Thromboembolism and Anticoagulant Therapy During the COVID-19 Pandemic: Interim Clinical Guidance from the Anticoagulation Forum
ISTH Academy. 05/21/20; 9440
Label: External COVID 19 Resources
Description
Abstract
Coronavirus disease 2019 (COVID-19) is a viral infection that can, in severe cases, result in cytokine storm, systemic inflammatory response and coagulopathy that is prognostic of poor outcomes. While some, but not all, laboratory findings appear similar to sepsis-associated disseminated intravascular coagulopathy (DIC), COVID-19- induced coagulopathy (CIC) appears to be more prothrombotic than hemorrhagic. It has been postulated that CIC may be an uncontrolled immunothrombotic response to COVID-19, and there is growing evidence of venous and arterial thromboembolic events in these critically ill patients. Clinicians around the globe are challenged with rapidly identifying reasonable diagnostic, monitoring and anticoagulant strategies to safely and effectively manage these patients. Thoughtful use of proven, evidence-based approaches must be carefully balanced with integration of rapidly emerging evidence and growing experience. The goal of this document is to provide guidance from the Anticoagulation Forum, a North American organization of anticoagulation providers, regarding use of anticoagulant therapies in patients with COVID-19. We discuss in-hospital and post-discharge venous thromboembolism (VTE) prevention, treatment of suspected but unconfirmed VTE, laboratory monitoring of COVID-19, associated anticoagulant therapies, and essential elements for optimized transitions of care specific to patients with COVID-19.
Disclaimer
Answers to questions about COVID-19 published herein are provided by the International Society on Thrombosis and Haemostasis, Inc. (“ISTH”) for voluntary, informational use by providers in the rapidly evolving novel coronavirus crisis. This information does not constitute medical or legal advice, is not intended for use in the diagnosis or treatment of individual conditions, does not endorse products or therapies, recommend or mandate any particular course of medical care, and is not a statement of the standard of care. New evidence may emerge between the time information is developed and when it is published or read. The information is not comprehensive or continually updated. This information is not intended to substitute for the independent professional judgment of the treating provider in the context of treating the individual patient. ISTH provides this information on an “as is” basis, and makes no warranty, express or implied, regarding the information, including but not limited to its completeness or accuracy. ISTH specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. ISTH assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Use of the information is subject to the complete ISTH website Terms of Use.
The appearance of external hyperlinks does not constitute endorsement by ISTH of the linked websites, or the information, products or services contained therein. ISTH does not exercise any editorial control over the information you may find at these locations nor does ISTH make any representation of their accuracy or completeness. Please contact those websites with any questions.
Coronavirus disease 2019 (COVID-19) is a viral infection that can, in severe cases, result in cytokine storm, systemic inflammatory response and coagulopathy that is prognostic of poor outcomes. While some, but not all, laboratory findings appear similar to sepsis-associated disseminated intravascular coagulopathy (DIC), COVID-19- induced coagulopathy (CIC) appears to be more prothrombotic than hemorrhagic. It has been postulated that CIC may be an uncontrolled immunothrombotic response to COVID-19, and there is growing evidence of venous and arterial thromboembolic events in these critically ill patients. Clinicians around the globe are challenged with rapidly identifying reasonable diagnostic, monitoring and anticoagulant strategies to safely and effectively manage these patients. Thoughtful use of proven, evidence-based approaches must be carefully balanced with integration of rapidly emerging evidence and growing experience. The goal of this document is to provide guidance from the Anticoagulation Forum, a North American organization of anticoagulation providers, regarding use of anticoagulant therapies in patients with COVID-19. We discuss in-hospital and post-discharge venous thromboembolism (VTE) prevention, treatment of suspected but unconfirmed VTE, laboratory monitoring of COVID-19, associated anticoagulant therapies, and essential elements for optimized transitions of care specific to patients with COVID-19.
