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Venous thrombotic events in severe and critically COVID-19 patients despite high dose prophylactic

Chantal Visser1, Reinier A Sprenger1, Hans J van den Bout2

  • 1Department of Internal Medicine, Maasstad Hospital, Locatiecode 1L3024, Postbus 9100, 3007 AC, Rotterdam, the Netherlands.

Thrombosis Update
|April 15, 2024
PubMed

Hypercoagulation is one of the most distinct prognostic factors of patients with COVID-19 and has been associated with arterial thrombosis and other venous thrombotic events (VTE). Bleeding complications are far less encountered. The International Society on Thrombosis and Haemostasis (ISTH) guidance advises giving prophylactic low-molecular-weight heparin (LMWH) to prevent these events, although there is evidence that the incidence remains high despite using prophylactic LMWH. We describe three cases of COVID-19 pneumonia that were admitted to our intensive care unit (ICU) and developed acute pulmonary embolisms (APE) despite high dosage prophylactic LMWH. These cases raise concerns about using prophylactic LMWH instead of therapeutic anticoagulation in severe and critically COVID-19 patients.

Keywords:
AnticoagulantsBlood CoagulationCOVID-19HeparinLow-molecular-weightPulmonary embolism

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