Thromboembolism and anticoagulation therapy among the COVID-19 patients

Suvvari, T. K.; Kuppili, S.; Simhachalam Kutikuppala, L. V.

Coronavirus disease 2019 (COVID-19), which is caused due to severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), can be complicated with coagulopathy through disseminated intravascular coagulation (DIC) in severe stages leading to profuse morbidity and mortality. The prothrombotic character of DIC can potentiate a higher risk of venous thromboembolism (VTE), whose incidence among COVID-19 patients in intensive care units appears to be a bit higher and severe. The prevalence of VTE was high in the COVID-19 patients due to inflammation and stasis of blood vessel endothelium resulting from viral infection. D-dimer monitoring can help in early recognition, proper treatment, and better prognosis in the high-risk COVID-19 patients. Recent studies show that anticoagulant therapy reduces the mortality in severe COVID-19 patients with sepsis-induced coagulopathy or markedly elevated d-dimer. Direct oral anticoagulants or low-molecular-weight-heparin can be administrated in hospitalized COVID-19 patients to minimize thrombosis risk. However, constant observation on anticoagulant therapy and post-discharge thromboprophylaxis in COVID-19 patients is recommended.