Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Aug;133(sup1):27-35.
doi: 10.1080/00325481.2021.1891788. Epub 2021 Mar 4.

Prophylaxis and treatment of COVID-19 related venous thromboembolism

F H J Kaptein  1 , M A M Stals  1 , M V Huisman  1 , F A Klok  1
Affiliations
Review

Prophylaxis and treatment of COVID-19 related venous thromboembolism

F H J Kaptein et al. Postgrad Med. 2021 Aug.

Abstract

COVID-19 pneumonia has been associated with high rates of thrombo-embolic complications, mostly venous thromboembolism (VTE), which is thought to be a combination of conventional VTE and in situ immunothrombosis in the pulmonary vascular tree. The incidence of thrombotic complications is dependent on setting (intensive care unit (ICU) versus general ward) and the threshold for performing diagnostic tests (screening versus diagnostic algorithms triggered by symptoms). Since these thrombotic complications are associated with in-hospital mortality, all current guidelines and consensus papers propose pharmacological thromboprophylaxis in all hospitalized patients with COVID-19. Several trials are ongoing to study the optimal intensity of anticoagulation for this purpose. As for the management of thrombotic complications, treatment regimens from non-COVID-19 guidelines can be adapted, with choice of anticoagulant drug class dependent on the situation. Parenteral anticoagulation is preferred for patients on ICUs or with impending clinical deterioration, while oral treatment can be started in stable patients. This review describes current knowledge on incidence and pathophysiology of COVID-19 associated VTE and provides an overview of guideline recommendations on thromboprophylaxis and treatment of established VTE in COVID-19 patients.

Keywords: COVID-19; anticoagulants; blood coagulation disorders; incidence; physiopathology; prophylaxis; treatment; venous thromboembolism.

PubMed Disclaimer

References

    1. WorldHealthOrganization . Coronavirus disease (COVID-19) pandemic. Numbers at a glance. [cited 2020 Nov 26]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
    1. Tang N, Li D, Wang X, et al. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–847. - PMC - PubMed
    1. Levi M, Thachil J, Iba T, et al. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020. June 01;7(6):e438–e440. - PMC - PubMed
    1. Cannegieter SC, Klok FA.. COVID-19 associated coagulopathy and thromboembolic disease: commentary on an interim expert guidance. Res Pract Thromb Haemost. 2020. May;4(4):439–445. - PMC - PubMed
    1. Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020. July;191:9–14. - PMC - PubMed