Antithrombin and antifactor Xa direct oral anticoagulants are well established in the prevention and management of venous thrombo- embolism, and since thrombin is the main activator of PAR-1, and coagulation factor Xa can induce production of proinflammatory cytokines via activation of PAR-2 and PAR-1,5 these drugs might be promising in ameliorating disease progression and severity of COVID-19. Bleeding risk will always be a concern, but in this procoagulant state the benefits might outweigh the risk and reversal drugs for the anticoagulant effects of these inhibitors now exist.