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Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection results in coagulation activation although it is usually not associated with consumption coagulopathy. D‐dimers are also commonly elevated despite systemic hypofibrinolysis. To understand these unusual features of coronavirus disease 2019 (COVID‐19) coagulopathy, 64 adult patients with SARS‐CoV‐2 infection (36 moderate and 28 severe) and 16 controls were studied. We evaluated the repertoire of plasma protease inhibitors (Serpins, Kunitz, Kazal, Cystatin‐like) targeting the fibrinolytic system: Plasminogen Activator Inhibitor‐1 (PAI‐1), Tissue Plasminogen Activator/Plasminogen Activator Inhibitor‐1 complex (t‐PA/PAI‐1), α‐2‐Antiplasmin, Plasmin‐α2‐Antiplasmin Complex, Thrombin‐activatable Fibrinolysis Inhibitor (TAFI)/TAFIa, Protease Nexin‐1 (PN‐1), and Neuroserpin (the main t‐PA inhibitor of the central nervous system …