Thrombotic complications of COVID-19
Open accessAbstract
Introduction The novel coronavirus disease of 2019 (COVID-19) is associated with significant morbidity and mortality. The impact of thrombotic complications has been increasingly recognized as an important component of this disease.Objective This narrative review summarizes the thrombotic complications associated with COVID-19 with an emphasis on information for Emergency Medicine clinicians.Discussion Thrombotic complications from COVID-19 are believed to be due to a hyperinflammatory response caused by the virus. Several complications have been described in the literature. These include acute limb ischemia, abdominal and thoracic aortic thrombosis, mesenteric ischemia, myocardial infarction, venous thromboembolism, acute cerebrovascular accident, and disseminated intravascular coagulation.Conclusion It is important for Emergency Medicine clinicians to be aware of the thrombotic complications of COVID-19. Knowledge of these components are essential to rapidly recognize and treat to reduce morbidity and mortality in these patients.
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In a clinical study by Stefely et al. [68] in a group of 102 patients with severe disease, an increase in factor V > 200 IU was identified in 48% of cases.
“In a clinical study by Stefely et al. [68] in a group of 102 patients with severe disease, an increase in factor V > 200 IU was identified in 48% of cases, the levels determined being statistically significantly higher than in non-COVID mechanically ventilated or unventilated patients hospitalized in intensive care.”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [68]
The increased activity of Factor V cannot be attributed to disease severity or mechanical ventilation.
“This showed that the increased activity of Factor V cannot be attributed to disease severity or mechanical ventilation.”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [68]
The levels of factor V in the Stefely et al. study were statistically significantly higher than in non-COVID mechanically ventilated or unventilated patients hospitalized in intensive care.
“In a clinical study by Stefely et al. [68] in a group of 102 patients with severe disease, an increase in factor V > 200 IU was identified in 48% of cases, the levels determined being statistically significantly higher than in non-COVID mechanically ventilated or unventilated patients hospitalized in intensive care.”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [68]
Viral binding to ACE2 receptors leads to significant changes in fluid-coagulation balance, including increased IL6 levels, cytokine storm, expression of tissue inhibitor of plasminogen-1 and tissue factor, and triggering of the coagulation system through binding to clotting factor VIIa.
“Viral binding to ACE2Receptors leads to significant changes in fluid-coagulation balance: reduction in Ang 2 degradation leads to increased Il6 levels, and the onset of storm cytokines, such as IL-2, IL-7, IL-10, granulocyte colony-stimulating factor, IgG -induced protein 10, monocyte chemoattractant protein-1, macrophage inflammatory protein 1-alpha, and tumor necrosis factor α [67], but also in”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [68]
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References 102 · Cited by 143
Research works printed but not linked: 1
- [27]27. Andrea V. Gianluca F. Rodolfo P. Paolo T. Alessandro P. Mauro G. Unheralded lower limb threatening ischemia in a COVID-19 patient [published online ahead of print, 2020 May 21] Int J Infect Dis S1201–9712 20 2020 10.1016/j.ijid.2020.05.0607 30367-2 · DOI
- Authors
- Avila, J., Long, B., Holladay, D., & Gottlieb, M.
- Affiliations
- University of Kentucky (US)
- Brooke Army Medical Center (US)
- Rush University Medical Center (US)
- Corresponding author
- Gottlieb, Michael
- Venue
- The American Journal of Emergency Medicine
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 39
- Pages
- 213-218
- ISSN
- 0735-6757 (ISSN-L)
- OpenAlex
- W3090530053
- Cited by
- 143
- References
- 102
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 14 · 2023: 32 · 2022: 43 · 2021: 44 · 2020: 2
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The American Journal of Emergency Medicine (acceptedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pandemic, thrombotic complications, venous thromboembolism, acute limb ischemia, aortic thrombosis, mesenteric ischemia, myocardial infarction, acute cerebrovascular accident, disseminated intravascular coagulation, hyperinflammation, emergency medicine
- MeSH terms
- COVID-19, Emergency Medicine, Humans, Thrombosis
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