Coronavirus disease 2019 (COVID-19) predisposes patients to thrombotic and thromboembolic events, owing to excessive
inflammation, endothelial cell activation and injury, platelet activation and
hypercoagulability. Patients with
COVID-19 have a prothrombotic or thrombophilic state, with elevations in the levels of several
biomarkers of
thrombosis, which are associated with disease severity and prognosis. Although some
biomarkers of COVID-19-associated coagulopathy, including high levels of
fibrinogen and
D-dimer, were recognized early during the pandemic, many new
biomarkers of thrombotic risk in
COVID-19 have emerged. In this Consensus Statement, we delineate the thrombotic signature of
COVID-19 and present the latest
biomarkers and platforms to assess the risk of
thrombosis in these patients, including markers of platelet activation, platelet aggregation, endothelial cell activation or injury, coagulation and fibrinolysis as well as
biomarkers of the newly recognized post-
vaccine thrombosis with
thrombocytopenia syndrome. We then make consensus recommendations for the clinical use of these
biomarkers to inform prognosis, assess disease acuity, and predict thrombotic risk and in-hospital mortality. A thorough understanding of these
biomarkers might aid risk stratification and prognostication, guide interventions and provide a platform for future research.