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
. 2022 Aug;54(2):197-210.
doi: 10.1007/s11239-022-02643-3. Epub 2022 May 17.

Thromboembolic prevention and anticoagulant therapy during the COVID-19 pandemic: updated clinical guidance from the anticoagulation forum

Geoffrey D Barnes  1 , Allison Burnett  2 , Arthur Allen  3 , Jack Ansell  4 , Marilyn Blumenstein  5 , Nathan P Clark  6 , Mark Crowther  7 , William E Dager  8 , Steven B Deitelzweig  9 , Stacy Ellsworth  10 , David Garcia  11 , Scott Kaatz  10 , Leslie Raffini  12 , Anita Rajasekhar  13 , Andrea Van Beek  14 , Tracy Minichiello  15
Affiliations

Thromboembolic prevention and anticoagulant therapy during the COVID-19 pandemic: updated clinical guidance from the anticoagulation forum

Geoffrey D Barnes et al. J Thromb Thrombolysis. 2022 Aug.

Abstract

Thromboembolism is a common and deadly consequence of COVID-19 infection for hospitalized patients. Based on clinical evidence pre-dating the COVID-19 pandemic and early observational reports, expert consensus and guidance documents have strongly encouraged the use of prophylactic anticoagulation for patients hospitalized for COVID-19 infection. More recently, multiple clinical trials and larger observational studies have provided evidence for tailoring the approach to thromboprophylaxis for patients with COVID-19. This document provides updated guidance for the use of anticoagulant therapies in patients with COVID-19 from the Anticoagulation Forum, the leading North American organization of anticoagulation providers. We discuss ambulatory, in-hospital, and post-hospital thromboprophylaxis strategies as well as provide guidance for patients with thrombotic conditions who are considering COVID-19 vaccination.

Keywords: Anticoagulation; Aspirin; COVID-19; Direct oral anticoagulant; Direct-acting oral anticoagulant; Enoxaparin; Low-molecular-weight heparin; Pregnancy; Prophylaxis; Stewardship; Thrombophilia; Thrombosis and thrombocytopenia syndrome; Venous thromboembolism; rivaroxaban.

PubMed Disclaimer

Conflict of interest statement

Marilyn Blumenstein, Allison Burnett, Nathan Clark, William Dager, Stacy Ellsworth, David Garcia, Tracy Minichiello, and Andrea Van Beek have no disclosures to declare. Arthur Allen has received consulting fees from Boehringer-Ingelheim, Bristol-Myers Squibb/Pfizer, Janssen Pharmaceuticals, Alexion Pharmaceuticals, and Roche Diagnostics. Jack Ansell Consultant to Covis Pharmaceuticals, Abbott Laboratories as well as serving on advisory board and has equity interest in Perosphere Technology, Inc. Geoffrey D Barnes has received grant funding from the Agency for Healthcare Quality and Research, National Heart, Lung, and Blood Institute, and Blue Cross Blue Shield of Michigan and has received consulting fees from Bristol-Myers Squibb/Pfizer, Janssen Pharmaceuticals, and Acelis Connected Health. Mark Crowther has sat on advisory boards and/or received personal funding from Precision Biologicals, Hemostasis Reference Laboratories, and Syneos Health. Dr Crowther has prepared educational materials and/or presented on behalf Bayer, Pfizer, and CSL Behring. Steven B Deitelzweig has received consulting fees from Bristol-Myers Squibb, Novosys, Pfizer, Scott Kaatz has received research funding from Janssen Pharmaceuticals, BMS, Osmosis Research and NIH and consulting fees from Janssen Pharmaceuticals, Bristol-Myers Squibb/Pfizer, Portola Pharmaceuticals/Alexion, Gilead and CSL Behring. Leslie Raffini has received consulting fees from Bayer, CSL Behring, and Genentech. Anita Rajasekhar has received consulting fees from Alexion, Baxter, Bayer, Kedrion Biopharma, Octapharma Plasma and her institution has received research support on her behalf from Biomarin, Bio Products laboratory, LTD, Dimensions Therapeutics, Genentech, Janssen Pharmaceuticals, Momenta Pharmaceutical, Roche, Sanofi, and Takeda.

References

    1. Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18:1023–1026. doi: 10.1111/jth.14810. - DOI - PMC - PubMed
    1. Spyropoulos AC, Levy JH, Ageno W, et al. Scientific and Standardization Committee communication: Clinical guidance on the diagnosis, prevention, and treatment of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020;18:1859–1865. doi: 10.1111/jth.14929. - DOI - PMC - PubMed
    1. Moores LK, Tritschler T, Brosnahan S, et al. Prevention, Diagnosis, and Treatment of VTE in Patients With Coronavirus Disease 2019. Chest. 2020;158:1143–1163. doi: 10.1016/j.chest.2020.05.559. - DOI - PMC - PubMed
    1. Barnes GD, Burnett A, Allen A, et al. Thromboembolism and anticoagulant therapy during the COVID-19 pandemic: interim clinical guidance from the anticoagulation forum. J Thromb Thrombolysis. 2020;50:72–81. doi: 10.1007/s11239-020-02138-z. - DOI - PMC - PubMed
    1. Young E. The anti-inflammatory effects of heparin and related compounds. Thromb Res. 2008;122:743–752. doi: 10.1016/j.thromres.2006.10.026. - DOI - PubMed