What is the role of anticoagulation in the treatment of COVID-19?

Updated: Jan 12, 2021
  • Author: Setu K Patolia, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Based on observational data, there appears to be a higher risk for venous thromboembolism (VTE) in patients with COVID-19. Based on the American Society of Hematology, reports of lower extremity deep vein thrombosis (DVT) range from 1.1% in no ICU patients to 69% in critically ill patients. Based on these observations, several institutions have developed anticoagulation protocols for patients infected with SARS-CoV-2. Unfortunately, at this time, no randomized controlled trials guide the empiric use of therapeutic anticoagulation in COVID-19 patients. [59]

The consensus from the Society of Critical Care Medicine and the American Society of Hematology does offer some recommendations. VTE prophylaxis is recommended for all COVID-19 patients in the absence of contraindications. Although higher D-dimers are associated with mortality in COVID-19, it is not known if therapeutic anticoagulation mitigates this risk and improves outcomes. Currently, where possible, a definitive diagnosis of VTE should be sought and parenteral therapeutic anticoagulation is not recommended at this time. [60]

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