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COVID-19 Related Arterial Coagulopathy

Gagandeep Singh1, Hassan Bin Attique2, Naga Vaishnavi Gadela3

  • 1Internal Medicine, Trinity Health of New England, Hartford, USA.

Cureus
|September 4, 2020
PubMed

Insights

COVID-19 causes a dramatic hypercoagulable state, leading to arterial thrombosis. D-dimer levels in COVID-19 patients did not reliably predict clot burden or future thrombosis risk.

Area of Science:

  • Cardiology
  • Hematology
  • Infectious Diseases

Background:

  • COVID-19, caused by SARS-CoV-2, presents with significant hypercoagulability.
  • The prothrombotic state in COVID-19 is more pronounced than typically seen in sepsis.

Observation:

  • Three cases of arterial thrombosis with substantial clot burden requiring urgent intervention are presented.
  • Clinical experience suggests D-dimer levels may not correlate with clot burden in COVID-19 patients.

Findings:

  • The hypercoagulable state in COVID-19 appears to be a direct prothrombotic effect of the disease.
  • D-dimer levels showed poor correlation with clot burden and future thrombosis risk in observed cases.

Implications:

  • Rethinking current practices for deep venous thrombosis (DVT) prophylaxis in COVID-19 patients is necessary.
  • Further research is needed to identify reliable markers for thrombosis risk assessment in COVID-19.
  • Understanding the mechanisms of COVID-19-induced hypercoagulability is crucial for effective patient management.

Keywords:
acute limb ischemiaarterial thrombosiscoagulopathycoronavirus disease of 2019 (covid-19)ischemic strokeleft ventricle (lv) thrombusvenous thromboembolism (vte)

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