Obstetrics, Gynecology and Reproduction

Advanced search

Coronavirus disease (COVID-19) and disseminated intravascular coagulation syndrome

Full Text:


COVID-19 is an infectious disease caused by the beta-coronavirus SARS-CoV-2 that in 2020 has spread worldwide. In most severe patients, the clinical picture begins with respiratory failure further deteriorating up to multiple organ failure. Development of coagulopathy is the most adverse prognostic. Analyzing currently available clinical data revealed that 71.4 % and 0.6 % of survivors and fatal cases, respectively, demonstrated signs of overt disseminated intravascular coagulation (DIC). Monitoring D-dimer level, prothrombin time, platelet count and fibrinogen content is important for determining indications for treatment and hospitalization in COVID-19 patients. In case such parameters deteriorate, a more pro-active “aggressive” intensive care should be applied. Low molecular weight heparin (LMWH) should be administered to all patients with diagnosed COVID-19 infection (including non-critical patients) requiring hospitalization, but having no contraindications to LMWH.

About the Authors

A. D. Makatsariya
Sechenov University
Russian Federation

Alexander D. Makatsariya – MD, Dr Sci Med, Professor, Academician of RAS, Head of the Department of Obstetrics and Gynecology, N. F. Filatov Clinical Institute of Children’s Health

62 St. Zemlyanoi Val, Moscow 109004

 Scopus Author ID: 6602363216

Researcher ID: M-5660-2016

K. N. Grigoreva
Sechenov University
Russian Federation

Kristina N. Grigoreva – 6th year Student, Faculty of Pediatrics

62 St. Zemlyanoi Val, Moscow 109004

M. A. Mingalimov
Sechenov University
Russian Federation

Marat A. Mingalimov – 6th year Student, N.F. Filatov Clinical Institute of Children’s Health

62 St. Zemlyanoi Val, Moscow 109004

V. O. Bitsadze
Sechenov University
Russian Federation

Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics and Gynecology, N. F. Filatov Clinical Institute of Children’s Health

62 St. Zemlyanoi Val, Moscow 109004

Scopus Author ID: 6506003478

Researcher ID: F-8409-2017

J. Kh. Khizroeva
Sechenov University
Russian Federation

Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, N. F. Filatov Clinical Institute of Children’s Health

62 St. Zemlyanoi Val, Moscow 109004

M. V. Tretyakova
«Medical Center» LLC
Russian Federation

Maria V. Tretyakova – MD, PhD, Obstetrician-Gynecologist, Department of Gynecology

15/1 Timura Frunze St., Moscow 119021

I. Elalamy
Sechenov University; Medicine Sorbonne University; Hospital Tenon
Russian Federation

Ismail Elalamy – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, N. F. Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Medicine Sorbonne University; Director of Hematology, Department of Thrombosis Center, Hospital Tenon

62 St. Zemlyanoi Val, Moscow 109004, 

12 Rue de l’École de Médecine, 75006 Paris, 

4 Rue de la Chine, 75020 Paris

Scopus Author ID: 7003652413

Researcher ID: AAC-9695-2019


A. S. Shkoda
City Clinical Hospital № 67 named after L.A. Vorokhobov, Moscow Healthcare Department;
Russian Federation

Andrey S. Shkoda – MD, Dr Sci Med, Professor, Chief Physician

2/44 Salyama Adilya St., Moscow 123423

V. B. Nemirovskiy
City Clinical Hospital № 67 named after L.A. Vorokhobov, Moscow Healthcare Department
Russian Federation

Vyacheslav B. Nemirovskiy – MD, PhD, Head of Maternity Hospital № 1, branch

2/44 Salyama Adilya St., Moscow 123423

D. V. Blinov
Institute for Preventive and Social Medicine; Lapino Clinic Hospital, MD Medical Group; Moscow Haass Medical – Social Institute
Russian Federation

Dmitry V. Blinov – MD, PhD, MBA, Head of Medical and Scientific Affairs, Institute of Preventive and Social Medicine; Neurologist, Lapino Clinic Hospital, MD Medical Group; Faculty Member, Department of Neurology, Psychiatry and Narcology, Moscow Haass Medical–Social Institute

4-10 Sadovaya-Triumfalnaya Str., Moscow 127006, 

1st Uspenskoye Highway, 111, Moscow Region, Odintsovo District, Lapino 143081, 

5 p. 1-1a 2nd Brestskaya Str., Moscow 123056

Researcher ID: E-8906-2017

RSCI: 9779-8290


D. V. Mitryuk
State Medical and Pharmaceutical University «Nicolae Testemitanu» Republic of Moldova
Moldova, Republic of

Diana V. Mitryuk – MD, Assistant, Department of Obstetrics and Gynecology

165 Вlvd. Stefan cel Mare, Kishinev MD 2004


1. World Health Organization. Novel Coronavirus — China. January 12, 2020 (

2. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-733.

3. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;NEJMoa2001316.4. Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating per-son-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-52

4. Levi M, van der Poll T. A short contemporary history of disseminated intravascular coagulation. Semin Thromb Hemost. 2014;40(8):874-880.

5. Boral B, Williams D, Boral L. Disseminated Intravascular Coagulation. Am J Clin Pathol. 2016;146(6):670-680.

6. Vaught A. Critical Care for the Obstetrician and Gynecologist: Obstetric Hemorrhage and Disseminated Intravascular Coagulopathy. Obstet Gynecol Clin North Am. 2016;43(4):611-622.

7. Levi M. Pathogenesis and diagnosis of disseminated intravascular coagulation. Int J Lab Hematol. 2018;40(Suppl 1):15-20.

8. Moellering R.C., Abbott G.F., Ferraro M.J. Case records of the Massachussets General Hospital Case 2-2011. A 30-year-old woman with shock after treatment for a furuncle. N Engl J Med. 2011;364(3):266–75. DOI: 10.1056/NEJMcpc1003886.

9. Russell J.A. Management of sepsis. N Engl J Med. 2006;355(16):1699–713. DOI: 10.1056/NEJMra043632.

10. Huang C, Wang Y, Li X, et al. Clinical features of patients in-fected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.

11. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al China Medical Treatment Expert Group for COVID-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Feb 28. doi: 10.1056/NEJMoa2002032.

12. 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 epublished

13. Brun-Buisson C. et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults: a multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis . J.A.M.A. – 1995. – Vol. 274. – P. 968 – 974.

14. Vanderschueren S. et al. Thrombocytopenia and prognosis in intensive care .Crit. Care Med. – 2000. – Vol. 28. – P 1871 -1876.

15. Lippi G, Plebani M, Michael Henry B.Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta. 2020 Mar 13. pii: S0009-8981(20)30124-8.

16. Wada H, Thachil J, Di Nisio M, Mathew P, Kurosawa S, Gando S, et al. Guidance for diagnosis and treatment of DIC from harmonization of the recommendations from three guidelines. The Scientific StandardizationCommittee on DIC of the International Society on Thrombosis Haemostasis. J Thromb Haemost. 2013 Feb 4. doi: 10.1111/jth.12155.

17. Taylor FB, Toh CH, Hoots WK, Wada H, Levi M. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 2001; 86:1327– 30.

18. Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol 2009; 145: 24– 33.

19. di Nisio M, Baudo F, Cosmi B, D'Angelo A, de Gasperi A, Malato A, et al, on behalf of the Italian Society for Thrombosis and Haemostasis. Diagnosis and treatment of disseminated intravascular coagulation: Guidelines of the Italian Society for Haemostasis and Thrombosis (SISET). Thromb Res 2012; 129: e177– 84

20. Gando S, Levi M, Toh C-H. Disseminated intravascular coagulation. Nat Rev Dis Prim. 2016;2(1):16037.

21. Ito T. PAMPs and DAMPs as triggers for DIC. J Intensive Care. 2014;2(1):65

22. Tang N. et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy //Journal of Thrombosis and Haemostasis. – 2020.

23. Iba T, Nisio MD, Levy JH, Kitamura N, Thachil J. New criteria for sepsisinduced coagulopathy (SIC) following the revised sepsis definition: a retrospective analysis of a nationwide survey. BMJ Open. 2017 Sep 27;7(9):e017046.

24. Poterucha TJ, Libby P, Goldhaber SZ. More than an anticoagulant: Do heparins have direct antiinflammatory effects? Thromb Haemost. 2017 Feb 28;117(3):437-444.


For citations:

Makatsariya A.D., Grigoreva K.N., Mingalimov M.A., Bitsadze V.O., Khizroeva J.K., Tretyakova M.V., Elalamy I., Shkoda A.S., Nemirovskiy V.B., Blinov D.V., Mitryuk D.V. Coronavirus disease (COVID-19) and disseminated intravascular coagulation syndrome. Obstetrics, Gynecology and Reproduction. 2020;14(2):123-131.

Views: 7361

ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)