A patient with COVID-19 may develop a hyperacute multi-organ thromboembolic storm.
Patient selection: severe acute COVID-19 infection
Purported mechanism: endotheliitis and hypercoagulability
Clinical and laboratory features:
(1) multi-organ thrombi and emboli with end-organ damage
(2) livedo racemosa
(3) elevated plasma D-dimer
(4) variable thrombocytopenia
Organs affected may include:
(1) heart
(2) lungs
(3) brain
(4) kidneys
The disseminated coagulation may occur despite prophylactic anticoagulation.
It is important to exclude other causes of DIC and hypercoagulability, including heparin-induced thrombocytopenia.
