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Anticoagulation in hospitalized patients with COVID-19

Lisa Baumann Kreuziger1, Michelle Sholzberg2,3, Mary Cushman2,4

  • 1Department of Medicine Medical College of Wisconsin, Blood Research Institute, Versiti, Milwaukee, WI.

Blood
|June 2, 2022
PubMed

Insights

Patients with COVID-19 face increased thrombosis risk. Therapeutic heparin shows benefit in non-critically ill patients, while prophylactic heparin is recommended for the critically ill, improving care.

Area of Science:

  • Internal Medicine
  • Cardiology
  • Hematology

Background:

  • COVID-19 is associated with a thromboinflammatory syndrome.
  • Patients with COVID-19 exhibit a higher incidence of venous thromboembolism compared to other hospitalized individuals.
  • Thrombosis in COVID-19 can manifest as both microvascular and macrovascular events.

Purpose of the Study:

  • To review the current understanding of thromboembolic complications in COVID-19.
  • To summarize the evidence for heparin use in hospitalized COVID-19 patients.
  • To outline current guideline recommendations for anticoagulation in COVID-19.

Main Methods:

  • Review of three randomized control trials (RCTs) on therapeutic heparin in non-critically ill COVID-19 patients.
  • Analysis of guideline recommendations for heparin prophylaxis in critically ill COVID-19 patients.
  • Synthesis of current research on COVID-19-associated thrombosis.

Main Results:

  • Therapeutic heparin demonstrated benefit in hospitalized, non-critically ill COVID-19 patients.
  • Conditional guideline recommendations support therapeutic heparin for this group.
  • Prophylactic-dose heparin is recommended for critically ill COVID-19 patients.

Conclusions:

  • Heparin plays a crucial role in managing thrombosis in COVID-19.
  • Dosing strategies differ based on illness severity.
  • Ongoing research and collaboration have advanced patient care during the pandemic.

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