ArticleInternal and emergency medicine2020
COVID-19: The crucial role of blood coagulation and fibrinolysis.
Article in Internal and emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers, 2 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mortality and risk factors associated with pulmonary embolism in coronavirus disease 2019 patients: a systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Associations of D-Dimer on Admission and Clinical Features of COVID-19 Patients: A Systematic Review, Meta-Analysis, and Meta-Regression.Frontiers in immunology · 2021Pooled it
- SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis.Clinical rheumatology · 2023Review
- Fibrinolytic system and COVID-19: From an innovative view of epithelial ion transport.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2023Review
- Time Course of Coagulopathy Evaluated with Rotational Thromboelastometry in Patients with Severe Coronavirus Disease 2019.Internal medicine (Tokyo, Japan) · 2023Article
- Acute Pancreatitis and Disseminated Intravascular Coagulopathy in COVID-19 Infection: A Case Report.Cureus · 2023Article
- Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series.Open medicine (Warsaw, Poland) · 2023Review
- Role of Fibrinolysis in the Management of Patients with COVID-19 and Thromboembolic Complications: A Review.Journal of cardiovascular development and disease · 2022Review
- Predictive ability of viscoelastic testing using ClotPro® for short-term outcome in patients with severe Covid-19 ARDS with or without ECMO therapy: a retrospective study.Thrombosis journal · 2022Article
- Global haemostatic tests demonstrate the absence of parameters of hypercoagulability in non-hypoxic mild COVID-19 patients: a prospective matched study.Journal of thrombosis and thrombolysis · 2022Article
- The evolution of clot strength in critically ill COVID-19 patients: a prospective observational thromboelastography study.Thrombosis journal · 2022Article
- Aging whole blood transcriptome reveals candidate genes for SARS-CoV-2-related vascular and immune alterations.Journal of molecular medicine (Berlin, Germany) · 2022Article
- Immuno-Thrombotic Complications of COVID-19: Implications for Timing of Surgery and Anticoagulation.Frontiers in surgery · 2022Review
- COVID-19 Coagulopathy: From Pathogenesis to Treatment.Acta haematologica · 2022Review
- Interaction of the inflammatory response and megakaryocytes in COVID-19 infection.Experimental hematology · 2021Review
- Increasing dosages of low-molecular-weight heparin in hospitalized patients with Covid-19.Internal and emergency medicine · 2021Observational
- Fibrinolysis Shutdown in COVID-19: Clinical Manifestations, Molecular Mechanisms, and Therapeutic Implications.Journal of the American College of Surgeons · 2021Review
- Role of combining anticoagulant and antiplatelet agents in COVID-19 treatment: a rapid review.Open heart · 2021Review
- Lung histopathological findings in COVID-19 disease - a systematic review.Infectious agents and cancer · 2021Review
- Improvement in plasma D-dimer level in severe SARS-CoV-2 infection can be an indicator of fibrinolysis suppression: Case reports.Medicine · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The overflow of studies in the recent literature on COVID-19 often gives provisional or contradictory results and therefore deserves pauses of reflection and reconsideration. In fact, knowledges of pathophysiology of this new disease are still in development and hence originate discussions and interpretations. Regarding the role of blood coagulation and fibrinolysis, these mechanisms should be considered as crucial especially in severe cases. It is proposed to consider two distinct phenotypes of thrombotic manifestations: the current "thromboembolic type" also occurring in other kinds of sepsis, and the diffuse micro-thrombotic type, prevailing in the lungs but sometimes extending to other organs. Both types can induce severe disease and are potentially lethal. The micro-thrombotic pattern, more specific for COVID-19, results from a massive activation of coagulation strictly coupled with a hyper-intense inflammatory and immune reaction. This results in widespread occlusive thrombotic micro-angiopathy with destruction of alveoli and obstructive neoangiogenesis. The involvement of fibrinolysis, often neglected, confers a double faceted process of activation/inhibition, finally conducive to a fibrinolytic shutdown that reinforces persistence of micro-thrombi. Considering these peculiar mechanisms, it seems evident that both prophylactic and therapeutic effects of current anti-thrombotic drugs cannot be taken for granted and need therefore new specific and rigorous controlled trials.
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