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COVID-19 has been shown to infect endothelial cells, which, along with inflammation, can lead to a hypercoagulable state. This session will review the pathophysiology of endotheliopathy and perturbation of coagulation in COVID-19, screening strategies for deep vein thrombosis and pulmonary embolism, evidence about timing and dosing of prophylactic and therapeutic anticoagulation, evidence for hyperviscosity, and the role of cytokine release in altered coagulation. Lessons learned from the COVID-19 pandemic may be applicable to other critically ill patients.