Abstract
As the current coronavirus pandemic continues and cases of COVID-19 critical illness rise, physicians and scientists across the globe are working to understand and study its pathophysiology. Part of the pathology of this illness may result from its prothrombotic potential as witnessed from derangements in coagulation and thrombotic complications reported in observational studies performed in China and Europe to findings of microthrombosis upon autopsy analysis of patients who succumbed to COVID-19. Multiple organizations, including the American Society of Hematology (ASH), recommend the routine use of prophylactic heparin to temper the thrombotic complications of this illness given its mortality benefit in severe COVID-19 infections. Reductions in circulating levels of Antithrombin III (AT), the primary mediator of heparin’s action, is present in cases of coronavirus related critical illness. AT’s use as a prognostic marker, an important effector of heparin resistance, and a potential therapeutic target for COVID-19 remains to be explored.
Keywords: Antithrombin III; COVID-19; Coagulopathy; Heparin resistance; SARS-CoV critical illness; SARS-CoV2; Thrombosis.
【저자키워드】 COVID-19, SARS-CoV2, thrombosis, Coagulopathy, antithrombin III, Heparin resistance, SARS-CoV critical illness, 【초록키워드】 pathology, Critical illness, coronavirus, Europe, pandemic, Mortality, thrombosis, SARS-CoV, Thrombotic complications, Prophylactic, heparin, observational studies, observational study, Coagulation, Coagulopathy, China, pathophysiology, Patient, Prognostic marker, hematology, Critical, Antithrombin, Microthrombosis, mediator, reduction, Society, COVID-19 infections, thrombotic, reductions, organizations, circulating, severe COVID-19 infections, physician, Multiple, potential therapeutic target, benefit, prothrombotic, thrombotic complication, autopsy analysis, performed, globe, reported, Part, temper, 【제목키워드】 understanding, Critical, cytokine release,