CHAPTER 11: COVID-19 and Coagulopathy

The 2019 novel coronavirus has shown phenotypic variability in clinical presentation ranging from completely asymptomatic carriers to critically ill patients with high mortality. Coagulopathy in coronavirus disease 2019 (COVID-19) is a common presentation in critically ill patients. Increased levels of cytokines and chemokines play a major role in coagulopathy. Endothelial inflammation along with formation of microthrombi in major organs has been reported by most of the post-mortem studies. Venous thrombosis is a far more common presentation than arterial thrombus, even after giving anticoagulant prophylaxis. Major investigations include complete blood count, prothrombin time, activated partial thromboplastin time, fibrinogen, and D-dimer level. Academic societies have given guidelines on management of patients with COVID-19. However, there is still deficiency in understanding the pathogenesis of this disease, and therefore, high-quality evidence-based studies need to be encouraged.