Diagnosis, Management, and Pathophysiology of Arterial and Venous Thrombosis in COVID-19

Gregory Piazza, David A. Morrow

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with arterial and venous thrombotic complications. In a US registry of patients with coronavirus disease 2019 (COVID-19), thrombotic complications occurred in 2.6% of 229 non–critically ill hospitalized patients and in 35.3% of 170 hospitalized critically ill patients. The risk of thromboembolism in SARS-CoV-2 infection in nonhospitalized patients is unknown. Thrombotic complications include myocardial infarction (MI), ischemic stroke, and venous thromboembolism (VTE). Autopsy findings of microthrombi in multiple organ systems, including the lungs, heart, and kidneys, suggest that thrombosis may contribute to multisystem organ dysfunction in severe COVID-19.

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