Severe acute respiratory coronavirus 2 (SARS-CoV2) and the resulting acute respiratory distress syndrome (COVID-19) is responsible for a worldwide pandemic, with over 10 million cases reported as of 28(th) June 2020.(S1) Whilst severe disease requiring hospitalisation is characterised by pneumonia and respiratory failure, a significant proportion also develop acute kidney injury (AKI). Within critical care admissions with COVID-19, 16 to 35% are reported as requiring renal replacement therapy.(2)(,)(3)(, S2,S3) There is increasing recognition of an associated coagulopathy in hospitalised patients characterised by a prothrombotic state and increased venous thromboembolism. This brief review presents the current understanding of the coagulopathy associated with COVID-19, the risk of venous thrombosis and the impact of this on management of renal replacement therapy in critically ill patients with COVID-19.
Hypercoagulability and anticoagulation in patients with COVID-19 requiring renal replacement therapy