Coagulation abnormalities and potential therapeutic in COVID19 patients

Abstract

Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease was first reported in Wuhan, China in late December 2019, has since been declared a global pandemic by the World Health Organization (WHO). Globally, there are 15.7 million confirmed cases including 360, 000 death as of 29 May 2020, majority (>77%) with underlying conditions. The major symptoms include respiratory failure, multiple organ dysfunction, dyspnea and blood oxygen saturation in severe and critical patients. However, studies have shown consistent deposition of fibrin in the lungs of COVID-19 patients due to abnormal regulation of the coagulation and fibrinolytic system mediated by inflammatory activities. Normal regulation of these systems is crucial in maintaining a hemostatic balance between clot formation and degradation. Furthermore, increased risk of death and increased incidence of venous thrombosis have also been observed in almost three-quarters of COVID-19 patients in intensive care unit (ICU) as a result of clotting disorders. Current treatments under investigation as COVID-19 therapies include antiviral, anti-inflammatory, antibiotics anti-cytokines and anti-coagulant agents. There are limited studies focusing on improving respiratory failure in COVID-19 patients as treatment alternative. Therefore, this study investigates the coagulation abnormalities in COVID-19 patients and potential therapeutic options. This is significant because anti-coagulant and fibrinolytic therapies are vital in reducing increased deposition of fibrin in the lungs and risk of blood clothing in the veins. This is important in alleviating the burden and rate of mortality associated with COVID-19.