Since its discovery in December 2019, SARS-CoV-2 has resulted in more than 23 million infected cases worldwide with more than 800.000 deaths with a mortality rate of about 3.47%. The respiratory system seems to be the primary target system for SARS-CoV-2, and infected patients may develop acute lung injury and Adult respiratory distress syndrome (ARDS). However, severe COVID-19 is a multi-systemic disease associated with a hypercoagulable state affecting the microvascular, venous, and arterial system. Severe COVID-19 infection is characterized by coagulation derangement and hyperinflammatory state that may lead to overt disseminated intravascular coagulopathy (DIC), a status termed Covid-19 Induced Coagulopathy (CIC). This can result in multi-organ involvement with microvascular, arterial, and venous thrombosis. In this article, we review the incidence of thrombosis in severe covid-19 patients, the mechanisms of Covid-19 induced thrombosis, and recommendations regarding anticoagulation in hospitalized Covid-19 patients.