ABSTRACT Patients with severe coronavirus disease-2019 (COVID-19) frequently have hypercoagulability caused by the immune response to the severe acute respiratory syndrome coronavirus-2 infection. The pathophysiology of COVID-19 associated hypercoagulability is not fully understood, but characteristic changes include: increased fibrinogen concentration, increased Factor VIII activity, increased circulating von Willebrand factor, and exhausted fibrinolysis. Anticoagulant therapy improves outcomes in mechanically ventilated patients with COVID-19 and viscoelastic coagulation testing offers an opportunity to tailor anticoagulant therapy based on an individual patient’s coagulation status. In this narrative review, we summarize clinical manifestations of COVID-19, mechanisms, monitoring considerations, and anticoagulant therapy. We also review unique considerations for COVID-19 patients who are on extracorporeal membrane oxygenation.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, thrombosis, prostacyclin, intensive care unit, severe acute respiratory syndrome coronavirus-2, Venous Thromboembolism, ICU, PAI-1, coronavirus disease-2019, Coagulation, extracorporeal membrane oxygenation, interleukin, tumor necrosis factor, ADAMTS13, ECMO, Jak, TNF, Embolism, Plasminogen activator inhibitor-1, Janus kinase, MAPK, VTE, thromboelastography, mitogen-activated protein kinase, Thromboelastometry, TEM, TEG, CFT, a disintegrin and metalloproteinase with thrombospondin type 1 motif member 13, clot formation time, IL, k, kinetic time, MA, maximum amplitude, MCF, maximum clot firmness, PGI2, ULVWF, ultra-large von Willebrand factor,