COVID-19-Associated Coagulopathy: Epidemiology, Pathophysiology, Biomarkers, and Antithrombotic Management

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) is now known to be a systemic illness that affects more than only the respiratory system. New research has shown that the vascular and coagulation systems are widely involved, underscoring the important role that thrombotic complications play in the course of the disease and patient outcomes. A hypercoagulable state is often linked to COVID-19, which can result in both microvascular and macrovascular thrombosis. This illness, also known as COVID-19-associated coagulopathy (CAC), significantly increases mortality and organ failure. A significant percentage of COVID-19 patients have been found to have laboratory abnormalities suggestive of coagulation problems, such as higher D-dimer levels, prolonged prothrombin time, and thrombocytopenia. Among these markers, increased D-dimer levels are useful prognostic indicators since they are closely linked to mortality, thrombotic complications, and the severity of the disease. Coagulation disorders are strongly associated with poor clinical outcomes and are especially common in critically ill patients.The current knowledge on COVID-19-associated coagulopathy's epidemiology, clinical signs, pathophysiological mechanisms, diagnostic biomarkers, and treatment approaches is compiled in this narrative review. The significance of routine monitoring of coagulation parameters and the role of D-dimer in early detection and risk classification are highlighted. Low-molecular-weight heparin (LMWH) is a first-line treatment for venous thromboembolism (VTE) prevention in hospitalized patients, according to available data. The review also covers modern antithrombotic therapeutic strategies for managing and preventing thrombotic episodes in COVID-19.Improving patient prognosis requires rapid diagnosis and appropriate therapy of COVID-19-associated coagulopathy because to the significant correlation between coagulation dysfunction and poor clinical outcomes. A comprehensive understanding of this coagulation anomalies could lead to more successful therapeutic strategies and lower COVID-19-related morbidity and death.