Thrombotic events are common complications in
COVID-19 patients that include both
thrombus formation in large vessels and the microvasculature of the lung and other organs. COVID-19-associated coagulopathy (CAC) and
disseminated intravascular coagulation (
DIC) have similarities and differences, and whether CAC is a form of
DIC is the subject of debate. Reported mechanisms of CAC include activated coagulation, endotheliopathy, up-regulated innate and adaptive immunity, and activated
complement system. Although the clinical features and laboratory findings of CAC and
DIC seem different, there are fundamental similarities that should be considered. Basically, the pathological findings of
COVID-19 fall within the scope of the definition of
DIC, i.e., systemic activation of coagulation caused by or resulting from the microvascular damage. Therefore, we suggest that although CAC differs from usual
infection-associated
DIC, its various features indicate that it can be considered a thrombotic phenotype
DIC. This review summarizes the current knowledge about CAC including differences and similarities with
sepsis-associated
DIC.