Decoding Covid-19: A Novel Role of Antithrombin Deficiency in the Novel Coronavirus

Mills, Krystal; Sobukonla, Timothy; Lee, Michelle; Odebunmi, Ifedolapo; Chang, Eric L.

doi:10.1016/j.chest.2020.08.493

Cited by 2 publications

(2 citation statements)

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“…This problem is usually due to low heparin concentrations, which results from binding of heparin to acute phase proteins in the context of systemic inflammation. There is also some evidence of AT deficiency in COVID-19 patients which may contribute to suspected heparin resistance [ 48 ]. Heparin functions as an anticoagulant by binding to AT, activating it, and then inhibiting clotting factors, most notably factor Xa [ 80 ].…”

Section: What Is the Appropriate Methods Of Monitoring Anticoagulation?mentioning

confidence: 99%

“…Antithrombin is a natural anticoagulant that inhibits thrombin and factor Xa, thereby helping to prevent thrombosis. There have been case reports of AT deficiency in COVID-19 patients which may place such patients are at higher risk of thrombosis [ 48 ]. However, as with the other biochemical testing, more studies are needed to determine if this knowledge is related to adverse outcomes such as thrombosis and if these results should be used to help guide anticoagulation practices.…”

Section: Pathogenesismentioning

confidence: 99%

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Nuts and bolts of COVID-19 associated coagulopathy: the essentials for management and treatment

Lindsay

Rosovsky

Bittner

et al. 2021

Postgraduate Medicine

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Introduction COVID-19-associated coagulopathy (CAC) is a well-recognized hematologic complication among patients with severe COVID-19 disease, where macro- and micro-thrombosis can lead to multiorgan injury and failure. Major societal guidelines that have published on the management of CAC are based on consensus of expert opinion, with the current evidence available. As a result of limited studies, there are many clinical scenarios that are yet to be addressed, with expert opinion varying on a number of important clinical issues regarding CAC management. Methods In this review, we utilize current societal guidelines to provide a framework for practitioners in managing their patients with CAC. We have also provided three clinical scenarios that implement important principles of anticoagulation in patients with COVID-19. Conclusion Overall, decisions should be made on acase by cases basis and based on the providers understanding of each patient’s medical history, clinical course and perceived risk.

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Section: What Is the Appropriate Methods Of Monitoring Anticoagulation?mentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

Nuts and bolts of COVID-19 associated coagulopathy: the essentials for management and treatment

Lindsay

Rosovsky

Bittner

et al. 2021

Postgraduate Medicine

View full text Add to dashboard Cite

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Assessment of COVID -19 associated coagulopathy and multiple hemostatic markers: a single center study in Egypt

et al. 2022

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Background Coagulopathy is still a serious pattern of coronavirus-19 disease. We aimed to evaluate COVID-19-associated coagulopathy and multiple hemostatic markers in Egyptian patients. In addition, to assess coagulation acute phase reactants and its effect on the outcome. Methods The study included 106 COVID-19 patients, and 51 controls. All patients were positive for COVID-19 infection by nasopharyngeal swab for detection of viral RNA by real-time PCR. In addition to baseline data and radiological findings, the coagulation profile was done with special attention to Fibrinogen, d-dimer, Factor VIII, von Willebrand factor (VWF), Protein C, Protein S, Antithrombin III (ATIII) and Lupus anticoagulant (LA)-1 and 2. Results The results showed significantly higher VWF, d-dimer, and LA1 (screening) and LA2 (confirmation) in patients than a control group. Significantly higher d-dimer FVIII, VWF and LA1-2 were detected in the severe group. ATIII had high diagnostic accuracy in severity prediction. We found a significantly higher international randomized ratio (INR) and VWF among patients with thrombotic events. For prediction of thrombosis; VWF at cutoff > 257.7 has 83.3% sensitivity and 83.3% specificity. Conclusion Patients with COVID-19 infection are vulnerable to different forms of coagulopathy. This could be associated with poor outcomes. d-Dimer is a chief tool in diagnosis, severity evaluation but not thrombosis prediction. Early screening for this complication and its proper management would improve the outcome.

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Decoding Covid-19: A Novel Role of Antithrombin Deficiency in the Novel Coronavirus

Cited by 2 publications

References 0 publications

Nuts and bolts of COVID-19 associated coagulopathy: the essentials for management and treatment

Nuts and bolts of COVID-19 associated coagulopathy: the essentials for management and treatment

Assessment of COVID -19 associated coagulopathy and multiple hemostatic markers: a single center study in Egypt

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