الفهرس 
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Abstract
Fibrinogen, D-dimer, VWF, and P-selectin all have pathological levels that may be decreased or elevated and are linked to abnormal coagulation and endothelial dysfunction. This molecule may also be significantly off in people with COVID-19. Lippi and Favaloro (2020) and others have observed that many proteins are out of whack during COVID-19. These include P-selectin (Neri et al., 2020), fibrinogen and D-dimers (Al-Samkari et al., 2020, Spiezia et al., 2020, Zou et al., 2020b), and VWF (Escher et al., 2020, Zachariah et al., 2020, Alexander et al., 2020, Zachariah et al., 2021). Variable levels of fibrinogen, D-dimer, VWF, and P-selectin may lead to either hypercoagulation or excessive bleeding and thrombocytopenia. In the context of normal bleeding and abnormal clotting conditions, low fibrinogen levels are connected to an increased propensity for bleeding, while high fibrinogen levels are associated with hypercoagulation (Pillai et al., 2014). (Pillai et al., 2014). People who have many mild risk factors that combine to produce symptoms often have bleeding and thrombotic events (Lazzari et al., 2012). (Lazzari et al., 2012). Individuals with COVID-19 often have acute respiratory distress syndrome (ARDS) and lung issues with haemorrhage, thrombocytopenia, and thrombotic disorders (Boccia et al., 2020, Li et al., 2020a, Bikdeli et al., 2020, Wright et al., 2020). Therefore, fibrinogen levels, D-dimer, VWF, and P-selectin may all be helpful indicators for helping clinicians make an accurate clinical diagnosis and treatment plan. Or, to rephrase the question: (Grobler et al., 2020)
from a clinical perspective, it appears that the early stage clinical picture of COVID-19 progresses to a fast rise in D-dimer; further higher levels of fibrinogen, VWF, and P-selectin; and hyperactivation of platelets in individuals presenting with normal or slightly raised D-dimer, fibrinogen, and VWF if left untreated. If you have thrombosis or hypercoagulability, you could experience anything like this. D-dimer and P-selectin levels are increased, whilst fibrinogen and VWF levels are lowered, in critically ill patients due to the depletion of these molecules from circulation or from damaged endothelial cells and hyperactivated platelets, respectively (Grobler et al., 2020). At this time in the progression of the disease, the cytokine storm is also common. However, P-selectin expression on platelets may be used to diagnose mild to moderate bleeding difficulties, and severely low P-selectin expression may be related with greater bleeding (Grobler et al., 2020). (Kyrle et al., 2007).
A major issue is the wide range of P-selectin expression among individuals.
Endotheliopathy is common in those infected with the COVID-19 strain and is strongly linked to coagulopathies and clinical symptoms (Goshua et al., 2020). Consistent monitoring of coagulation/bleeding patterns and blood clot fibrinolysis may be done at the bedside using point-of-care equipment and diagnostics such the thromboelastograph (TEG; displays fibrinogen levels) and point-of-care ultrasonography (POCUS) (Rubulotta et al., 2020). (Rubulotta et al., 2020). Fibrinolysis evaluation in COVID-19 patients is greatly aided by TEG (Wright et al., 2020). Thromboembolic events in patients with COVID-19 who are already in poor health may also be predicted by the TEG (Wright et al., 2020).