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ISTH DIC subcommittee communication on anticoagulation in COVID-19
Jecko Thachil1, Nicole P Juffermans2,3, Marco Ranucci4
1Department of Haematology, Manchester University Hospitals, Manchester, UK.
Insights
Anticoagulation is crucial for managing hypercoagulability in SARS-CoV-2 infection (COVID-19). This review offers a practical approach to heparin use, especially for high-risk patients, while awaiting further clinical trial data.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Hematology
Background:
- SARS-CoV-2 infection is linked to hypercoagulability.
- Anticoagulation is a key component of COVID-19 treatment.
- Uncertainties remain regarding optimal anticoagulation strategies.
Purpose of the Study:
- To provide a pragmatic approach to anticoagulation in COVID-19 patients.
- To address specific considerations for patient populations like those with obesity or renal impairment.
- To highlight the need for further research and clinical trials.
Main Methods:
- Review of current evidence on anticoagulation in COVID-19.
- Discussion of heparin types and dosages.
- Consideration of special patient populations.
Main Results:
- Hypercoagulability is a significant complication of COVID-19.
- Standard anticoagulation protocols may need adjustment.
- Specific patient groups require tailored approaches.
Conclusions:
- A pragmatic approach to anticoagulation in COVID-19 is proposed.
- Further clinical trials are essential to refine treatment guidelines.
- Evidence-based management of COVID-19-associated coagulopathy is critical.
Abstract:
Hypercoagulability is an increasingly recognized complication of SARS-CoV-2 infection. As such, anticoagulation has become part and parcel of comprehensive COVID-19 management. However, several uncertainties exist in this area, including the appropriate type and dose of heparin. In addition, special patient populations, including those with high body mass index and renal impairment, require special consideration. Although the current evidence is still insufficient, we provide a pragmatic approach to anticoagulation in COVID-19, but stress the need for further trials in this area.
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