Coagulopathy of Coronavirus Disease 2019: A Case Series

Jonathan Arifputra; Harlinda Haroen; Linda Wilhelma Ancella  Rotty; Pearla Fidei Cindy Lasut; Cecilia Hendratta

doi:10.3889/oamjms.2021.6026

Authors

Jonathan Arifputra Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University, Prof. dr. R. D. Kandou Hospital, Manado, Indonesia https://orcid.org/0000-0002-7791-7015
Harlinda Haroen Division of Hematology Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University, Prof. dr. R. D. Kandou Hospital, Manado, Indonesia https://orcid.org/0000-0002-9881-5093
Linda Wilhelma Ancella Rotty Division of Hematology Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University, Prof. dr. R. D. Kandou Hospital, Manado, Indonesia
Pearla Fidei Cindy Lasut Division of Hematology Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University, Prof. dr. R. D. Kandou Hospital, Manado, Indonesia
Cecilia Hendratta Division of Hematology Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University, Prof. dr. R. D. Kandou Hospital, Manado, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6026

Keywords:

Coronavirus disease-19, Coagulopathy, Thrombotic risk assessment models, Heparin, D-dimer

Abstract

BACKGROUND: In Coronavirus disease 2019 (COVID-19), the main manifestations were fever, cough, and anosmia.

AIM: We aimed to investigate coagulopathy and disseminated intravascular coagulation in severe COVID-19 patients.

METHODS: Five cases of COVID-19 with coagulopathy have been reported.

RESULTS: All patients presented with various main complaints such as fever, cough, shortness of breath, and diarrhea. An increase in D-dimer value was found in all cases, with an increase of 4–5 times from the upper limit of normal. All patients were evaluated with the IMPROVE-VTE and PADUA thrombotic risk assessment models. Thromboprophylaxis with low molecular weight heparin LMWH intensive dosage was given to four patients. However, one patient was not given thromboprophylaxis because of the high risk of bleeding. All cases were not given long-term thromboprophylaxis after the patients were discharged from the hospital. All hospitalized COVID-19 patients can be considered to give thromboprophylaxis unless contraindicated. Thromboprophylaxis is preferable to use LMWH with a dose adjusted to the severity of COVID-19. Administration of thromboprophylaxis after hospitalization may be considered in patients who have thromboembolic risk factors.

CONCLUSION: More research is being encouraged to increase understanding of the prevention and treatment of thrombotic complications of COVID-19.

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