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Thrombosis in COVID-19

Thomas C Hanff1,2, Amir M Mohareb3,4, Jay Giri1

  • 1Division of Cardiology, Department of Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

American Journal of Hematology
|August 29, 2020
PubMed

Thrombotic complications are frequent in COVID-19 and contribute significantly to mortality and morbidity. We review several mechanisms of hypercoagulability in sepsis that may be upregulated in COVID-19. These include immune-mediated thrombotic mechanisms, complement activation, macrophage activation syndrome, antiphospholipid antibody syndrome, hyperferritinemia, and renin-angiotensin system dysregulation. We highlight biomarkers within each pathway with potential prognostic value in COVID-19. Lastly, recent observational studies have evaluated a role for the expanded use of therapeutic anticoagulation in COVID-19. We review strengths and weaknesses of these studies, and we also discuss the hypothetical benefit and anticipated challenges of fibrinolytic therapy in COVID-19.

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