Thrombotic risk in patients with COVID-19

Rev Cardiovasc Med. 2021 Jun 30;22(2):277-286. doi: 10.31083/j.rcm2202035.

Abstract

Emerging evidences prove that the ongoing pandemic of coronavirus disease 2019 (COVID-19) is strictly linked to coagulopathy even if pneumonia appears as the major clinical manifestation. The exact incidence of thromboembolic events is largely unknown, so that a relative significant number of studies have been performed in order to explore thrombotic risk in COVID-19 patients. Cytokine storm, mediated by pro-inflammatory interleukins, tumor necrosis factor α and elevated acute phase reactants, is primarily responsible for COVID-19-associated hypercoagulopathy. Also comorbidities, promoting endothelial dysfunction, contribute to a higher thromboembolic risk. In this review we aim to investigate epidemiology and clarify the pathophysiological pathways underlying hypercoagulability in COVID-19 patients, providing indications on the prevention of thromboembolic events in COVID-19. Furthermore we aim to reassume the pathophysiological paths involved in COVID-19 infection.

Keywords: COVID-19; Coagulopathy; Endothelitis; Pulmonary embolism; Thrombosis.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Blood Coagulation* / drug effects
  • COVID-19 / blood*
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 Drug Treatment
  • Host-Pathogen Interactions
  • Humans
  • Prognosis
  • Pulmonary Embolism / blood*
  • Pulmonary Embolism / epidemiology
  • Pulmonary Embolism / prevention & control
  • Pulmonary Embolism / virology
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2 / pathogenicity
  • Venous Thromboembolism / blood*
  • Venous Thromboembolism / epidemiology
  • Venous Thromboembolism / prevention & control
  • Venous Thromboembolism / virology
  • Venous Thrombosis / blood*
  • Venous Thrombosis / epidemiology
  • Venous Thrombosis / prevention & control
  • Venous Thrombosis / virology

Substances

  • Anticoagulants