Pathophysiological and Laboratory Aspects of Hemostatic Disorders in Patients with COVID-19

Abstract

Introduction/Aim. Although coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affects the respiratory system, the possibility of multisystem tissue and organ damage is not excluded. In severe forms of the disease, hematological disorders with the accompanying laboratory derangements often occur. The aim of the review was to describe and further improve our understanding of the possible pathophysiological mechanisms involved in hemostatic derangements in COVID-19 patients with accompanying laboratory findings.Material and Methods. A comprehensive investigation was conducted using keywords COVID-19, SARS-CoV-2, hemostatic disturbances in COVID-19, laboratory findings in COVID-19, in the PubMed, Google Scholar and Science Direct databases to determine the eligible studies.Results. The most recognizable laboratory findings of these disorders include increase in the concentration of D-dimer values, prolonged prothrombin time with or without slight changes in the activated partial thromboplastin time, changes in the number of platelets according to thrombocytopenia or thrombocytosis (rarely), as well as an increase in the concentration of fibrinogen, usually in the initial stages of the disease.Conclusion. The importance of COVID-19 coagulopathy is reflected in an increased mortality rate due to the high frequency of thromboembolic episodes, which can be the reason for multiorgan dysfunction syndrome.