D-Dimer and Thrombosis in COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has taken medical community by surprise, but it also saw significant advances in understanding of infection induced coagulopathy. Pulmonary and macrovascular thrombosis is one of the hallmarks of this pandemic and has intrigued vascular surgeons world over. In this review, the lessons learnt from COVID-19 coagulopathy are summarised with some perspectives on role of newer concepts of immune mediated thrombosis and endothelial inflammation. D-dimers have become one of the most discussed inflammatory marker and also one of the commonest blood tests ordered in the COVID-19 pandemic. Its usefulness in management of COVID induced thrombosis has been a matter of debate and this article looks in to evidence based application of D-dimer in clinical practice. Role of Heparins, Direct Oral Anticoagulants (DOACs) and anti-platelets in prophylaxis and management of vascular thrombosis has also been summarised.