Submitted Successfully!
To reward your contribution, here is a gift for you: A free trial for our video production service.
Thank you for your contribution! You can also upload a video entry or images related to this topic.
Version Summary Created by Modification Content Size Created at Operation
1 -- 1366 2022-11-05 14:00:31 |
2 format corrected. Meta information modification 1366 2022-11-07 04:13:08 |

Video Upload Options

Do you have a full video?


Are you sure to Delete?
If you have any further questions, please contact Encyclopedia Editorial Office.
Zając, P.;  Kaziród-Wolski, K.;  Oleś, I.;  Sielski, J.;  Siudak, Z. Fibrinolysis for Patients with COVID-19. Encyclopedia. Available online: (accessed on 24 June 2024).
Zając P,  Kaziród-Wolski K,  Oleś I,  Sielski J,  Siudak Z. Fibrinolysis for Patients with COVID-19. Encyclopedia. Available at: Accessed June 24, 2024.
Zając, Patrycja, Karol Kaziród-Wolski, Izabela Oleś, Janusz Sielski, Zbigniew Siudak. "Fibrinolysis for Patients with COVID-19" Encyclopedia, (accessed June 24, 2024).
Zając, P.,  Kaziród-Wolski, K.,  Oleś, I.,  Sielski, J., & Siudak, Z. (2022, November 05). Fibrinolysis for Patients with COVID-19. In Encyclopedia.
Zając, Patrycja, et al. "Fibrinolysis for Patients with COVID-19." Encyclopedia. Web. 05 November, 2022.
Fibrinolysis for Patients with COVID-19

An impaired fibrinolytic process has been demonstrated in patients infected with SARS-CoV-2, including those in severe or critical condition. Disruption of fibrinolysis leads to fibrin deposition, which exacerbates inflammation and fibrosis and damages the pulmonary surfactant. Numerous authors point out the different course of coagulopathy in patients with COVID-19. It is reported that they may have a state of secondary hyperfibrinolysis, which may explain, at least in part, the increased incidence of venous thromboembolism, even among those patients already receiving appropriate anticoagulant treatment. This raises the question of whether current guidelines for the prevention and treatment of embolic–thrombotic complications, among patients with severe COVID-19, are sufficient. Some studies show evidence of clinical improvement in patients who have received fibrinolytic therapy, beyond the current indications for its implementation. 

