Venous Thromboembolism Complicated with COVID-19: What Do We Know So Far?

Acta Haematol. 2020;143(5):417-424. doi: 10.1159/000508233. Epub 2020 May 12.

Abstract

Coronavirus disease (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is responsible for the ongoing 2019-2020 pandemic. Venous thromboembolism (VTE), a frequent cardiovascular and/or respiratory complication among hospitalized patients, is one of the known sequelae of the illness. Hospitalized COVID-19 patients are often elderly, immobile, and show signs of coagulopathy. Therefore, it is reasonable to assume a high incidence of VTE among these patients. Presently, the incidence of VTE is estimated at around 25% of patients hospitalized in the intensive care unit for COVID-19 even under anticoagulant treatment at prophylactic doses. In this review, we discuss present knowledge of the topic, the unique challenges of diagnosis and treatment of VTE, as well as some of the potential mechanisms of increased risk for VTE during the illness. Understanding the true impact of VTE on patients with COVID-19 will potentially improve our ability to reach a timely diagnosis and initiate proper treatment, mitigating the risk for this susceptible population during a complicated disease.

Keywords: COVID-19; Deep vein thrombosis; Pulmonary emboli; Venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anticoagulants / therapeutic use*
  • Betacoronavirus / pathogenicity*
  • Biomarkers / blood
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / mortality
  • Coronavirus Infections / virology
  • Disseminated Intravascular Coagulation / complications*
  • Disseminated Intravascular Coagulation / drug therapy
  • Disseminated Intravascular Coagulation / mortality
  • Disseminated Intravascular Coagulation / virology
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Heparin / therapeutic use
  • Humans
  • Intensive Care Units
  • Lung / blood supply
  • Lung / drug effects
  • Lung / pathology
  • Lung / virology
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / virology
  • Pulmonary Embolism / complications*
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / mortality
  • Pulmonary Embolism / virology
  • Respiratory Insufficiency / complications*
  • Respiratory Insufficiency / drug therapy
  • Respiratory Insufficiency / mortality
  • Respiratory Insufficiency / virology
  • Risk Factors
  • SARS-CoV-2
  • Survival Analysis
  • Troponin / blood
  • Venous Thromboembolism / complications*
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / mortality
  • Venous Thromboembolism / virology

Substances

  • Anticoagulants
  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • Troponin
  • fibrin fragment D
  • Heparin