Thrombotic or Thromboembolic Events in COVID-19: A Literature Review

Abstract

Context: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as a novel virus infection, was first detected in China in 2019 and has quickly spread as a pandemic leading to a high mortality rate and unprecedented challenges for healthcare systems. Although the SARS-CoV-2 clinical spectrum is different, acute failure of respiratory function and coagulopathy as a common manifestation can be observed in cases with severe coronavirus disease 2019 (COVID-19). Methods: This literature review was conducted based on standard guidelines to evaluate related-to-title information about thrombotic or thromboembolic events in COVID-19. Keywords were combined and included as “thrombotic event”, “thromboembolic events”, “diagnosis”, “management”, “SARS-CoV-2”, “COVID-19”, and “literature review”. Results: Lung tissue is a serious target of the COVID-19 virus leading to acute respiratory distress syndrome related to a thromboinflammatory condition. The storm of cytokines, pulmonary tropism, and thromboinflammation are bases of tissue damage leading to acute failure of the respiratory system and extended infection, which can lead to different organ failure and death. The thrombogenicity of this condition has been shown by the high prevalence rate of thromboembolic events observed in SARS-CoV-2 cases treated with anticoagulation. Enhanced D-dimers, as a biomarker reflecting the activation of fibrinolysis and hemostasis, and thrombocytopenia have a relationship with a higher mortality rate in COVID-19 cases. Conclusions: Based on the finding, the inflammation phase of COVID-19 can induce thromboinflammation and lead to thromboembolic events.