The mechanism and the management strategy of COVID-19 associated thromboembolic manifestations

Abstract

Objectives: Severe acute respiratory syndrome corona virus 2 (SARS-COV-2) is a recently known zoonotic coronavirus that has   devastated the whole world. The objective of this review paper is to find out the available information related to COVID-19 infection and thromboembolism. This would help build better understanding of the pathophysiology and effective management strategy of thromboembolism in COVID-19 patients.

Data sources: A few articles are available on printed versions, but many more are available online versions or in the pipeline. We used various search engines to find out COVID-19 and thromboembolism related articles.

Study selection: The papers depicting various aspects of COVID-19 and thromboembolism have been selected and analyzed. Their core messages have been extracted and compiled.

Data extraction: Data have been collected from the articles available from MEDLINE and Google Scholar up to July, 2020. We also gathered information from doctors involved in the treatment of the COVID patients.

Data synthesis: Information on relationship between COVID-19 and thromboembolism has been collected. In addition, there have  been reports of many sudden deaths attributed to deadly cardiac arrythmia and increased thromboembolic manifestation. A higher risk of vessel thrombosis has been correlated with severity of the disease and multiorgan involvement.

Conclusions: COVID-19 appears to be associated with thrombosis in general, both venous and arterial. These patients have increased risk of thromboembolism due to infection related inflammation, immobility and hypercoagulable state.  Adequate thromboprophylaxis should be administered in all moderate to severe COVID-19 patients including patients of comorbidity and aged patients.