{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:45:56Z","timestamp":1783507556626,"version":"3.55.0"},"reference-count":229,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:00:00Z","timestamp":1647648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently complicated by thrombosis. In some cases of severe COVID-19, fibrinolysis may be markedly enhanced within a few days, resulting in fatal bleeding. In the treatment of COVID-19, attention should be paid to both coagulation activation and fibrinolytic activation. Various thromboses are known to occur after vaccination with SARS-CoV-2 vaccines. Vaccine-induced immune thrombotic thrombocytopenia (VITT) can occur after adenovirus-vectored vaccination, and is characterized by the detection of anti-platelet factor 4 antibodies by enzyme-linked immunosorbent assay and thrombosis in unusual locations such as cerebral venous sinuses and visceral veins. Treatment comprises high-dose immunoglobulin, argatroban, and fondaparinux. Some VITT cases show marked decreases in fibrinogen and platelets and marked increases in D-dimer, suggesting the presence of enhanced-fibrinolytic-type disseminated intravascular coagulation with a high risk of bleeding. In the treatment of VITT, evaluation of both coagulation activation and fibrinolytic activation is important, adjusting treatments accordingly to improve outcomes.<\/jats:p>","DOI":"10.3390\/ijms23063338","type":"journal-article","created":{"date-parts":[[2022,3,20]],"date-time":"2022-03-20T21:30:14Z","timestamp":1647811814000},"page":"3338","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7415-2918","authenticated-orcid":false,"given":"Shinya","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Hematology, Kanazawa University Hospital, Takaramachi 13-1, Kanazawa 920-8640, Ishikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1834-1690","authenticated-orcid":false,"given":"Hidesaku","family":"Asakura","sequence":"additional","affiliation":[{"name":"Department of Hematology, Kanazawa University Hospital, Takaramachi 13-1, Kanazawa 920-8640, Ishikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"357S","DOI":"10.1378\/chest.124.6_suppl.357S","article-title":"Prevention of Venous Thromboembolism in the ICU","volume":"124","author":"Geerts","year":"2003","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"406","DOI":"10.5551\/jat.RPT001","article-title":"The Questionnaire-survey Joint Team on The COVID-19-related thrombosis COVID-19-Related Thrombosis in Japan: Final Report of a Questionnaire-Based Survey in 2020","volume":"28","author":"Horiuchi","year":"2021","journal-title":"J. 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