fibrinolysis COVID-19 venosus thromboembolism pulmonary embolism


  1. Koenig, W. Fibrinogen and coronary risk. Curr. Cardiol. Rep. 1999, 1, 112–118.
  2. Pieters, M.; Ferreira, M.; de Maat, M.P.M.; Ricci, C. Biomarker association with cardiovascular disease and mortality—The role of fibrinogen. A report from the NHANES study. Thromb. Res. 2021, 198, 182–189.
  3. Meizoso, J.P.; Moore, H.B.; Moore, E.E. Fibrinolysis Shutdown in COVID-19: Clinical Manifestations, Molecular Mechanisms, and Therapeutic Implications. J. Am. Coll. Surg. 2021, 232, 995–1003.
  4. 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, 18, 844–847.
  5. Li, Q.; Cao, Y.; Chen, L.; Wu, D.; Yu, J.; Wang, H.; He, W.; Chen, L.; Dong, F.; Chen, W.; et al. Hematological features of persons with COVID-19. Leukemia 2020, 34, 2163–2172.
  6. Thachil, J.; Tang, N.; Gando, S.; Falanga, A.; Cattaneo, M.; Levi, M.; Clark, C.; Iba, T. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J. Thromb. Haemost. 2020, 18, 1023–1026.
  7. Kanji, R.; Gue, Y.X.; Memtsas, V.; Gorog, D.A. Fibrinolysis in Platelet Thrombi. Int. J. Mol. Sci. 2021, 22, 5135.
  8. Bachler, M.; Bösch, J.; Stürzel, D.P.; Hell, T.; Giebl, A.; Ströhle, M.; Klein, S.J.; Schäfer, V.; Lehner, G.F.; Joannidis, M.; et al. Impaired fibrinolysis in critically ill COVID-19 patients. Br. J. Anaesth. 2021, 126, 590–598.
  9. Boknäs, N.; Laine, C.; Hillarp, A.; Macwan, A.S.; Gustafsson, K.M.; Lindahl, T.L.; Holmström, M. Associations between hemostatic markers and mortality in COVID-19—Compounding effects of D-dimer, antithrombin and PAP complex. Thromb. Res. 2022, 213, 97–104.
  10. Whyte, C.S.; Morrow, G.B.; Mitchell, J.L.; Chowdary, P.; Mutch, N.J. Fibrinolytic abnormalities in acute respiratory distress syndrome (ARDS) and versatility of thrombolytic drugs to treat COVID-19. J. Thromb. Haemost. 2020, 18, 1548–1555.
  11. Coccheri, S. COVID-19: The crucial role of blood coagulation and fibrinolysis. Intern. Emerg. Med. 2020, 15, 1369–1373.
  12. Manzoor, D.; Bui, C.; Makhoul, E.; Luthringer, D.; Marchevsky, A.; Volod, O. Improvement in plasma D-dimer level in severe SARS-CoV-2 infection can be an indicator of fibrinolysis suppression: Case reports. Medicine 2021, 100, e25255.
  13. Ji, H.L.; Zhao, R.; Matalon, S.; Matthay, M.A. Elevated Plasmin(ogen) as a Common Risk Factor for COVID-19 Susceptibility. Physiol. Rev. 2020, 100, 1065–1075.
  14. Della Bona, R.; Valbusa, A.; La Malfa, G.; Giacobbe, D.R.; Ameri, P.; Patroniti, N.; Robba, C.; Gilad, V.; Insorsi, A.; Bassetti, M.; et al. Systemic fibrinolysis for acute pulmonary embolism complicating acute respiratory distress syndrome in severe COVID-19: A case series. Eur. Heart J. Cardiovasc. Pharmacother. 2021, 7, 78–80.
  15. Medcalf, R.L.; Keragala, C.B.; Myles, P.S. Fibrinolysis and COVID-19: A plasmin paradox. J. Thromb. Haemost. 2020, 18, 2118–2122.
  16. Barrett, C.D.; Moore, H.B.; Moore, E.E.; Benjamin Christie, D., 3rd; Orfanos, S.; Anez-Bustillos, L.; Jhunjhunwala, R.; Hussain, S.; Shaefi, S.; Wang, J.; et al. MUlticenter STudy of tissue plasminogen activator (alteplase) use in COVID-19 severe respiratory failure (MUST COVID): A retrospective cohort study. Res. Pract. Thromb. Haemost. 2022, 6, e12669.
  17. Ghia, S.; Bhatt, H.; Lazar, M. Role of Tissue Plasminogen Activator for Diffuse Pulmonary Microemboli in Coronavirus Disease 2019 Patient. J. Cardiothorac. Vasc. Anesth. 2021, 35, 2137–2139.
  18. Wang, J.; Hajizadeh, N.; Moore, E.E.; McIntyre, R.C.; Moore, P.K.; Veress, L.A.; Yaffe, M.B.; Moore, H.B.; Barrett, C.D. Tissue plasminogen activator (tPA) treatment for COVID-19 associated acute respiratory distress syndrome (ARDS): A case series. J. Thromb. Haemost. 2020, 18, 1752–1755.
  19. Poor, H.D.; Ventetuolo, C.E.; Tolbert, T.; Chun, G.; Serrao, G.; Zeidman, A.; Dangayach, N.S.; Olin, J.; Kohli-Seth, R.; Powell, C.A. COVID-19 Critical Illness Pathophysiology Driven by Diffuse Pulmonary Thrombi and Pulmonary Endothelial Dysfunction Responsive to Thrombolysis. Clin. Transl. Med. 2020, 10, e44.
  20. Sehgal, T.; Gupta, N.; Kohli, S.; Khurana, A.; Dass, J.; Diwan, S.; Mahendran, A.J.; Khan, M.; Aggarwal, M.; Subramanian, A. A Prospective Study of Specialized Coagulation Parameters in Admitted COVID-19 Patients and Their Correlation With Acute Respiratory Distress Syndrome and Outcome. Cureus 2021, 13, e17463.
  21. So, M.; Steiger, D.J.; Takahashi, M.; Egorova, N.N.; Kuno, T. The characteristics and outcomes of critically Ill patients with COVID-19 who received systemic thrombolysis for presumed pulmonary embolism: An observational study. J. Thromb. Thrombolysis 2021, 52, 1061–1067.
  22. Della-Morte, D.; Pacifici, F.; Ricordi, C.; Massoud, R.; Rovella, V.; Proietti, S.; Iozzo, M.; Lauro, D.; Bernardini, S.; Bonassi, S.; et al. Low level of plasminogen increases risk for mortality in COVID-19 patients. Cell Death Dis. 2021, 12, 773.
  23. Wu, Y.; Wang, T.; Guo, C.; Zhang, D.; Ge, X.; Huang, Z.; Zhou, X.; Li, Y.; Peng, Q.; Li, J. Plasminogen improves lung lesions and hypoxemia in patients with COVID-19. QJM Int. J. Med. 2020, 113, 539–545.
  24. Zuo, Y.; Warnock, M.; Harbaugh, A.; Yalavarthi, S.; Gockman, K.; Zuo, M.; Madison, J.A.; Knight, J.S.; Kanthi, Y.; Lawrence, D.A. Plasma tissue plasminogen activator and plasminogen activator inhibitor-1 in hospitalized COVID-19 patients. Sci. Rep. 2021, 11, 1580.
  25. Available online: (accessed on 24 March 2021).
  26. Rashidi, F.; Barco, S.; Rezaeifar, P.; Sadeghipour, P.; Ghodrati, S.; Bakhshandeh, H.; Mousavi-Aghdas, S.A.; Sadeghi, A.; Sharifi, A.; Valizadeh, H.; et al. Tissue plasminogen activator for the treatment of adults with critical COVID-19: A pilot randomized clinical trial. Thromb. Res. 2022, 216, 125–128.
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to : , , , ,
View Times: 473
Revisions: 2 times (View History)
Update Date: 07 Nov 2022
Video Production Service