This is precisely what happens in COVID-19 - as well as metatastic cancer: Mechanisms for cancer-induced hypercoagulation and consequential D-dimer formation. Cancer cells promote a hypercoagulable status and activate the hemostatic system. The cancer cells induce the hypercoagulable status by cell-to-cell interaction with endothelial cells, direct release of TF and CP, production of cytokines such as IL-1and TNF and activation of monocyte, macrophage, and platelet. CP ¼ cancer procoagulants, IL-1 ¼ interleukin-1, PAI ¼ plasminogen activator inhibitor, TF ¼ tissue factor, TNF ¼ tumor necrosis factor.