Cardiology Letters 2021, 30(2):119-125

Prothrombotic milieu (arterial and venous thrombosis) in COVID-19 disease and its clinical impact

Nehaj F^{1, 2}, Sokol J², Tomka J⁴, Chudej J³, Hatala R^{1, 2}

¹ Oddelenie arytmií a kardiostimulácie, Národný ústav srdcových a cievnych chorôb, a. s., Bratislava

² Klinika kardiológie a angiológie, Národný ústav srdcových a cievnych chorôb, a. s. a Lekárská fakulta Slovenskej zdravotníckej univerzity, Bratislava

³ Klinika hematológie a transfuziológie, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave

⁴ Klinika cievnej chirurgie, Národný ústav srdcových a cievnych chorôb, a. s., a Lekárská fakulta Slovenskej zdravotníckej univerzity, Bratislava, Slovenská republika

COVID-19 disease (Corona Virus Disease 19), especially its severe forms, is frequently accompanied by thrombotic or thromboembolic events with various organ localizations. These life-threatening complications are due to enhanced prothrombotic milieu of multifactorial aetiology. Main pathogenetic factors are: 1. dysregulation of the renin-angiotensin aldosterone system (RAAS) with decreased protective activity of ACE2 (angiotensin-converting enzyme), and 2. complex immune response of the infected organism. The incidence of venous thrombosis in studies on severe COVID-19 cases can be as high as 30% and is frequently refractory to prophylactic anticoagulation. Results of both basic and clinical research of the SARS-CoV2 (Severe acute respiratory syndrome coronavirus 2) infection have demonstrated that severe COVID-19 disease is associated with generalized endothelial dysfunction with resulting thrombophilia. This concise review article focuses on current pathophysiological and clinical aspects of both venous and arterial thrombosis in COVID-19 disease. Fig. 1, Schema 1, Tab. 4, Ref. 33, on-line full text (Free, PDF) www.cardiologyletters.sk

Keywords: COVID-19; venous thrombosis; arterial thrombosis; renin-angiotensin system

Published: February 1, 2021  Show citation