Current Overview on Hypercoagulability in COVID-19

Namrata Singhania; Saurabh Bansal; Divya P. Nimmatoori; Abutaleb A. Ejaz; Peter A. McCullough; Girish Singhania


Am J Cardiovasc Drugs. 2020;20(5):393-403. 

In This Article

Abstract and Introduction


The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought many unique pathologies, such as coagulopathy, prompting a desperate need for effective management. COVID-19-associated coagulopathy (CAC) can cause various thromboembolic complications, especially in critically ill patients. The pathogenesis is likely due to endothelial injury, immobilization, and an increase in circulating prothrombotic factors. Data on treatment are limited, although prophylactic anticoagulation is advised in all hospitalized patients. Herein, we have comprehensively reviewed the current literature available on CAC and highlight the pathogenesis, clinical features, and management of CAC.


A novel coronavirus was first identified in late 2019 in Wuhan, China, and rapidly spread throughout the world, causing a pandemic.[1] The virus was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the World Health Organization designated the disease as coronavirus disease 2019 (COVID-19). The most common symptoms are respiratory, but gastrointestinal, neurological, and other atypical symptoms can also be seen, although these symptoms are rare.[2] Recent studies showed several coagulation abnormalities in patients with COVID-19, raising questions about appropriate management to prevent or treat thrombosis; this state has been termed COVID-19-associated coagulopathy (CAC).[3] The International Society on Thrombosis and Hemostasis (ISTH), the American Society of Hematology (ASH), and the American College of Cardiology (ACC) have posted interim guidance on this topic. Herein, we provide a clinical overview on the pathogenesis, clinical features, and management of hypercoagulability in individuals with COVID-19.