Coagulation Status and Venous Thromboembolism Risk in African Americans: A Potential Risk Factor in COVID-19

Clin Appl Thromb Hemost. 2020 Jan-Dec:26:1076029620943671. doi: 10.1177/1076029620943671.

Abstract

Severe acute respiratory syndrome coronavirus 2 infection (COVID-19) is known to induce severe inflammation and activation of the coagulation system, resulting in a prothrombotic state. Although inflammatory conditions and organ-specific diseases have been shown to be strong determinants of morbidity and mortality in patients with COVID-19, it is unclear whether preexisting differences in coagulation impact the severity of COVID-19. African Americans have higher rates of COVID-19 infection and disease-related morbidity and mortality. Moreover, African Americans are known to be at a higher risk for thrombotic events due to both biological and socioeconomic factors. In this review, we explore whether differences in baseline coagulation status and medical management of coagulation play an important role in COVID-19 disease severity and contribute to racial disparity trends within COVID-19.

Keywords: COVID-19; SARS-CoV-2; anticoagulation; coagulation; ethnicity; race; thrombosis.

MeSH terms

  • Anemia, Sickle Cell / blood
  • Anemia, Sickle Cell / ethnology
  • Anticoagulants / therapeutic use
  • Betacoronavirus*
  • Black or African American* / genetics
  • Blood Proteins / analysis
  • Blood Proteins / genetics
  • COVID-19
  • Clinical Trials as Topic
  • Comorbidity
  • Coronavirus Infections / blood
  • Coronavirus Infections / complications
  • Coronavirus Infections / ethnology*
  • Factor VIII / analysis
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • Healthcare Disparities
  • Humans
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / ethnology
  • Male
  • Pandemics*
  • Patient Selection
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / ethnology*
  • Polymorphism, Single Nucleotide
  • Prevalence
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / ethnology
  • Risk Factors
  • SARS-CoV-2
  • Social Determinants of Health
  • Socioeconomic Factors
  • Thrombophilia / blood
  • Thrombophilia / drug therapy
  • Thrombophilia / ethnology*
  • Thrombophilia / etiology
  • Venous Thromboembolism / blood
  • Venous Thromboembolism / ethnology*
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control

Substances

  • Anticoagulants
  • Blood Proteins
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • Factor VIII