The SARS-Cov-2 (COVID-19) pandemic has already claimed over 200,000 lives. Quite early on in this pandemic, it was recognised that the virus triggers the immune system leading to a cytokine storm in some severely ill patients . This hyper-responsiveness has been suggested to be the predominant aetiology for clinical deterioration and mortality in patients with this infection . More recently, there have been several reports of increased thrombotic events in these patients [3-6]. From a laboratory perspective, this hypercoagulability is reflected in the marked elevation of the fibrinolytic marker, D-dimer, in almost all hospitalised COVID-19 patients . We must, therefore, ask ourselves what is the link between the extremes of the immune system, presenting as cytokine storm, and the extremes of coagulation, presenting as arterial and venous thromboembolism?
Keywords: COVID-19; coagulation; thrombosis.
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