Ιncidence, pathogenesis and management of thromboembolic complications in severe COVID-19

ABSTRACT

Arterial and venous thromboembolic events are frequent complications of severe COVID 19 with an estimated incidence approximately 30%. High levels of D-dimers and fibrinogen, prothrombin time (PT) prolongation and mild thrombocytopenia compose the hypercoagulable profile of COVID 19 patients, while positive antiphospholipid antibodies have also been reported. The hyperinflammatory state in combination with the endothelial damage by the virus and the diffuse microvascular thrombosis contribute to the pathogenesis. Vigilance should be maintained for the early diagnosis of thrombotic complications. Low molecular weight heparin (LMWH) has been shown to reduce mortality in high risk patients, while the administration of higher dose of anticoagulants (intermediate, therapeutic) in order to prevent thromboembolic disease is further investigated. Pneumon 2020, 33(4)1-5.