Management of the thrombotic risk associated with COVID-19: what is the role of the hemostasis laboratory?

Michael Hardy, Jonathan Douxfils, Jean-Michel Dogné, Sarah Lessire, Bernard Chatelain, Sophie Testa, Isabelle Gouin-Thibault, Yves Gruel, Thomas Lecompte, François Mullier

Research output: Contribution to journalReview articlepeer-review

Abstract

COVID-19 is associated with disturbances of hemostasis in the laboratory and an increased thrombotic risk. Routine laboratory tests - activated partial thromboplastin time (aPTT), prothrombin time, Clauss fibrinogen and D-dimers levels measurement - are used for the evaluation of the thrombotic risk and the monitoring of hemostasis, but are subject to several drawbacks that may affect the reliability and clinical relevance of the delivered results. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment. For instance, the issue of the monitoring of unfractionated heparin remains debated, the more so when there is a tremendous inflammatory response. This brief review considers the role of laboratory tests of hemostasis in the management of COVID-19 and discusses their main limitations to be kept in mind.

Original languageEnglish
Pages (from-to)471-481
Number of pages11
JournalAnnales de biologie clinique
Volume78
Issue number5
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • COVID-19
  • hémostase
  • thrombose
  • inflammation
  • endothélium
  • microcirculation
  • anticoagulants
  • D-dimers
  • thrombosis
  • anticoagulation
  • coagulopathy
  • Pandemics
  • Betacoronavirus/physiology
  • Humans
  • Risk Factors
  • Thrombosis/diagnosis
  • Coronavirus Infections/blood
  • Anticoagulants/therapeutic use
  • Pneumonia, Viral/blood
  • Drug Monitoring/methods
  • Hemostasis/drug effects
  • Laboratories, Hospital
  • Blood Coagulation Tests

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