Hyper-coagulation and The Used of Anticoagulant for Patient with COVID-19

Alyssa Claudia V. Gunawan, Bernadette Dian Novita


Coronavirus SARS-CoV-2 (COVID-19) infection has become a global infection with high mortality and morbidity rate. The pathophysiology of COVID-19 has not yet clear but associated with increasing proinflammatory cytokines and chemokines that leads to cytokine storm. Cytokine storm leads to increasing coagulation that defined by increasing D-dimer, Prothrombin Time (PT), and activated partial thromboplastin time (aPTT). The use of anticoagulant in patient with COVID-19 decrease the mortality rate and become one of the recommended therapy.

Save to Mendeley


COVID-19; Hyper-coagulation; Anticoagulant

Full Text:



Fehr AR, Perlman S. Coronaviruses: An overview of their replication and pathogenesis. Molecular Biology vol 1282. 2015. DOI: 10.1007/978-1-4939-2438-7_1

Peta Sebaran [Internet]. Gugus Tugas Percepatan Penangan COVID-19; 2020. Available from


Li X, Xu S, Yu M, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunology; April 2020.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506

Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 – United States, February 12 – March 28. CDC COVID-19 Response Team, 2020. MMWR April 2020; vol. 69; no. 13.

Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; published online Feb 28. DOI:10.1056/NEJMoa2002032.

Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395: 507–13.

Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020; 41: 145–51

Verity R, Okell L, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet. Published online March 2020. DOI: 10.1016/S1473-3099(20)30243-7.

Jose RJ. COVID-19 Cytokine Storm: the interplay between inflammation and coagulation. Lancet; published online April 2020. DOI: 10.1016/S2213-2600(20)30216-2

Law HKW, Cheung CY, Ng HY, Sia SF, Chan YO, Luk W, et al. Chemokine up-regulation in SARS-coronavirus-infected, monocyte-derived human dendritic cells. Blood. 2005;106(7):2366–74 PubMed PMID: 15860669. Epub 2005/04/28.

Cheung CY, Poon LLM, Ng IHY, Luk W, Sia S-F, Wu MHS, et al. Cytokine responses in severe acute respiratory syndrome coronavirus-infected macrophages in vitro: possible relevance to pathogenesis. J Virol. 2005;79(12):7819–26 PubMed PMID: 15919935.

Ye Q, Wang B, et al. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. Journal of Infection. Published online March 2020. DOI: 10.1016/j.jinf.2020.03.037

Kim ES, Choe PG, Park WB, Oh HS, Kim EJ, Nam EY, et al. Clinical progression and cytokine profiles of middle east respiratory syndrome coronavirus infection. J Korean Med Sci. 2016;31(11):1717–25 PubMed PMID: 27709848.

Ng DL, Al Hosani F, Keating MK, Gerber SI, Jones TL, Metcalfe MG, et al. Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of middle east respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014. Am J Pathol. 2016;186(3):652–8 PubMed PMID: 26857507. Epub 2016/02/05.

Marchingo JM, Sinclair LV, Howden AJM, Cantrell DA. Quantitative analysis of how Myc controls T cell proteomes and metabolic pathways during T cell activation. eLife. 2020;9:e53725 2020/02/05

Yang X, Yu Y, Xu J, Shu H, Ja Xia, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respirat Med. 2020 S2213-600(20)30079-5. PubMed PMID: 32105632.

Parsons PE, Eisner MD, Thompson BT, Matthay MA, Ancukiewicz M, Bernard GR, et al. Lower tidal volume ventilation and plasma cytokine markers of inflammation in patients with acute lung injury. Critical Care Med. 2005;33(1):1–232 PubMed PMID: 15644641.

Wang H, Ma S. The cytokine storm and factors determining the sequence and severity of organ dysfunction in multiple organ dysfunction syndrome. Am J Emerg Med. 2008;26(6):711–15 PubMed PMID: 18606328.

Esmon CT, Xu J, Lupu F. Innate Immunity and Coagulation. J Thromb Heamost. 2011; 9(Suppl 1): 182–188.

José RJ, Williams AE, Chambers RC. Proteinaseactivated receptors in fibroproliferative lung disease. Thorax. 2014; 69: 190–92

Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020; 18: 844–47.

Zhou F, Yu T, et al. Clinical course and risk factors for mortality of adult inpatient with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395: 1054-62.

Ranucci M, Balotta A, et al. The procoagulant pattern of patient with COVID-19 acute respiratory distress syndrome. J Thromb Haemost. 2020.

Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020; DOI: 10.1111/jth.14817.

Paranjpe I, Fuster V, et al. Association of Treatment Dose Anticoagulant with In-Hospital Survival Among Hospitalized Patient with COVID-19. JACC. 2020; DOI: 10.1016/j.jacc.2020.05.001.

Iba T, Nisio M, et al. New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: a retrospective analysis of a nationwide survey. BMJ Open. 2017; 7:e017046. DOI:10.1136/bmjopen-2017-017046.

Ozolina A, Sarkele M, Sabelnikovs O, et al. Activation of coagulation and fibrinolysis in acute respiratory distress syndrome: a prospective pilot study. Front Med. 2016;3:64.

DOI: https://doi.org/10.33508/jwm.v6i2.2787