Related Experiment Video
Updated: Jul 17, 2025
06:12
Author Spotlight: A Novel Method for Comprehensive Cell Component Analysis of Cerebral Blood Clots
Published on: July 21, 2023
642
COVID-19 thromboprophylaxis. New evidence.
R Ferrandis1, P Sierra2, A Gomez-Luque3
1Servicio de Anestesiología-Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, SEDAR, Valencia, Spain; SEDAR Haemostasis, Transfusion Medicine and Fluid Therapy Division, Valencia, Spain.
Revista Espanola De Anestesiologia Y Reanimacion
|September 7, 2023
Summary
Standard doses of low molecular weight heparin (LMWH) are recommended for critically ill COVID-19 patients. Therapeutic LMWH doses are advised for non-critical inpatients with low bleeding risk, updating treatment guidelines.
Area of Science:
- Internal Medicine
- Hematology
- Infectious Diseases
Background:
- Recent studies challenge the effectiveness of intermediate or therapeutic doses of low molecular weight heparin (LMWH) for COVID-19 patients, particularly severe cases.
- Existing treatment guidelines require updates based on current evidence regarding LMWH efficacy in COVID-19 management.
Purpose of the Study:
- To conduct a non-systematic review to update recommendations on the use of LMWH in COVID-19 patients.
- To analyze the efficacy of LMWH and alternative anticoagulants/antiplatelets across different COVID-19 patient strata.
Main Methods:
- A non-systematic review of major medical databases was performed.
- Included 14 randomized clinical trials, 14 meta-analyses, and recommendations from 12 scientific societies.
- Data were stratified by patient type: outpatient, hospitalized, critical care, and post-discharge.
Main Results:
- Standard LMWH doses are recommended for thromboprophylaxis in critically hospitalized COVID-19 patients.
- Therapeutic LMWH doses are suggested for non-critically hospitalized patients if bleeding risk is low.
- Prophylactic LMWH doses may be used in outpatients/discharged patients with thrombotic risk factors and low bleeding risk.
Conclusions:
- The study provides updated recommendations for LMWH use in diverse COVID-19 patient populations.
- Combination therapy with antiplatelet agents and LMWH is not generally recommended unless specifically indicated.
- Evidence supports tailored LMWH dosing strategies based on patient severity and bleeding risk.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
01:29Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
747
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
747
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
14
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
14
01:29Pulmonary Embolism I: Introduction
7
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
7