Medical journal of the Islamic Republic of Iran · 2026
Coagulation Disorders and Thrombotic Events in Patients with COVID-19: A Narrative Review.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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Khatuni Mahdi, Varaminian Behnaz, Ghoreyshi Maryamolsadat, Ghalamkari Marziyeh
Аннотация
BACKGROUND: This review explores the coagulation disorders and thrombotic events observed in COVID-19 patients, highlighting the underlying pathophysiological mechanisms and current management strategies.
PATHOPHYSIOLOGY AND CLINICAL IMPACT: Important mechanisms contributing to thrombosis include cytokine storm-induced thrombosis, antiphospholipid antibody syndrome, macrophage activation syndrome, complement cascade activation, and renin-angiotensin system dysregulation. Thrombotic complications significantly impact mortality and morbidity, with pulmonary emboli frequently observed in autopsy studies. Notably, this prothrombotic state may persist for weeks post-hospitalization.
MANAGEMENT: Effective management of COVID-19-associated coagulopathy requires prompt treatment of underlying infections and comprehensive assessment of co-infections in critically ill patients. While heparin and its derivatives remain the cornerstone for managing venous thromboembolism, their efficacy for COVID-19-associated coagulopathy remains to be a subject of investigation.
CONCLUSION: Understanding the complex interplay between inflammation and thrombosis in COVID-19 is crucial for developing targeted therapeutic strategies that address coagulation disorders and the underlying infection.
PATHOPHYSIOLOGY AND CLINICAL IMPACT: Important mechanisms contributing to thrombosis include cytokine storm-induced thrombosis, antiphospholipid antibody syndrome, macrophage activation syndrome, complement cascade activation, and renin-angiotensin system dysregulation. Thrombotic complications significantly impact mortality and morbidity, with pulmonary emboli frequently observed in autopsy studies. Notably, this prothrombotic state may persist for weeks post-hospitalization.
MANAGEMENT: Effective management of COVID-19-associated coagulopathy requires prompt treatment of underlying infections and comprehensive assessment of co-infections in critically ill patients. While heparin and its derivatives remain the cornerstone for managing venous thromboembolism, their efficacy for COVID-19-associated coagulopathy remains to be a subject of investigation.
CONCLUSION: Understanding the complex interplay between inflammation and thrombosis in COVID-19 is crucial for developing targeted therapeutic strategies that address coagulation disorders and the underlying infection.