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Venous thromboembolism in the era of COVID-19

Konstantinos G Kyriakoulis1, Damianos G Kokkinidis2,3, Ioanna A Kyprianou4

  • 1Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece.

Phlebology
|November 30, 2020
PubMed

Insights

COVID-19 is a systemic disease causing high rates of venous thromboembolism in hospitalized patients. Autopsy studies are crucial for understanding microthrombi formation and coagulopathy in COVID-19 patients.

Area of Science:

  • Internal Medicine
  • Pathology
  • Infectious Diseases

Background:

  • COVID-19 (Coronavirus disease 2019) presents as a systemic illness, not solely respiratory.
  • Venous thromboembolism (VTE) incidence is notably higher in COVID-19 patients compared to other viral infections.
  • Pathophysiology of VTE in COVID-19 requires further investigation, with autopsy studies offering critical insights.

Purpose of the Study:

  • To explore the pathophysiology of microthrombi formation in COVID-19.
  • To understand the association between COVID-19's inflammatory burden and coagulopathy.
  • To highlight diagnostic challenges for pulmonary embolism (PE) in COVID-19 patients.

Main Methods:

  • Review of autopsy findings in COVID-19 patients.
  • Analysis of microthrombi distribution in pulmonary vasculature and other organs.
  • Correlation of inflammatory markers with coagulopathy in COVID-19.

Main Results:

  • Microthrombi are prevalent in the pulmonary vasculature and other organs of COVID-19 patients.
  • A high inflammatory burden in COVID-19 is linked to significant coagulopathy.
  • Diagnostic challenges for PE in COVID-19 stem from overlapping symptoms with pneumonia and isolation protocols.

Conclusions:

  • COVID-19-associated coagulopathy and VTE necessitate further research into optimal prophylactic and therapeutic anticoagulant strategies.
  • Autopsy studies are vital for elucidating the mechanisms of thromboembolism in COVID-19.
  • Clinical management guidelines for VTE in COVID-19 patients require ongoing refinement.

Keywords:
COVID-19SARS-CoV-2deep vein thrombosisnovel coronaviruspulmonary embolismreviewvenous thromboembolism

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