The Anatolian Journal of Cardiology

Thrombosis, an important piece in the COVID-19 puzzle: From pathophysiology to therapy


Department of Medical and Surgical Specialties, Faculty of Medicine, Transilvania University of Brasov; Brasov- Romania


Department of Cardiology, Clinical County Emergency Hospital Brasov; Brasov-Romania

Anatol J Cardiol 2021; 25: 601-608
DOI: 10.5152/AnatolJCardiol.2021.475
Read: 132 Downloads: 72 Published: 01 September 2021

A lot of data about coronavirus disease 2019 (COVID-19) have been already published; however, these still form only a part of the pandemic puzzle. Once we have all the pieces of the puzzle, we will be able to successfully treat this disease with its multiple challenges. COVID-19 has a high thrombogenic potential. In this study, we aimed to review published data about COVID-19 associated thrombosis from pathophysiology to treatment and the role in patient evolution. We searched for articles and studies published online through MEDLINE/PubMed database, Google Scholar, ScienceDirect, Wiley Online Library, and Nature Public Health Emergency Collection. We found numerous articles regarding COVID-19 infection but selected only those focused on thrombosis. D-dimers have a predictive value in identifying thrombosis and a high level correlates with the severity of the infection and death. Most patients who were on chronic anticoagulant therapy before contracting the virus had a better prognosis. Heparin has other favorable effects such as a direct antiviral and anti-inflammatory effect in addition to its anticoagulant effect. COVID-19 infections are frequently complicated by thrombotic pathology. High plasma level of D-dimers is a predictive factor for severe prognosis, and the recommended anticoagulant, associated with low mortality, is heparin followed by a direct oral anticoagulant. Randomized studies in large groups of patients and therapeutic guidelines are still needed on this subject.

Cite this article as: Bobescu E, Marceanu LG, Covaciu A, Vladau LA. Thrombosis, an important piece in the COVID-19 puzzle: From pathophysiology to therapy. Anatol J Cardiol 2021; 25: 601-8.

ISSN 2149-2263 EISSN 2149-2271