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COVID-19 and Venous Thromboembolism Pharmacologic Thromboprophylaxis

Cassandra Benge1, Bishoy Ragheb1

  • 1is a Clinical Pharmacy Specialist, Surgical Intensive Care Unit, and is a Clinical Pharmacy Specialist, Anticoagulation, both at Veterans Affairs Tennessee Valley Healthcare System in Nashville/Murfreesboro.

Federal Practitioner : for the Health Care Professionals of the VA, Dod, and PHS
|December 17, 2020
PubMed

Insights

Coronavirus 2019 (COVID-19) causes coagulopathy, complicating thromboprophylaxis protocols. This guide simplifies expert consensus and highlights differences in COVID-19 thromboprophylaxis recommendations for healthcare providers.

Area of Science:

  • Critical Care Medicine
  • Hematology
  • Infectious Diseases

Background:

  • Coagulopathy is a significant complication of coronavirus 2019 (COVID-19).
  • Developing institutional thromboprophylaxis protocols is challenging due to limited high-quality prospective evidence.
  • Existing guidance relies on expert consensus, with notable variations in recommendations.

Purpose of the Study:

  • To streamline and simplify existing guidance on COVID-19 thromboprophylaxis.
  • To help healthcare providers identify consensus and divergence in recommendations.
  • To provide an example protocol for order-set development.

Main Methods:

  • Review and synthesis of expert consensus guidelines from leading thrombosis and hemostasis societies.
  • Analysis of recommendations from the US National Institutes of Health.
  • Inclusion of a specific institutional protocol as a practical example.

Main Results:

  • Identification of areas of agreement and significant differences in COVID-19 thromboprophylaxis recommendations.
  • A simplified framework to aid in the development of local institutional policies.
  • Presentation of the US Department of Veterans Affairs Tennessee Valley Healthcare System's protocol.

Conclusions:

  • Healthcare facilities need to carefully consider divergent recommendations when developing local COVID-19 thromboprophylaxis guidelines.
  • This document facilitates informed decision-making by clarifying consensus and discrepancies.
  • The provided example protocol serves as a model for guideline-directed order-set implementation.
Abstract

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