COVID-19 pneumonia: the point of view of vascular specialist
Автор: Costanzo Luca, Grasso Simona Antonina, Palumbo Francesco Paolo, Ardita Giorgio, Di Pino Luigi, Antignani Pier Luigi, Aluigi Leonardo, Arosio Enrico, Failla Giacomo
Журнал: Ульяновский медико-биологический журнал @medbio-ulsu
Рубрика: Клиническая медицина
Статья в выпуске: 3, 2020 года.
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The development of coagulopathy is emerging as one of the most significant poor prognostic features in COVID-19 pneumopathy. Thromboembolic manifestations such as pulmonary embolism and disseminated intravascular coagulation (DIC) have been reported and resulted in poor prognosis for the patient. Starting from the evidence in the literature, the purpose of this paper is to analyze potential mechanism involved in coagulation impairment following COVID-19 infection and identify possible vascular therapeutic strategies. D-dimer, a protein product of fibrin degradation, has been found elevated in the most severe cases and correlated to mortality. Potentially involved factors in the impairment of coagulation caused by viral infection include the dysregulated inflammatory response, platelet and endothelial dysfunction with impaired fibrinolysis. Heparin is an anticoagulant molecule that also showed anti-inflammatory properties and a potential antiviral effect. A favorable outcome was highlighted with the use of LMWH in severe patients with COVID-19 who meet the SIC criteria (sepsis-induced coagulopathy) or with markedly high D-dimer. The use of low molecular weight heparin could prevent thromboembolic complications in COVID-19 pneumopathy. However, the correct timing of prophylaxis according to the stage of COVID-19 disease and the appropriate therapeutic dosage to use in severe cases need further researches.
Covid-19, pneumonia, thrombosis, coagulopathy, d-dimer, low molecular weight heparin, d-димер
Короткий адрес: https://sciup.org/14117581
IDR: 14117581 | DOI: 10.34014/2227-1848-2020-3-21-27
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