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Venous and arterial thrombosis in COVID-19: An updated narrative review

Zainab Al Duhailib1, Simon Oczkowski2, Kamil Polok3

  • 1Department of Critical Care Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Journal of Infection and Public Health
|June 1, 2022
PubMed

Insights

Coronavirus disease 2019 (COVID-19) increases thrombosis risk in hospitalized patients. D-dimer aids risk stratification, but optimal anticoagulation strategies require further high-quality evidence.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Hospitalized patients with COVID-19, especially in the ICU, face high morbidity and mortality.
  • Observational studies indicate hemostatic derangements and thrombotic complications are common in COVID-19 patients.

Purpose of the Study:

  • To review evidence on COVID-19-associated thrombosis.
  • To summarize pathologic findings, pathophysiology, coagulation abnormalities, D-dimer's prognostic role, risk factors, and anticoagulation strategies.

Main Methods:

  • Literature review of existing evidence on COVID-19 and thrombosis.

Main Results:

  • COVID-19 is linked to increased micro- and macro-vascular thrombosis in hospitalized and critically ill patients.
  • D-dimer shows utility in risk stratifying hospitalized COVID-19 patients.
  • The role of D-dimer in guiding anticoagulation therapy is uncertain.

Conclusions:

  • COVID-19 contributes to increased thrombosis, impacting disease severity.
  • High-quality evidence is needed to define the role of therapeutic anticoagulation and intensive prophylaxis in COVID-19 patients.

Keywords:
AnticoagulationCOVID-19Critically illD-dimer levelThrombosisVenous thromboembolism prophylaxis

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