Thromboprophylaxis: balancing evidence and experience during the COVID-19 pandemic

Area of Science:

• * Internal Medicine
• * Hematology
• * Critical Care Medicine

Background:

• * The novel coronavirus disease 2019 (COVID-19) presents a significant risk of venous thromboembolism (VTE).
• * COVID-19 is associated with a distinct coagulopathy requiring careful management.
• * Guidance from major societies on managing this coagulopathy has emerged.

Purpose of the Study:

• * To provide an updated focus on thromboprophylaxis in COVID-19 patients.
• * To compare current VTE incidence in intensive care unit (ICU) and non-ICU patients.
• * To highlight discrepancies between International Society on Thrombosis and Haemostasis (ISTH) and American College of Chest Physicians (CHEST) guidelines and discuss ongoing trials.

Main Methods:

• * Review of recent published studies on VTE incidence in COVID-19 patients.
• * Analysis of current guidelines from ISTH and CHEST regarding thromboprophylaxis.
• * Summary of key ongoing randomized controlled trials (RCTs) investigating anticoagulation strategies.

Main Results:

• * Significant VTE incidence reported in both ICU and non-ICU COVID-19 patients.
• * Identified discrepancies in thromboprophylaxis recommendations between ISTH and CHEST guidelines.
• * Several RCTs are underway to evaluate optimal anticoagulation in COVID-19.

Conclusions:

• * COVID-19 coagulopathy necessitates specific attention to VTE risk and management.
• * Further research and clarification of guidelines are crucial for effective thromboprophylaxis.
• * Ongoing trials are expected to refine anticoagulation strategies for COVID-19 patients.