLO, Marcello IZZO, Francesco POMPEO

Department of Vascular and Endovascular Surgery, IRCCS Neuromed Institute, Pozzilli, Isernia, Italy

On late December 2019, an outbreak of a novel coronavirus (SARS-CoV-2) causing severe pneumonia (COVID-19) was reported in Wuhan, Hubei Province, China and then in all around the world. Data suggest that a lung-centric and systemic coagulopathy may play an important role. Elevated D-dimer levels which correlated inversely with overall survival were recently reported in Chinese studies. Critically however, severe COVID-19 infection is associated with a significant coagulopathy that correlates with disease severity and a 3-4-fold higher mortality risk. COVID-19 patients with acute respiratory failure present a severe hypercoagulability rather than consumptive coagulopathy. Fibrin formation and polymerization may predispose to thrombosis and correlate with a worse outcome. However, increasing the prophylaxis towards high-prophylactic doses to the patients admitted to the ICU, going from enoxaparin 40 mg OD to 40 mg BID, prevents major vascular complications and reduces mortality rate.

KEY WORDS: COVID-19; Pneumonia; Blood coagulation disorders