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COVID-19-Associated Coagulopathy and Inflammatory Response: What Do We Know Already and What Are the Knowledge Gaps?
Anesth Analg. 2020 11; 131(5):1324-1333.A&A

Abstract

Patients with coronavirus disease 2019 (COVID-19) frequently experience a coagulopathy associated with a high incidence of thrombotic events leading to poor outcomes. Here, biomarkers of coagulation (such as D-dimer, fibrinogen, platelet count), inflammation (such as interleukin-6), and immunity (such as lymphocyte count) as well as clinical scoring systems (such as sequential organ failure assessment [SOFA], International Society on Thrombosis and Hemostasis disseminated intravascular coagulation [ISTH DIC], and sepsis-induced coagulopathy [SIC] score) can be helpful in predicting clinical course, need for hospital resources (such as intensive care unit [ICU] beds, intubation and ventilator therapy, and extracorporeal membrane oxygenation [ECMO]) and patient's outcome in patients with COVID-19. However, therapeutic options are actually limited to unspecific supportive therapy. Whether viscoelastic testing can provide additional value in predicting clinical course, need for hospital resources and patient's outcome or in guiding anticoagulation in COVID-19-associated coagulopathy is still incompletely understood and currently under investigation (eg, in the rotational thromboelastometry analysis and standard coagulation tests in hospitalized patients with COVID-19 [ROHOCO] study). This article summarizes what we know already about COVID-19-associated coagulopathy and-perhaps even more importantly-characterizes important knowledge gaps.

Authors+Show Affiliations

From the Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany. Medical Department, Tem Innovations GmbH, Munich, Germany.From the Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.Clinical Department, Instrumentation Laboratory India Private Limited, New Delhi, India.General Internal Medicine and Thrombotic and Haemorrhagic Diseases Units, Department of Medicine, Padova University Hospital, Padova, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33079850

Citation

Görlinger, Klaus, et al. "COVID-19-Associated Coagulopathy and Inflammatory Response: what Do We Know Already and what Are the Knowledge Gaps?" Anesthesia and Analgesia, vol. 131, no. 5, 2020, pp. 1324-1333.
Görlinger K, Dirkmann D, Gandhi A, et al. COVID-19-Associated Coagulopathy and Inflammatory Response: What Do We Know Already and What Are the Knowledge Gaps? Anesth Analg. 2020;131(5):1324-1333.
Görlinger, K., Dirkmann, D., Gandhi, A., & Simioni, P. (2020). COVID-19-Associated Coagulopathy and Inflammatory Response: What Do We Know Already and What Are the Knowledge Gaps? Anesthesia and Analgesia, 131(5), 1324-1333. https://doi.org/10.1213/ANE.0000000000005147
Görlinger K, et al. COVID-19-Associated Coagulopathy and Inflammatory Response: what Do We Know Already and what Are the Knowledge Gaps. Anesth Analg. 2020;131(5):1324-1333. PubMed PMID: 33079850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19-Associated Coagulopathy and Inflammatory Response: What Do We Know Already and What Are the Knowledge Gaps? AU - Görlinger,Klaus, AU - Dirkmann,Daniel, AU - Gandhi,Ajay, AU - Simioni,Paolo, PY - 2020/10/20/entrez PY - 2020/10/21/pubmed PY - 2020/10/29/medline SP - 1324 EP - 1333 JF - Anesthesia and analgesia JO - Anesth Analg VL - 131 IS - 5 N2 - Patients with coronavirus disease 2019 (COVID-19) frequently experience a coagulopathy associated with a high incidence of thrombotic events leading to poor outcomes. Here, biomarkers of coagulation (such as D-dimer, fibrinogen, platelet count), inflammation (such as interleukin-6), and immunity (such as lymphocyte count) as well as clinical scoring systems (such as sequential organ failure assessment [SOFA], International Society on Thrombosis and Hemostasis disseminated intravascular coagulation [ISTH DIC], and sepsis-induced coagulopathy [SIC] score) can be helpful in predicting clinical course, need for hospital resources (such as intensive care unit [ICU] beds, intubation and ventilator therapy, and extracorporeal membrane oxygenation [ECMO]) and patient's outcome in patients with COVID-19. However, therapeutic options are actually limited to unspecific supportive therapy. Whether viscoelastic testing can provide additional value in predicting clinical course, need for hospital resources and patient's outcome or in guiding anticoagulation in COVID-19-associated coagulopathy is still incompletely understood and currently under investigation (eg, in the rotational thromboelastometry analysis and standard coagulation tests in hospitalized patients with COVID-19 [ROHOCO] study). This article summarizes what we know already about COVID-19-associated coagulopathy and-perhaps even more importantly-characterizes important knowledge gaps. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/33079850/COVID_19_Associated_Coagulopathy_and_Inflammatory_Response:_What_Do_We_Know_Already_and_What_Are_the_Knowledge_Gaps L2 - https://doi.org/10.1213/ANE.0000000000005147 DB - PRIME DP - Unbound Medicine ER -