Relationship Between COVID-19 And Venous Thromboembolism

Abstract

Coronaviruses were considered as small pathogens that caused mild cold until the 21st century. However, in the 21st century, three worrying outbreaks caused by coronaviruses occurred. These are severe acute respiratory syndrome coronavirus (SARS-CoV) outbreak, Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak. The SARS-CoV-2 epidemic, which started in Wuhan, China in December 2019, spread rapidly throughout China and the world. For this reason, on March 11, 2020, the World Health Organization declared the SARS-CoV-2 outbreak as a pandemic and named the disease caused by this virus as COVID-19. Nowadays, the family of coronavirus is considered as a large and important group of viruses that mostly affect people through transmission. Venous thromboembolism (VTE) is a fatal but treatable disease. Deep vein thrombosis (DVT), which develops in the lower extremity deep veins, can lead to pulmonary embolism. Today, DVT and pulmonary embolism are known by the common name of VTE. It has recently been found to play an important role of inflammation in the development of VTE. COVID-19, a viral respiratory disease, is likely to play a role in the development of VTE as it is characterized by excessive inflammation, platelet activation, endothelial dysfunction and stasis. It has been reported that aspartate aminotransferase, alanine aminotransferase and C reactive protein (CRP) levels increased significantly in COVID-19 cases with high VTE risk. In addition, D-dimer levels were significantly higher in COVID-19 cases with DVT detected. There have been studies reporting that vitamin D deficiency increases the risk of DVT. Due to measures such as lockdown imposed during the COVID-19 pandemic period, the risk of vitamin D deficiency increases as a result of not taking advantage of sunlight. Therefore, even measures implemented due to this viral zoonotic disease can increase the risk of DVT.