Hypercoagulable states with respect to COVID-19 infection emerging as significant and prevalent threats

Although most patients with COVID-19 predominantly have a respiratory tract infection, a proportion of patients progress to a more severe and systemic disease, characterized by treatment-resistant fever, acute lung injury with acute respiratory distress syndrome (ARDS), shock, and multiple organ dysfunction, associated with substantial mortality. Many patients with severe COVID-19 present with coagulation abnormalities that mimic other systemic coagulopathies associated with severe infections, such as disseminated intravascular coagulation (DIC) [thrombotic microangiopathy], but COVID-19 has distinct features. Chiefly, coagulopathy (clotting disorders) in patients with COVID-19 is associated with an increased risk of death. Also, the relevance of COVID-19-coagulation abnormalities is becoming increasingly clear as a substantial proportion of patients with severe COVID-19 develop, sometimes unrecognized, venous and arterial thromboembolic complications.

Darlene Gildersleeve thought she had recovered from COVID-19. Doctors said she just needed rest. And for several days, no one suspected her worsening symptoms were related — until a May 4 video call, when her physician heard her slurred speech and consulted a specialist.

“You’ve had two strokes,’’ a neurologist told her at the hospital. The Hopkinton, New Hampshire, mother of three is only 43.

All the knowledge physicians and scientists are gathering as the virus approaches 100K deaths in the U.S. (the country with the dealiest epidemic in the world) is coming in real time – as facts, research, treamtents, and followup are often occurring in parallel.

Michael L. Douglas @doctorpundit

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