A novel coronavirus termed as COVID-19 by WHO has been the causative agent of an unprecedented pandemic in the history of humanity. The global burden of mortality and morbidity associated with this pandemic continues to increase with each passing day as it is progressively leading to multiorgan dysfunction. In most cases, the cause of death has been attributed to respiratory failure, sepsis, cardiac failure, kidney injury, or coagulopathy. As more knowledge is being unfolded, an in-depth understanding of various systemic manifestations and complications of SARS-CoV2 is vital for optimum management of these patients. This novel virus is known to spread faster than its two ancestors, the SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), demonstrating a case fatality ranging from 5 to 8% [ 1 ]. Hematological abnormalities such as lymphopenia, thrombocytopenia, elevated D-Dimer, elevated fibrinogen, elevated fibrinogen degradation products as well as cytokines such as IL-6 are emerging as important prognostic marker for worse outcome of COVID-19. Among various systemic manifestations, hematological complications such as venous thrombosis causing pulmonary embolism or deep vein thrombosis, and arterial thrombosis causing myocardial infarction, strokes or limb ischemia are being noted to be directly linked to high mortality from COVID-19. An attempt to understand the pathophysiology of various hematological abnormalities including cytokine storm, hypercoagulable state and some rare presentations of this disease hence becomes imperative. Through this review, we aim to provide an up-to-date summary of current evidence-based literature of hematological manifestations, their consequences and management including role of anticoagulation and drugs targeting cytokine storm in patients with SARS-CoV-2.

Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly present with upper and lower respiratory tract symptoms, with complications related to cytokine storm syndrome and acute respiratory distress syndrome. It has also been described to predispose to venous and arterial thromboembolism; however, limited published data is available regarding thrombosis in coronavirus disease 2019 (COVID-19). Here we are presenting a case of arterial thrombosis in a patient with COVID-19 and a systematic review on coagulopathy associated with COVID-19.

The World Health Organization has declared novel coronavirus disease 2019 (COVID-19) a global public health emergency. Although respiratory symptoms predominate in COVID-19, thrombosis can occur in patients with COVID-19. This paper reports a case of an 82-year-old female with a prior medical history of hypertension, diabetes presenting with fever and cough, and was diagnosed with COVID-19. The patient subsequently developed progressively worsening of abdominal distention, tenderness, and underwent emergent laparotomy. She was found to have a gangrenous colon. This case adds to the limited literature regarding the extrapulmonary complications of COVID-19.

Splanchnic vein thrombosis in COVID-19: A review of literature Dear Editor , Coronavirus disease-2019 (COVID-19) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) can predispose to both venous and arterial thromboembolism [1-4]. Splanchnic vein thrombosis (SVT) including portal, mesenteric, splenic vein thrombosis and the Budd-Chiari syndrome, is a manifestation of unusual site venous thromboembolism. SVT usually occurs in association with cirrhosis, liver malignancy or in patients with inherited or acquired thrombophilia [5]. Limited literature is available regarding SVT in COVID-19. We did an extensive literature review on COVID-19 associated SVT. We searched PubMed for this literature review using search terms 'COVID-19 and splanchnic vein thrombosis, 'COVID-19 and portal vein thrombosis', 'COVID-19 and mesenteric vein thrombosis', COVID-19 and Budd-Chiari syndrome', COVID-19 and hepatic vein thrombosis' and 'COVID-19 and splenic vein thrombosis'. All the case reports with COVID-19 associated SVT so far were reviewed, and relevant data was abstracted from these studies. COVID-19 diagnosis was made by PCR assay except in one patient it was negative (suspected COVID-19). The clinical features, laboratory values and outcome are summarized in Table 1 [6-11]. We found total of six patients. The median age of patients was 58 years (range 27-79 years) and 50% were male. Presenting symptoms were vomiting, abdominal pain, diarrhea, fever, shortness of breath, jaundice and altered mental status. None of the patients had cirrhosis or hepatocellular cancer. Work up done to rule out known associated inherited or acquired