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. 2021 May;51(4):947-952.
doi: 10.1007/s11239-020-02257-7.

Diagnosis, management, and outcomes of venous thromboembolism in COVID-19 positive patients: a role for direct anticoagulants?

Charalampos Kartsios  1 , Anand Lokare  2 , Husam Osman  3 , Damian Perrin  4 , Shahzad Razaq  5 , Namrah Ayub  5 , Bobby Daddar  5 , Susan Fair  4
Affiliations

Diagnosis, management, and outcomes of venous thromboembolism in COVID-19 positive patients: a role for direct anticoagulants?

Charalampos Kartsios et al. J Thromb Thrombolysis. 2021 May.

Abstract

Coronavirus disease 2019 (COVID-19) has been associated with an increased risk of thromboembolic complications due to systemic coagulation activation. Little is known about the role of direct anticoagulants (DOACs) in COVID-19 related thrombosis. In this audit we sought to distinguish COVID-19 hospitalised patients with a diagnosis of venous thromboembolism (VTE) and record their outcomes over a period of 3 months (01/02/2020-30/04/2020). A total of 1583 patients were diagnosed with laboratory proven COVID-19 disease. Amongst them, 38 patients (0.82%) suffered VTE (median age 68 years, male/female: 20/18). VTE was the presenting symptom on admission in 71%. Pulmonary embolism was diagnosed in 92% of patients; 5 patients required intensive care and 3 underwent thrombolysis. 27 patients received initial treatment with unfractionated heparin/low molecular weight heparin (LMWH) while 10 were treated with direct anticoagulants (DOACs). After a median follow up of 25 days, 29 (76%) patients were alive while 5 were still hospitalised. Most patients (83%) were discharged on DOACs, no VTE recurrence or bleeding was recorded post-discharge. Our results suggest that direct anticoagulants could be a safe and effective treatment option in selected COVID-19 positive patients who have suffered venous thromboembolism.

Keywords: COVID-19; D-dimers; Direct anticoagulants; Heparin; Venous thromboembolism.

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Conflict of interest statement

C. Kartsios reports research support and lecturing or consultancy fees, outside the present work, from Bayer, Daiichi Sankyo, Bristol Meyers Squibb, and Pfizer. The other authors have no disclosures.

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