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Review
. 2022 Jun;15(6):689-702.
doi: 10.1016/j.jiph.2022.05.003. Epub 2022 May 14.

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

Zainab Al Duhailib  1 , Simon Oczkowski  2 , Kamil Polok  3 , Jakub Fronczek  3 , Wojciech Szczeklik  3 , Joshua Piticaru  4 , Manoj J Mammen  5 , Fayez Alshamsi  6 , John Eikelboom  7 , Emilie Belley-Cote  7 , Waleed Alhazzani  8
Affiliations
Review

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

Zainab Al Duhailib et al. J Infect Public Health. 2022 Jun.

Abstract

Hospitalized patients with coronavirus disease 2019 (COVID-19), particularly those admitted to the intensive care unit (ICU) are at high risk of morbidity and mortality. Several observational studies have described hemostatic derangements and thrombotic complications in patients with COVID-19. The aim of this review article is to summarize the current evidence on pathologic findings, pathophysiology, coagulation and hemostatic abnormalities, D-dimer's role in prognostication epidemiology and risk factors of thrombotic complications, and the role of prophylactic and therapeutic anticoagulation in patients with COVID-19. While existing evidence is limited in quality, COVID-19 appears to increase micro-and macro-vascular thrombosis rates in hospitalized and critically ill patients, which may contribute to the burden of disease. D-dimer can be used for risk stratification of hospitalized patients, but its role to guide anticoagulation therapy remains unclear. Evidence of higher quality is needed to address the role of therapeutic anticoagulation or high-intensity venous thromboembolism prophylaxis in COVID-19 patients. TAKE-HOME POINTS.

Keywords: Anticoagulation; COVID-19; Critically ill; D-dimer level; Thrombosis; Venous thromboembolism prophylaxis.

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Figures

Fig. 1
Fig. 1
Pathophysiology of COVID-19 associated thrombosis.
Fig. 2
Fig. 2
The pooled incidence of venous thromboembolism in inpatients and outpatient population.
See this image and copyright information in PMC

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