University of Michigan - Ann Arbor

Hamilton College

COVID-19 may predispose patients to thrombotic disease in both the venous and arterial circulations. This predisposition is caused by:

1. Direct and indirect effects of COVID-19 infection (e.g., severe illness and hypoxia).
2. Adverse interactions between therapies for COVID-19 and antithrombotic drugs (e.g., antiplatelet agents and anticoagulants).
3. Negative impacts on the timely treatment of patients with thrombotic events due to pandemic-related resource allocations and social distancing recommendations.

Predisposing Factors for Thrombotic Disease in COVID-19

Bikdeli, B., Madhavan, M. V., Jimenez, D., Chuich, T., Dreyfus, I., Driggin, E., Nigoghossian, C., Ageno, W., Madjid, M., Guo, Y., Tang, L. V., Hu, Y., Giri, J., Cushman, M., Quéré, I., Dimakakos, E. P., Gibson, C. M., Lippi, G., Favaloro, E. J., … Lip, G. Y. Global COVID-19 Thrombosis Collaborative Group, Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function (2020). COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 75(23), 2950–2973. https://doi.org/10.1016/j.jacc.2020.04.031


COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow Up 

Mechanisms of Coagulopathy and Pathogenesis of Thrombosis in COVID-19

184 patients identified with COVID-19 were studied from ICUs within 2 Dutch university hospitals and 1 Dutch teaching hospital. These patients were admitted between March 7th and April 5th. The composite outcome consisted of acute pulmonary embolism (PE), deep-vein thrombosis (DVT), ischemic stroke, myocardial infarction or systemic arterial embolism. Diagnosis tests were only applied if there was clinical suspicion of thrombotic complications within the patients. The cumulative incidence of the compositie outcome was 31%. 

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