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Review
. 2020 Nov;50(4):799-808.
doi: 10.1007/s11239-020-02231-3.

Thromboprophylaxis: balancing evidence and experience during the COVID-19 pandemic

Benjamin Marchandot  1 , Antonin Trimaille  1 , Anais Curtiaud  1 , Kensuke Matsushita  1   2 , Laurence Jesel  1   2 , Olivier Morel  3   4
Affiliations
Review

Thromboprophylaxis: balancing evidence and experience during the COVID-19 pandemic

Benjamin Marchandot et al. J Thromb Thrombolysis. 2020 Nov.

Abstract

A common and potent consideration has recently entered the landscape of the novel coronavirus disease of 2019 (COVID-19): venous thromboembolism (VTE). COVID-19 has been associated to a distinctive related coagulopathy that shows unique characteristics. The research community has risen to the challenges posed by this « evolving COVID-19 coagulopathy » and has made unprecedented efforts to promptly address its distinct characteristics. In such difficult time, both national and international societies of thrombosis and hemostasis released prompt and timely responses to guide recognition and management of COVID-19-related coagulopathy. However, latest guidelines released by the international Society on Thrombosis and Haemostasis (ISTH) on May 27, 2020, followed the American College of Chest Physicians (CHEST) on June 2, 2020 showed some discrepancies regarding thromboprophylaxis use. In this forum article, we would like to offer an updated focus on thromboprophylaxis with current incidence of VTE in ICU and non-ICU patients according to recent published studies; highlight the main differences regarding ISTH and CHEST guidelines; summarize and describe which are the key ongoing RCTs testing different anticoagulation strategies in patients with COVID-19; and finally set a proposal for COVID-19 coagulopathy specific risk factors and dedicated trials.

Keywords: COVID-19; Coronavirus; Guidelines; Thromboprophylaxis; Venous thromboembolism.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Reported incidence of venous thrombotic events in COVID-19 patients hospitalized in ICU (a) and non-ICU (b). Covid-19 coronavirus disease 201, ICU intensive care unit
Fig. 2
Fig. 2
Intrinsic and extrinsic risk factors for venous thromboembolism in COVID-19. Covid-19 coronavirus disease 2019, CT computed tomography, DVT deep vein thrombosis, ICU intensive care unit, PE pulmonary embolism
Fig. 3
Fig. 3
A proposal for COVID-19 coagulopathy specific risk factors and dedicated trials. Covid-19 coronavirus disease 2019, CT computed tomography, ICU intensive care unit, RCTs randomized controlled trials, VTE venous thromboembolic events
See this image and copyright information in PMC

References

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