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Ethnic differences in thromboprophylaxis for COVID-19 patients: should they be considered?

Toshiaki Iba1, Jean Marie Connors2, Alex C Spyropoulos3

  • 1Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan. toshiiba@juntendo.ac.jp.

International Journal of Hematology
|January 20, 2021
PubMed

Insights

COVID-19 patients require thromboprophylaxis with low-molecular-weight heparin (LMWH). Current evidence suggests standard LMWH dosing is appropriate for all hospitalized patients, irrespective of ethnicity, balancing thrombosis risk and bleeding.

Area of Science:

  • Medical Science
  • Pharmacology
  • Epidemiology

Background:

  • Thromboembolic events are a significant cause of morbidity and mortality in COVID-19.
  • Low-molecular-weight heparin (LMWH) is recommended for thromboprophylaxis in hospitalized COVID-19 patients.
  • Potential ethnic variations in thrombogenicity and thromboembolic event incidence exist, with lower rates noted in Asian populations.

Purpose of the Study:

  • To review existing data on ethnic differences in thrombosis and bleeding risk among COVID-19 patients.
  • To evaluate the appropriateness of universal thromboprophylaxis guidelines in diverse ethnic groups.
  • To inform clinical practice regarding anticoagulant use in hospitalized COVID-19 patients of varying ethnicities.

Main Methods:

  • Literature review of studies examining thrombosis and bleeding in COVID-19.
  • Analysis of data concerning ethnic variations in thromboembolic events.
  • Assessment of current guidelines for thromboprophylaxis.

Main Results:

  • Limited data currently exists regarding specific ethnic differences in COVID-19-related thrombosis and bleeding.
  • Existing evidence does not contraindicate the routine use of anticoagulants for thromboprophylaxis.
  • Standard dosing of LMWH appears to be a reasonable approach across different ethnicities.

Conclusions:

  • Routine anticoagulant thromboprophylaxis with standard-dose LMWH is supported for hospitalized COVID-19 patients, regardless of ethnicity.
  • Further research is needed to fully elucidate ethnic variations in thrombosis and bleeding risk.
  • Clinical decisions should consider the balance between preventing thromboembolic events and managing bleeding risk.

Keywords:
COVID-19Deep vein thrombusEthnic differenceThromboembolismThromboprophylaxis

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