en Internal Medicine Internal Medicine Review Article Review Article <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">This review explores the coagulation disorders and thrombotic events observed in COVID-19 patients, highlighting the underlying pathophysiological mechanisms and current management strategies.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Pathophysiology and clinical impact:</b> Important mechanisms contributing to thrombosis include cytokine storm-induced thrombosis, antiphospholipid antibody syndrome, macrophage activation syndrome, complement cascade activation, and renin-angiotensin system dysregulation. Thrombotic complications significantly impact mortality and morbidity, with pulmonary emboli frequently observed in autopsy studies. Notably, this prothrombotic state may persist for weeks post-hospitalization.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Management:</b> Effective management of COVID-19-associated coagulopathy requires prompt treatment of underlying infections and comprehensive assessment of co-infections in critically ill patients. While heparin and its derivatives remain the cornerstone for managing venous</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;thromboembolism, their efficacy for COVID-19-associated coagulopathy remains to be a subject of investigation.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> Understanding the complex interplay between inflammation and thrombosis in COVID-19 is crucial for developing targeted therapeutic strategies that address coagulation disorders and the underlying infection.</span></span></span></span></span></span></span></span><br> &nbsp; COVID-19, Coagulopathy, Thrombosis, Immunothrombosis, D-dimer, Anticoagulation 729 735 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-6738-2&slc_lang=en&sid=1 Mahdi Khatuni mef_kh@yahoo.com 200319475328460099366 200319475328460099366 No Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Behnaz Varaminian varaminianb@gmail 200319475328460099367 200319475328460099367 No Department of Internal Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran Maryamolsadat Ghoreyshi Ghoreyshi.maryam75@gmail.com 200319475328460099368 200319475328460099368 No Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Marziyeh Ghalamkari dr.ghalam@yahoo.com 200319475328460099369 200319475328460099369 Yes Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran