Pathophysiology and Laboratory Markers in COVID-19-Associated Thrombosis

The objective was to analyze the pathophysiology and laboratory markers associated with the development of thrombosis in patients with COVID-19. A systematic review was conducted following PRISMA 2020 guidelines, involving a literature search in PubMed, SciELO, and Google Scholar covering publications from 2021 to 2025; this process comprising identification, screening, eligibility, and inclusion phases culminated in the selection of 25 studies. The results indicate that thrombosis in COVID-19 arises from the interplay between endothelial dysfunction, cytokine storm, and immunothrombosis, constituting a pathophysiological entity distinct from classic disseminated intravascular coagulation. D-dimer emerged as the biomarker with the greatest prognostic significance, although its heterogeneous thresholds necessitate interpretation within an integrated panel alongside fibrinogen, aPTT, platelet count, and inflammatory markers. Deep vein thrombosis and pulmonary thromboembolism were the most frequent complications, revealing a clear diagnostic gap in Ecuadorian healthcare facilities due to the absence of consensus-based protocols. It is concluded that integrating available pathophysiological knowledge with the systematic use of accessible markers offers a concrete approach to improving thrombotic risk stratification and reducing hospital mortality associated with this complication.