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Cited by 1,351

The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.

COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection

Open access
Al-Samkari, Hanny, Karp Leaf, Rebecca S., Dzik, Walter H., Carlson, Jonathan C. T., Fogerty, Annemarie E., Waheed, Anem, Goodarzi, Katayoon, Bendapudi, Pavan K., Bornikova, Larissa, Gupta, Shruti, Leaf, David E., Kuter, David J., Rosovsky, Rachel P.·2020·Blood
DOI 10.1182/blood.2020006520
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Abstract

Patients with coronavirus disease 2019 (COVID-19) have elevated D-dimer levels. Early reports describe high venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC) rates, but data are limited. This multicenter retrospective study describes the rate and severity of hemostatic and thrombotic complications of 400 hospital-admitted COVID-19 patients (144 critically ill) primarily receiving standard-dose prophylactic anticoagulation. Coagulation and inflammatory parameters were compared between patients with and without coagulation-associated complications. Multivariable logistic models examined the utility of these markers in predicting coagulation-associated complications, critical illness, and death. The radiographically confirmed VTE rate was 4.8% (95% confidence interval [CI], 2.9-7.3), and the overall thrombotic complication rate was 9.5% (95% CI, 6.8-12.8). The overall and major bleeding rates were 4.8% (95% CI, 2.9-7.3) and 2.3% (95% CI, 1.0-4.2), respectively. In the critically ill, radiographically confirmed VTE and major bleeding rates were 7.6% (95% CI, 3.9-13.3) and 5.6% (95% CI, 2.4-10.7), respectively. Elevated D-dimer at initial presentation was predictive of coagulation-associated complications during hospitalization (D-dimer >2500 ng/mL, adjusted odds ratio [OR] for thrombosis, 6.79 [95% CI, 2.39-19.30]; adjusted OR for bleeding, 3.56 [95% CI, 1.01-12.66]), critical illness, and death. Additional markers at initial presentation predictive of thrombosis during hospitalization included platelet count >450 × 109/L (adjusted OR, 3.56 [95% CI, 1.27-9.97]), C-reactive protein (CRP) >100 mg/L (adjusted OR, 2.71 [95% CI, 1.26-5.86]), and erythrocyte sedimentation rate (ESR) >40 mm/h (adjusted OR, 2.64 [95% CI, 1.07-6.51]). ESR, CRP, fibrinogen, ferritin, and procalcitonin were higher in patients with thrombotic complications than in those without. DIC, clinically relevant thrombocytopenia, and reduced fibrinogen were rare and were associated with significant bleeding manifestations. Given the observed bleeding rates, randomized trials are needed to determine any potential benefit of intensified anticoagulant prophylaxis in COVID-19 patients.

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Metadata

Authors
Al-Samkari, H., Karp Leaf, R. S., Dzik, W. H., Carlson, J. C. T., Fogerty, A. E., Waheed, A., Goodarzi, K., Bendapudi, P. K., Bornikova, L., Gupta, S., Leaf, D. E., Kuter, D. J., & Rosovsky, R. P.
Venue
Blood
Publisher
American Society of Hematology
Published
2020-07-23
Volume
136
Issue
4
Pages
489-500
ISSN
  • 0006-4971 (ISSN-L)
  • 1528-0020
DOI
10.1182/blood.2020006520
OpenAlex
W3028989873
Cited by
1,351
References
20
FWCI
35.37
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection. https://app.cochat.ai/papers/10.1182/blood.2020006520
The paper
Al-Samkari, H., Karp Leaf, R. S., Dzik, W. H., Carlson, J. C. T., Fogerty, A. E., Waheed, A., Goodarzi, K., Bendapudi, P. K., Bornikova, L., Gupta, S., Leaf, D. E., Kuter, D. J., & Rosovsky, R. P. (2020). COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection. Blood. https://doi.org/10.1182/blood.2020006520

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.