ReviewThrombosis research2020
The hypercoagulable state in COVID-19: Incidence, pathophysiology, and management.
Review in Thrombosis research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 390 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
390 citing papers in PubMed, 6 syntheses or guidelines pooled it, 706 citations in OpenAlex.
- Symptomatology of Long COVID Associated with Inherited and Acquired Thrombophilic Conditions: A Systematic Review.Viruses · 2025Pooled it
- Pooled it
- Accuracy of routine laboratory tests to predict mortality and deterioration to severe or critical COVID-19 in people with SARS-CoV-2.The Cochrane database of systematic reviews · 2024Pooled it
- A systematic review of thromboembolic complications and outcomes in hospitalised COVID-19 patients.BMC infectious diseases · 2024Pooled it
- Comprehensive collection of COVID-19 related prosthetic valve failure: a systematic review.Journal of thrombosis and thrombolysis · 2023Pooled it
- Prognostic value of novel serum biomarkers, including C-reactive protein to albumin ratio and fibrinogen to albumin ratio, in COVID-19 disease: A meta-analysis.Reviews in medical virology · 2022Pooled it
- Prophylactic vs Therapeutic Anticoagulation in Hospitalized Patients With COVID-19: A Randomized Clinical Trial.JAMA network open · 2026Trial
- SARS-CoV-2 spike-armed vesicular stomatitis virus recapitulates severe COVID-19 acute respiratory distress syndrome in mice.iScience · 2026Article
- Promoting expertise knowledge sharing in paediatric virology: An update (Review).Experimental and therapeutic medicine · 2026Review
- Thrombotic risk trajectories in patients with coronary artery disease before and during COVID-19.iScience · 2026Article
- Identification of Clinical Factors Associated With the Immunogenicity of Homologous ChAdOx1-nCoV-19 Vaccine in Hemodialysis Patients.The Kaohsiung journal of medical sciences · 2026Article
- The association of angiostatin and plasminogen plasma levels with Charlson comorbidity burden and mortality in COVID-19.Journal of thrombosis and thrombolysis · 2026Observational
- Association of laboratory and radiological findings during hospitalization with early post-COVID pulmonary function and exercise capacity: a retrospective study.BMC pulmonary medicine · 2026Article
- Thoracolumbar spine surgery in the post-pandemic era: a national retrospective analysis of thrombotic complications, vaccination status, and prior hospitalization with COVID-19.Asian spine journal · 2026Article
- Enhancing AMI mortality trend analysis in CKD patients: addressing code specificity, comorbidity patterns, and pandemic effects.International urology and nephrology · 2026Article
- Blood Coagulation in COVID-19: Systems-Biology Evidence, Clinical Implications, and Therapeutic Opportunities in an Evolving Pandemic.ACS omega · 2026Article
- Navigating Ankle Fracture Surgery in the Shadow of COVID-19.Foot & ankle specialist · 2026Article
- Mild SARS-CoV-2 maternal infection in mice induces transient offspring neurodevelopmental aberrance.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Association Between ADA (Age-D-dimer-Albumin) Score and Chest CT Severity Score in COVID-19 Pneumonia.Journal of personalized medicine · 2026Article
- Cardiovascular Complications of Seasonal Influenza in the Pre- and Post-COVID-19 Era: Epidemiology, Mechanisms, and Clinical Implications.Medical sciences (Basel, Switzerland) · 2026Review
330 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
The 2019 coronavirus disease (COVID-19) presents with a large variety of clinical manifestations ranging from asymptomatic carrier state to severe respiratory distress, multiple organ dysfunction and death. While it was initially considered primarily a respiratory illness, rapidly accumulating data suggests that COVID-19 results in a unique, profoundly prothrombotic milieu leading to both arterial and venous thrombosis. Consistently, elevated D-dimer level has emerged as an independent risk factor for poor outcomes, including death. Several other laboratory markers and blood counts have also been associated with poor prognosis, possibly due to their connection to thrombosis. At present, the pathophysiology underlying the hypercoagulable state is poorly understood. However, a growing body of data suggests that the initial events occur in the lung. A severe inflammatory response, originating in the alveoli, triggers a dysfunctional cascade of inflammatory thrombosis in the pulmonary vasculature, leading to a state of local coagulopathy. This is followed, in patients with more severe disease, by a generalized hypercoagulable state that results in macro- and microvascular thrombosis. Of concern, is the observation that anticoagulation may be inadequate in many circumstances, highlighting the need for alternative or additional therapies. Numerous ongoing studies investigating the pathophysiology of the COVID-19 associated coagulopathy may provide mechanistic insights that can direct appropriate interventional strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.