The presence of coagulation abnormalities in acute respiratory distress syndrome (ARDS) has been identified and studied for decades, and these investigations have increased substantially during the coronavirus disease 2019 (COVID-19) pandemic. Hypercoagulability in response to severe acute respiratory syndrome coronavirus-2 infection is a well documented phenomenon characterized by increased plasma concentrations of d-dimer, fibrin, fibrin degradation products, and fibrinogen, contributing to thromboembolic events, multiorgan failure, and death. However, the relationship between quantitative measures of hypercoagulability, hypoxemia, and clinical outcomes in patients with COVID-19 has not been fully elucidated.

In this issue of Anesthesiology, Corey et al. report a prospective observational single-center study investigating the association between respiratory failure and hypercoagulability in patients with extreme respiratory failure caused by severe acute respiratory syndrome coronavirus-2 infection. The authors studied 55 critically ill patients with COVID-19, of which 89% were receiving invasive mechanical ventilation and 16% were...

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