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Risk of Thrombosis during and after a SARS-CoV-2 Infection: Pathogenesis, Diagnostic Approach, and Management
Henry Sutanto1,2, Gatot Soegiarto1,2,3
1Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.
Insights
Coronavirus disease 2019 (COVID-19) significantly elevates the risk of dangerous blood clots (thromboembolism), impacting survival and long-term health. Understanding COVID-19
Area of Science:
- Medical Research
- Infectious Diseases
- Cardiovascular Science
Background:
- Coronavirus disease 2019 (COVID-19) is linked to an increased risk of thromboembolic events.
- Severe COVID-19 infections requiring intensive care heighten this risk.
- Thromboembolic complications in COVID-19 patients correlate with higher mortality and reduced quality of life.
Purpose of the Study:
- To comprehensively review the pathogenesis of thrombosis in COVID-19.
- To discuss clinical manifestations and diagnostic markers of COVID-19-associated thromboembolism.
- To explain preventive and therapeutic strategies for thromboembolism during and after COVID-19 infection.
Main Methods:
- Literature review focusing on COVID-19 pathophysiology.
- Analysis of molecular and cellular mechanisms of COVID-19-associated thrombosis.
- Discussion of clinical data on venous and arterial thromboembolism in COVID-19 patients.
Main Results:
- COVID-19 infection presents specific clinical characteristics and underlying pathophysiology contributing to thrombosis.
- Detailed review of molecular and cellular pathways involved in COVID-19-related blood clot formation.
- Clinical manifestations and potential diagnostic markers for thromboembolism in COVID-19 are explored.
Conclusions:
- Understanding COVID-19 thrombosis pathogenesis is crucial for prevention and treatment.
- Effective management strategies are needed to reduce morbidity, mortality, and disability associated with COVID-19 thromboembolism.
- The risk of thromboembolism persists long after acute COVID-19 infection, necessitating ongoing vigilance.
Abstract:
Coronavirus disease 2019 (COVID-19) increases the risk of thromboembolic events, especially in patients with severe infections requiring intensive care and cardiorespiratory support. COVID-19 patients with thromboembolic complications have a higher risk of death, and if they survive, these complications are expected to negatively affect these patients' quality of life. Moreover, recent data reported that the risk of thromboembolism remains high months after a COVID-19 infection. Therefore, understanding the pathogenesis of thrombosis in the setting of COVID-19 may facilitate the early prevention and treatment of COVID-19-associated thromboembolism to reduce concomitant morbidity, mortality, and disability. This review will first discuss the clinical characteristics of COVID-19 infections, particularly with regard to the underlying pathophysiology. Then, the pathogenesis of COVID-19-associated thrombosis at the molecular and cellular levels will be comprehensively reviewed. Next, the clinical manifestations of venous and arterial thromboembolism in COVID-19 as well as the potential benefits of several laboratory markers of thrombosis will be further discussed. Lastly, the preventive and therapeutic management of thromboembolism during and after COVID-19 will also be explained.
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