COVID-19 Associated Coagulopathy In The Setting of Underlying Malignancy

Coronavirus Disease 2019 (COVID-19) associated coagulopathy is growingly recognized as the predictor for morbidity and mortality in COVID-19 patients. Deep vein thrombosis (DVT) and pulmonary embolism (PE) have been increasingly observed in COVID-19 patients. Nonetheless, there are no consensus guidelines on the use of therapeutic coagulation in this group of patients. We herein presenting a unique case of a COVID-19 patient with metastatic ovarian cancer who presented with DVT/PE despite being on therapeutic anticoagulation, highlighting the unpredictability of COVID-19 associated coagulopathy. This is to raise the awareness that thrombophilic state in metastatic malignancies is potentially augmented by COVID-19. We also discussed the complexity of making anticoagulation treatment decision in COVID-19 patients in the absence of evidence-based guidelines.