Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past

J Clin Virol. 2020 Jun:127:104362. doi: 10.1016/j.jcv.2020.104362. Epub 2020 Apr 9.


Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus strain disease, has recently emerged in China and rapidly spread worldwide. This novel strain is highly transmittable and severe disease has been reported in up to 16% of hospitalized cases. More than 600,000 cases have been confirmed and the number of deaths is constantly increasing. COVID-19 hospitalized patients, especially those suffering from severe respiratory or systemic manifestations, fall under the spectrum of the acutely ill medical population, which is at increased venous thromboembolism risk. Thrombotic complications seem to emerge as an important issue in patients infected with COVID-19. Preliminary reports on COVID-19 patients' clinical and laboratory findings include thrombocytopenia, elevated D-dimer, prolonged prothrombin time, and disseminated intravascular coagulation. As the pandemic is spreading and the whole picture is yet unknown, we highlight the importance of coagulation disorders in COVID-19 infected patients and review relevant data of previous coronavirus epidemics caused by the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome coronavirus (MERS-CoV).

Keywords: COVID-19; MERS-CoV; SARS-CoV; coagulation; coronavirus; thrombosis.

Publication types

  • Review

MeSH terms

  • Animals
  • Blood Coagulation Disorders / virology*
  • COVID-19
  • China
  • Coronavirus Infections / blood
  • Coronavirus Infections / complications*
  • Disseminated Intravascular Coagulation / virology
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Mice
  • Middle East Respiratory Syndrome Coronavirus
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / complications*
  • Severe Acute Respiratory Syndrome / blood
  • Severe Acute Respiratory Syndrome / complications*
  • Thrombocytopenia / virology


  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D