Persistent hypercoagulable state in COVID-19: A case series of COVID-19 associated pulmonary embolism

Abstract

Coronavirus disease 2019 (COVID-19) has swept through the world with millions of cases and hundreds of thousands of deaths. COVID-19-associated coagulopathy has been recognized as the major cause of morbidity and mortality. To the best of our knowledge, a majority of the cases of coagulopathy have been reported in patients with moderate-to-severe COVID-19 and limited to observations during the recovery/postcytokine storm state. Herein, we report a case series of two patients with COVID-19 who developed pulmonary embolism in the late phase of the disease. This raised the hypothesis that the risk of hypercoagulability in patients with COVID-19 can persist until the recovery phase, which would warrant a follow-up with D-dimer and fibrinogen trending, as well as postdischarge thromboprophylaxis for at least 2 weeks during the recovery phase.

Keywords

• anticoagulation
• coronavirus disease 2019
• hypercoagulable
• pulmonary embolism
• severe acute respiratory syndrome coronavirus 2