COVID-19 is known to induce clotting cascade abnormalities, posing challenges in managing warfarin for patients with thromboembolic conditions like atrial fibrillation and pulmonary embolism [1]. Some studies suggest a hypercoagulation state in COVID-19, potentially resulting in a reduced International Normalized Ratio (INR) for patients on warfarin [2]. However, the literature does not conclusively demonstrate a clear association between COVID-19 and fluctuations in the International Normalized Ratio (INR), particularly an increase in INR.
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Powell et al. (2024) studied this question.
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