Hypercoagulable state
The third component is the hypercoagulable state, caused by the virus-induced cytokine storm. The hyper inflammation phase is characterized by the release of inflammatory markers and a cytokine storm.47–52 In retrospective studies, critically ill COVID-19 patients had increased proinflammatory cytokines, including IL-2 and TNF-α4, which can upregulate the coagulation system.2 In a recent Dutch study, there was a 31% incidence of thrombotic complications in patients with COVID-19 admitted to the ICU, mainly consisting of acute pulmonary embolism, deep vein thrombosis, ischemic stroke, myocardial infarction, and systemic arterial embolism.53