COVID-19 and Hypercoagulability: A Review

Abstract

Thrombotic complications of the novel coronavirus (COVID-19) are a concerning aspect of the disease, due to the high incidence in critically ill patients and poor clinical outcomes. COVID-19 predisposes patients to a hypercoagulable state, however, the pathophysiology behind the thrombotic complications seen in this disease is not well understood. Several mechanisms have been proposed and the pathogenesis likely involves a host immune response contributing to vascular endothelial cell injury, inflammation, activation of the coagulation cascade via tissue factor expression, and shutdown of fibrinolysis. Treatments targeting these pathways may need to be considered to improve clinical outcomes and decrease overall mortality due to thrombotic complications. In this review, we will discuss the proposed pathophysiologic mechanisms for thrombotic complications in COVID-19, as well as treatment strategies for these complications based on the current literature available.

The role of rotational thromboelastometry during the COVID-19 pandemic: a narrative review

“…The required r-tPA-dose can vary from patient to patient. Therefore, monitoring the effect of thrombolytic therapy in COVID-19 patients by rotational thromboelastometry is recommended [ 50 , 53 ]. Here, rotational thromboelastometry is not only important in selecting the COVID-19 patient population who might benefit from thrombolytic therapy, but it can also detect the patient population with a higher risk of developing bleeding complications under thrombolytic therapy.…”

COVID-19-associated ischaemic stroke due to underlying carotid artery thrombosis in a healthy young woman

“…The incidence of thrombotic events in patients infected with SARS-CoV-2 is as high as 79%. 2 Within these events, arterial thrombosis ranked low in occurrences with approximately 3.7% of cases. 3 Still, COVID-19 thrombotic events prove to be unpredictable in location and association with other medical conditions.…”

Delayed hypercoagulable state in COVID‐19 adolescent patient: a case report

“…Coronavirus disease 2019 (COVID‐19) is a disease which can cause systemic hyperinflammation and has spread worldwide. The usual symptoms are fever, cough, malaise, anosmia, loss of appetite, diarrhoea, and other varying symptoms [1]. To date, there is no definitive treatment which can cure the disease.…”