{
  "abstract": "Background\n\nCOVID-19-associated coagulopathy has been predominantly characterised as a hypercoagulable state with fibrinolytic shutdown. However, the full phenotypic spectrum of disseminated intravascular coagulation (DIC) in COVID-19 remains incompletely characterised. This report adds two cases demonstrating that COVID-19-associated DIC can manifest as two distinct phenotypes at opposite ends of the coagulation spectrum.Case summary\n\nWe report two cases of severe COVID-19 with diametrically opposed DIC phenotypes. Case 1: a 23-year-old immunosuppressed male with SARS-CoV-2 bloodstream and central nervous system infection developed haemorrhagic DIC, characterised by severe hypofibrinogenemia (0.76 g/L), markedly elevated PIC (>40 μg/mL), and preserved platelet counts (>100 × 10⁹/L). He was successfully treated with titrated tranexamic acid. Case 2: a 54-year-old previously healthy female with severe COVID-19 pneumonia developed thrombotic DIC, characterised by significant thrombocytopenia (platelets 65 × 10⁹/L, nadir 40 × 10⁹/L), multi-organ injury, and lower extremity venous thrombosis. She was successfully treated with low-molecular-weight heparin.Conclusion\n\nCOVID-19-associated DIC spans two phenotypes-thrombotic (platelet consumption, requiring anticoagulation) and haemorrhagic (fibrinogen consumption with hyperfibrinolysis, requiring antifibrinolytics)-validating the 2025 ISTH classification and highlighting the need for phenotype-specific therapy guided by serial coagulation monitoring.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Critical Care Medicine, The 908th Hospital of Joint Logistic Support Force, Nanchang, China.",
    "Nanchang Key Laboratory of Thrombosis and Haemostasis, Nanchang, China."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Jingchun Song"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Junjie Zeng"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiaomin Song"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/24j5t6r8tgs6t.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1999533",
  "fulltext_url": "https://europepmc.org/articles/PMC13686822",
  "id": "24j5t6r8tgs6t",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42922967",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|COVID-19 Clinical Research Studies"
    ]
  ],
  "openalex": "W7221038002",
  "pdf_url": "https://europepmc.org/articles/PMC13686822?pdf=render",
  "pmcid": "PMC13686822",
  "pmid": "42922967",
  "published": "2026-10-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/24j5t6r8tgs6t.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42922967",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42922967"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|COVID-19 Clinical Research Studies",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Case Report: Thrombotic and haemorrhagic disseminated intravascular coagulation in COVID-19.",
  "title_text": "Case Report: Thrombotic and haemorrhagic disseminated intravascular coagulation in COVID-19.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/24j5t6r8tgs6t",
  "venue": "Frontiers in medicine",
  "versions": []
}