ISSN 2149-2263 | E-ISSN 2149-2271
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Inflammation and thrombosis in patients with COVID-19: A prothrombotic and inflammatory disease caused by SARS coronavirus-2 [Anatol J Cardiol]
Anatol J Cardiol. 2020; 24(4): 224-234 | DOI: 10.14744/AnatolJCardiol.2020.56727

Inflammation and thrombosis in patients with COVID-19: A prothrombotic and inflammatory disease caused by SARS coronavirus-2

Burak Pamukçu
Department of First and Emergency Aid, Acıbadem Mehmet Ali Aydınlar University, Vocational School of Health Services; İstanbul-Turkey

Coronavirus disease 2019 (COVID-19) caused by “Severe Acute Respiratory Syndrome Coronavirus-2” (SARS-CoV-2) infection emerged in Wuhan, a city of China, and spread to the entire planet in early 2020. The virus enters the respiratory tract cells and other tissues via ACE2 receptors. Approximately 20% of infected subjects develop severe or critical disease. A cytokine storm leads to over inflammation and thrombotic events. The most common clinical presentation in COVID-19 is pneumonia, typically characterized by bilateral, peripheral, and patchy infiltrations in the lungs. However multi-systemic involvement including peripheral thromboembolic skin lesions, central nervous, gastrointestinal, circulatory, and urinary systems are reported. The disease has a higher mortality compared to other viral agents causing pneumonia and unfortunately, no approved specific therapy, nor vaccine has yet been discovered. Several clinical trials are ongoing with hydroxychloroquine, remdesivir, favipiravir, and low molecular weight heparins. This comprehensive review aimed to summarize coagulation abnormalities reported in COVID-19, discuss the thrombosis, and inflammation-driven background of the disease, emphasize the impact of thrombotic and inflammatory processes on the progression and prognosis of COVID-19, and to provide evidence-based therapeutic guidance, especially from antithrombotic and anti-inflammatory perspectives.

Keywords: COVID-19, SARS-CoV-2, inflammation, thrombosis, clinical outcomes, d-dimer, disseminated intravascular coagulation, antithrombotic therapy, heparin, low molecular weight heparins, oral anticoagulants

Burak Pamukçu. Inflammation and thrombosis in patients with COVID-19: A prothrombotic and inflammatory disease caused by SARS coronavirus-2. Anatol J Cardiol. 2020; 24(4): 224-234

Corresponding Author: Burak Pamukçu, Türkiye
Manuscript Language: English


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