COVID-19 is known to trigger a prothrombotic state, causing thromboses
and thromboembolic events (TTEE) in patients with COVID-19. Both bleeding and
thrombosis can result in significant morbidity in COVID-19. The entity paves the way
to arterial TTEE (i.e., stroke and/or extremity ischemia) as well as small vessel
thrombosis, which are commonly recorded at autopsy in the pulmonary vasculature.
Elevated D-dimer is associated with a higher risk for TTEE, hemorrhage, critical
illness, and mortality. Likewise, levels of fibrinogen, ferritin, procalcitonin are also
higher in patients with thrombosis. There is also a propensity to develop pulmonary
thromboembolism (PTE) in cases with COVID-19. Treatment with anticoagulant
prophylaxis (i.e., heparin and/or aspirin) is recommended in many researches, but
robust evidence is still warranted to draw firm conclusions on the benefit-to-harm ratio
of the agents in most patients.
Keywords: Anticoagulant prophylaxis, Cardiovascular disease, Coagulopathy,
COVID-19, D-dimer, Thromboembolic events, Thrombosis.
