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COVID-19 coagulopathy and thrombosis: Analysis of hospital protocols in response to the rapidly evolving pandemic

Anna L Parks1, Andrew D Auerbach2, Jeffrey L Schnipper3

  • 1Division of Hematology and Oncology, University of California, San Francisco, CA, USA.

Thrombosis Research
|September 25, 2020
PubMed

Insights

COVID-19 associated coagulopathy prompted US hospitals to create management protocols. While most agreed on heparin for venous thromboembolism (VTE) prophylaxis, significant differences existed in testing, dosing, and extended prophylaxis strategies.

Area of Science:

  • Internal Medicine
  • Hematology
  • Infectious Diseases

Background:

  • The Coronavirus disease 2019 (COVID-19) pandemic presented unique challenges, including the emergence of coagulopathy and thrombotic complications.
  • Hospitals rapidly developed institutional protocols to manage COVID-19-related thrombosis and coagulopathy.

Discussion:

  • Analysis of 21 protocols from US academic medical centers (January-May 2020) revealed variations in management strategies.
  • Greatest consensus was observed for heparin-based pharmacologic venous thromboembolism (VTE) prophylaxis in non-contraindicated COVID-19 patients.

Key Insights:

  • Significant protocol discrepancies were noted concerning D-dimer testing, VTE prophylaxis dosing, and post-discharge prophylaxis indications.
  • Variations also existed in VTE evaluation methods and the use of empiric therapeutic anticoagulation.

Outlook:

  • The observed heterogeneity in COVID-19 coagulopathy management protocols highlights the need for standardized, evidence-based international guidelines.
  • Further research is crucial to refine optimal anticoagulation strategies for COVID-19 patients.

Keywords:
AnticoagulationCoagulopathyCoronavirusDeep vein thrombosis (DVT)Pulmonary embolism (PE)ThrombosisVenous thromboembolism (VTE)

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