COVID-19, caused by severe acute respiratory syndrome coronavirus 2
(SARS CoV 2), has put the global health system into crisis. The complications of the
disease include respiratory failure, proinflammatory, and thromboembolic
presentations. It is being increasingly recognised that host response with the
inflammatory and thrombotic state is responsible for the severity of the disease.
Numerous studies are now showing that increased inflammatory markers like
interleukin (IL) 6 portray a poor prognosis. Thrombo-embolic complications like
pulmonary embolism also produce clinical deterioration in COVID 19. The
management of the disease presently includes antiviral, anti-inflammatory, and
anticoagulant therapy along with supportive care for respiratory complications. The
therapeutic challenge is augmented due to the varied clinical presentations, rapid
worsening, and lack of a clear understanding of the pathophysiology. The initial data
regarding the treatment options are of low quality and are mostly from cohort analysis.
Many randomised controlled trials (RCT) are ongoing, and the results from the RCTs
will help in developing better treatment options. We discuss in this review the
pathophysiology and mechanism behind the increased inflammation and thrombosis.
We will also discuss the available therapeutics options and the recommendations of
various guidelines regarding the management of the proinflammatory and thrombotic