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Hematologic Emergencies in Patients with Covid-19

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Critical Care of COVID-19 in the Emergency Department

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Abstract

Coronavirus disease 2019 (Covid-19) is primarily a respiratory illness caused by infection with the SARS-CoV-2 virus. In addition to pulmonary sequelae, clinicians should be aware of significant vascular and hematologic effects. Biomarker patterns suggest coagulopathy distinct from both sepsis and disseminated intravascular coagulation. Thrombotic complications, while primarily venous, also include arterial thrombosis affecting cerebrovascular and cardiovascular systems. Pulmonary embolism and deep vein thrombosis appear to be especially prevalent in Covid-19. In addition, high rates of microvascular thrombosis have been found in autopsy studies which has an unclear role in the pathophysiology of Covid-19 ARDS. Diagnosis of venous thromboembolism presents an additional challenge, as previously used laboratory markers have proven unreliable in Covid-19. Aggressive anticoagulation strategies for inpatients with Covid-19 have undergone mostly retrospective analysis suggesting improved outcomes, although new prospective data suggests otherwise. Incorporating new information into the diagnosis and management of these complex patients and continuing to adapt practice according to emerging data will be essential to optimize patient clinical outcomes.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, USA

    Jessica Waters

  2. Departments of Emergency Medicine and Critical Care, MedStar Washington Hospital Center, Washington, DC, USA

    Rory Spiegel

  3. University of Maryland School of Medicine, Baltimore, MD, USA

    Michael T. McCurdy

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  1. Jessica Waters
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  2. Rory Spiegel
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  3. Michael T. McCurdy
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Editors and Affiliations

  1. Departments of Emergency Medicine, Neurology and Surgery, University of Florida Health Science Center, Jacksonville, FL, USA

    Joseph R. Shiber

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Waters, J., Spiegel, R., McCurdy, M.T. (2021). Hematologic Emergencies in Patients with Covid-19. In: Shiber, J.R. (eds) Critical Care of COVID-19 in the Emergency Department. Springer, Cham. https://doi.org/10.1007/978-3-030-85636-6_13

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