J Trauma Acute Care Surg. 2020 Sep 1. doi: 10.1097/TA.0000000000002938. Online ahead of print.
The SARS-CoV-2 viral infection causes COVID-19 pneumonia. Acute lung injury in COVID-19 is likely a result of a syndrome of hyperinflammation-driven coagulopathy occurring through immunothrombosis. This COVID-19 associated coagulopathy (CAC) is potentially the source of macrovascular complications of arterial and venous thromboembolism. Microvascular thrombosis as a result of CAC may be a defining feature increasing multiple organ failure and worsening acute lung injury. CAC may therefore be an emerging target for COVID-19 therapies. This current opinion report addresses the mechanisms by which CAC may develop, discusses how CAC may worsen lung injury, and treatment strategies under investigation. LEVEL OF EVIDENCE: Non-systematic review. Level IV/V.