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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ann+Hematol
2020 ; 99
(9
): 1953-1965
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gab.com Text
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English Wikipedia
Coagulopathy and thromboembolic events in patients with SARS-CoV-2 infection:
pathogenesis and management strategies
#MMPMID32671455
Allegra A
; Innao V
; Allegra AG
; Musolino C
Ann Hematol
2020[Sep]; 99
(9
): 1953-1965
PMID32671455
show ga
In October 2019, a viral infectious disease appeared in the city of Wuhan in
China. A new betacoronavirus, SARS-CoV-2, has been recognized as the responsible
pathogen in this infection. Although coronavirus disease is principally expressed
as a pulmonary infection, critical SARS-CoV-2 infection is frequently complicated
with coagulopathy, and thromboembolic events are recognizable in several
patients. Dehydration, acute inflammatory condition, protracted immobilization
during disease, existence of multiple cardiovascular risk factors such as
diabetes, obesity or hypertension, previous coronary artery disease, ischemic
stroke, peripheral artery disease are frequent comorbidities in SARS-CoV-2
hospitalized subjects, which possibly augment thrombo-embolic risk. However,
other causal factors can still be identified such as unrestricted angiotensin II
action, the use of immunoglobulins, an increased production of adhesion molecules
able to induce vascular inflammation and endothelial activation, complement
stimulation, excessive production of neutrophil extracellular traps (NETs), and
increased platelet count. Low-molecular-weight heparin should be chosen as early
treatment because of its anti-inflammatory action and its ability to antagonize
histones and so defend the endothelium. However, several therapeutic
possibilities have also been proposed such as fibrinolytic treatment, drugs that
target NETs, and complement inhibition. Nevertheless, although the violence of
the pandemic may suggest the use of heroic treatments to reduce the frightening
mortality that accompanies SARS-CoV-2 infection, we believe that experimental
treatments should only be used within approved and controlled protocols, the only
ones that can provide useful and specify information on the validity of the
treatments.