key: cord-0950352-zsbigpd0
authors: Tang, Ning
title: Response to 'Pulmonary thrombosis in 2019‐nCoV pneumonia?'
date: 2020-05-12
journal: J Thromb Haemost
DOI: 10.1111/jth.14843
sha: 49211296b524b8f56522fdb4a8afd7d2eeaf06fc
doc_id: 950352
cord_uid: zsbigpd0

We appreciate the opportunity to respond to the comments by Dr. Marongiu et al., they presented that as only laboratory findings of Disseminated Intravascular Coagulation (DIC) but no bleeding was mentioned, indicating that there was not an overt DIC in our patients, instead, the abnormal laboratory findings could be an expression of local DIC, i.e. a pulmonary vascular thrombosis. Thus they suggested the anticoagulant treatment in patients with coronavirus disease 2019 (COVID-19).

We appreciate the opportunity to respond to the comments by First, bleeding is less common than thrombosis and presents late in DIC induced by infection, and the site of bleeding is sometimes hard to find (eg, brain, intra-abdominal). 1 We suggest the International Society of Thrombosis and Haemostasis diagnostic criteria 2 rather than just relying on clinical manifestation for DIC diagnosis. In fact, because of neglect or lack of available coagulation tests, the diagnosis of DIC is often delayed until bleeding from multiple sites occurs. 3 We agree with Dr. Marongiu et al that pulmonary vascular thrombosis may exist in some severe COVID-19 cases, the pulmo- 

Extended evaluation of recombinant human activated protein C United States Trial (ENHANCE US): a single-arm, phase 3B, multicenter study of drotrecogin alfa (activated) in severe sepsis

Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation

Platelets and infections in the resource-limited countries with a focus on malaria and viral haemorrhagic fevers

The stimulation of thrombosis by hypoxia

Pathogenesis, diagnosis, and management of disseminated intravascular coagulation: a literature review

The coagulation system in host defense

A multicenter, prospective validation of disseminated intravascular coagulation diagnostic criteria for critically ill patients: comparing current criteria

Diagnosis and management of sepsis-induced coagulopathy and disseminated intravascular coagulation