By vgreene, 19 May, 2020 Pathogenesis of hypercoagulation remains unknown, however hypoxia and systemic inflammation may lead to high levels of inflammatory cytokines and activation of coagulation pathway
By vgreene, 19 May, 2020 Reports of thrombotic complications, esp DVT and PE. Other manifestations include microvascular thrombosis of toes, clotting of catheters, myocardia injury w/ ST elevation; large vessel strokes
By vgreene, 19 May, 2020 Lab abnormalities commonly observed in such pts: mild thrombocytopenia, increased d-dimer (strongly assoc w/ mortality risk), increased fibrin degradation products, prolonged PT
By vgreene, 19 May, 2020 Some pts may develop signs of a hypercoagulable state and be at risk for venous and arterial thrombosis of large and small vessels
By vgreene, 19 May, 2020 In-pt mgmt consists of supportive care for COVID complications: pneumonia, ARDS, sepsis/septic shock, cardiomyopathy, arrhythmia, AKI, and complications of prolonged hospitalization (eg, secondary bacterial infxn, thromboembolism, GI bleeding, polyneuropa
By vgreene, 19 May, 2020 Make in-pt vs out-pt decision on case-by-case basis; will depend on clinical presentation, requirement for supportive care, risk factors for severe dz,1 ability to self-isolate at home
By vgreene, 19 May, 2020 Pts w/ mild presentation (no pneumonia or hypoxia) may not initially require hospitalization
By vgreene, 19 May, 2020 Clinical management: NIH has published guidelines on prophylaxis, testing, and mgmt of pts w/ COVID-19. See NIH guideline