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

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

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.

MeSH terms

  • Anticoagulants / therapeutic use
  • COVID-19 Vaccines
  • COVID-19*
  • Humans
  • Pandemics
  • Venous Thromboembolism* / drug therapy
  • Venous Thromboembolism* / etiology
  • Venous Thromboembolism* / prevention & control

Substances

  • Anticoagulants
  • COVID-19 Vaccines