Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

被引：47

作者：

Hardy, M. ^{[1
,2
]}

Lecompte, T. ^{[3
,4
]}

Douxfils, J. ^{[5
,6
]}

Lessire, S. ^{[2
]}

Dogne, J. M. ^{[5
]}

Chatelain, B. ^{[1
]}

Testa, S. ^{[7
]}

Gouin-Thibault, I. ^{[8
]}

Gruel, Y. ^{[9
,10
]}

Medcalf, R. L. ^{[10
]}

ten Cate, H. ^{[11
]}

Lippi, G. ^{[12
]}

Mullier, F. ^{[1
]}

机构：

[1] Catholic Univ Louvain, CHU UCL Namur, Namur Thrombosis & Hemostasis Ctr NTHC, Hematol Lab, Yvoir, Belgium

[2] Catholic Univ Louvain, Namur Thrombosis & Hemostasis Ctr NTHC, Dept Anesthesiol, CHU UCL Namur, Yvoir, Belgium

[3] Hop Univ Geneve, Serv Angiol & Hemostase, Dept Med, Geneva, Suisse, Switzerland

[4] Univ Geneva, Geneva Platelet Grp GpG, Fac Med, Geneva, Suisse, Belgium

[5] Univ Namur, Dept Pharm, Namur Thrombosis & Hemostasis Ctr NTHC, Namur, Belgium

[6] Qualiblood Sa, Namur, Belgium

[7] Cremona Hosp, Haemostasis & Thrombosis Ctr, Cremona, Italy

[8] Univ Rennes, CHU Rennes, Dept Hematol Biol, INSERM CIC 1414,Ctr Invest Clin Rennes, Rennes, France

[9] CHRU Tours, Lab Hematol Hemostase, Hop Trousseau, Tours, France

[10] Monash Univ, Australian Ctr Blood Dis, Melbourne, Vic, Australia

[11] Maastricht Univ, Cardiovasc Res Inst CARIM, Dept Internal Med, Med Ctr, Maastricht, Netherlands

[12] Univ Verona, Sect Clin Biochem, Verona, Italy

来源：

THROMBOSIS JOURNAL | 2020年 / 18卷 / 01期

关键词：

Thrombosis; D-dimers; Anticoagulation; COVID-19; Coagulopathy; Hemostasis; Fibrinolysis; Heparin; Thrombin generation; Viscoelastic tests; PARTIAL THROMBOPLASTIN TIME; PLASMINOGEN-ACTIVATOR INHIBITOR-1; HEPARIN-INDUCED THROMBOCYTOPENIA; PNEUMATIC TUBE SYSTEM; MONITORING UNFRACTIONATED HEPARIN; LOW FIBRINOGEN LEVELS; D-DIMER; VENOUS THROMBOEMBOLISM; SOLUBLE FIBRIN; CITRATE STORAGE;

D O I：

10.1186/s12959-020-00230-1

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.

引用

页数：16

共 172 条

[1]

COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection [J].