COVID-19: Thrombosis, thromboinflammation, and anticoagulation considerations.
Abstract
Vascular endothelial injury is a hallmark of acute infection at both the microvascular
and macrovascular levels. The hallmark of SARS-CoV-2 infection is the current COVID-19
clinical sequelae of the pathophysiologic responses of hypercoagulability and thromboinflammation
associated with acute infection. The acute lung injury that initially occurs in COVID-19
results from vascular and endothelial damage from viral injury and pathophysiologic
responses that produce the COVID-19-associated coagulopathy. Clinicians should continue
to focus on the vascular endothelial injury that occurs and evaluate potential therapeutic
interventions that may benefit those with new infections during the current pandemic
as they may also be of benefit for future pathogens that generate similar thromboinflammatory
responses. The current Accelerating COVID-19 Therapeutic Interventions and Vaccines
(ACTIV) studies are important projects that will further define our management strategies.
At the time of writing this report, two mRNA vaccines are now being distributed and
will hopefully have a major impact on slowing the global spread and subsequent thromboinflammatory
injury we see clinically in critically ill patients.
Type
Journal articleSubject
COVID-19anticoagulant therapy
coagulopathy
disseminated intravascular coagulation
endothelial cell
thrombosis
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https://hdl.handle.net/10161/23478Published Version (Please cite this version)
10.1111/ijlh.13500Publication Info
Levy, Jerrold H; Iba, Toshiaki; Olson, Lyra B; Corey, Kristen M; Ghadimi, Kamrouz;
& Connors, Jean M (2021). COVID-19: Thrombosis, thromboinflammation, and anticoagulation considerations. International journal of laboratory hematology, 43 Suppl 1(S1). pp. 29-35. 10.1111/ijlh.13500. Retrieved from https://hdl.handle.net/10161/23478.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Kristin Corey
House Staff
Kamrouz Ghadimi
Associate Professor of Anesthesiology
OverviewDr. Ghadimi is a cardiothoracic anesthesiologist, intensivist (ICU doc), physician
scientist and director of the clinical research unit in the Department of Anesthesiology
at Duke Health. Clinical EducationDr. Ghadimi is a medical school graduate of Boston
University School of Medicine, completed his internship in general surgery at the
University of California Irvine Medical Center and Long Beach Veterans Affairs Med
Jerrold Henry Levy
Professor of Anesthesiology
Jerrold Levy is Professor of Anesthesiology, Critical Care, and Surgery (Cardiothoracic)
at Duke University Medical Center in Durham, NC. He obtained his medical degree from
the University of Miami, where he was an intern in internal medicine, and undertook
his residency in the Department of Anesthesiology of the Massachusetts General Hospital
and Harvard Medical School in Boston, where he was also Chief Resident, and completed
fellowships in both Respiratory ICU and Cardiac Anesthesiology. 
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