Hypercoagulability and COVID-19 Infection

COVID-19 is a relatively recent and clinically heterogeneous infection, with a broad spectrum of complications, including significant hematologic involvement.Since 2020, COVID-19-associated coagulopathy has been investigated both biologically and clinically through single-center and multicenter studies—initially in China and subsequently across all continents.These investigations have consistently reported elevated D-dimer levels, disseminated intravascular coagulation (DIC), impaired fibrinolysis, disruptions in coagulation factors, endotheliopathy linked to thrombopathy, antiphospholipid syndrome, and complex alterations involving genetic dysfunction and neutrophil extracellular traps (NETs). Research has encompassed patients in the acute phase, as well as those experiencing long COVID or postacute sequelae, with follow-up extending beyond one year.Notably, a prothrombotic state has been observed to persist even in the post-acute phase. More recent investigations have examined vaccine-related effects, particularly those associated with adenoviral vector-based vaccines such as ChAdOx1 and Ad26.COV2.S, where thromboembolic adverse events have been documented. In conclusion, the pathogenesis of COVID-19-related coagulopathy is multifactorial, and the elevated risk of thromboembolic events may persist for up to one year following the acute phase.This underscores the critical need for continuous clinical and laboratory monitoring of affected patients.