Disclaimer
Answers to questions about COVID-19 published herein are provided by the International Society on Thrombosis and Haemostasis, Inc. (“ISTH”) for voluntary, informational use by providers in the rapidly evolving novel coronavirus crisis. This information does not constitute medical or legal advice, is not intended for use in the diagnosis or treatment of individual conditions, does not endorse products or therapies, recommend or mandate any particular course of medical care, and is not a statement of the standard of care. New evidence may emerge between the time information is developed and when it is published or read. The information is not comprehensive or continually updated. This information is not intended to substitute for the independent professional judgment of the treating provider in the context of treating the individual patient. ISTH provides this information on an “as is” basis, and makes no warranty, express or implied, regarding the information, including but not limited to its completeness or accuracy. ISTH specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. ISTH assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Use of the information is subject to the complete ISTH website Terms of Use.
The appearance of external hyperlinks does not constitute endorsement by ISTH of the linked websites, or the information, products or services contained therein. ISTH does not exercise any editorial control over the information you may find at these locations nor does ISTH make any representation of their accuracy or completeness. Please contact those websites with any questions.
Abstract
Coronavirus disease 2019 (COVID-19) is a viral infection that can, in severe cases, result in cytokine storm, systemic inflammatory response and coagulopathy that is prognostic of poor outcomes. While some, but not all, laboratory findings appear similar to sepsis-associated disseminated intravascular coagulopathy (DIC), COVID-19- induced coagulopathy (CIC) appears to be more prothrombotic than hemorrhagic. It has been postulated that CIC may be an uncontrolled immunothrombotic response to COVID-19, and there is growing evidence of venous and arterial thromboembolic events in these critically ill patients. Clinicians around the globe are challenged with rapidly identifying reasonable diagnostic, monitoring and anticoagulant strategies to safely and effectively manage these patients. Thoughtful use of proven, evidence-based approaches must be carefully balanced with integration of rapidly emerging evidence and growing experience. The goal of this document is to provide guidance from the Anticoagulation Forum, a North American organization of anticoagulation providers, regarding use of anticoagulant therapies in patients with COVID-19. We discuss in-hospital and post-discharge venous thromboembolism (VTE) prevention, treatment of suspected but unconfirmed VTE, laboratory monitoring of COVID-19, associated anticoagulant therapies, and essential elements for optimized transitions of care specific to patients with COVID-19.
Disclaimer
Answers to questions about COVID-19 published herein are provided by the International Society on Thrombosis and Haemostasis, Inc. (“ISTH”) for voluntary, informational use by providers in the rapidly evolving novel coronavirus crisis. This information does not constitute medical or legal advice, is not intended for use in the diagnosis or treatment of individual conditions, does not endorse products or therapies, recommend or mandate any particular course of medical care, and is not a statement of the standard of care. New evidence may emerge between the time information is developed and when it is published or read. The information is not comprehensive or continually updated. This information is not intended to substitute for the independent professional judgment of the treating provider in the context of treating the individual patient. ISTH provides this information on an “as is” basis, and makes no warranty, express or implied, regarding the information, including but not limited to its completeness or accuracy. ISTH specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. ISTH assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Use of the information is subject to the complete ISTH website Terms of Use.
The appearance of external hyperlinks does not constitute endorsement by ISTH of the linked websites, or the information, products or services contained therein. ISTH does not exercise any editorial control over the information you may find at these locations nor does ISTH make any representation of their accuracy or completeness. Please contact those websites with any questions.
Coronavirus disease 2019 (COVID-19) is a viral infection that can, in severe cases, result in cytokine storm, systemic inflammatory response and coagulopathy that is prognostic of poor outcomes. While some, but not all, laboratory findings appear similar to sepsis-associated disseminated intravascular coagulopathy (DIC), COVID-19- induced coagulopathy (CIC) appears to be more prothrombotic than hemorrhagic. It has been postulated that CIC may be an uncontrolled immunothrombotic response to COVID-19, and there is growing evidence of venous and arterial thromboembolic events in these critically ill patients. Clinicians around the globe are challenged with rapidly identifying reasonable diagnostic, monitoring and anticoagulant strategies to safely and effectively manage these patients. Thoughtful use of proven, evidence-based approaches must be carefully balanced with integration of rapidly emerging evidence and growing experience. The goal of this document is to provide guidance from the Anticoagulation Forum, a North American organization of anticoagulation providers, regarding use of anticoagulant therapies in patients with COVID-19. We discuss in-hospital and post-discharge venous thromboembolism (VTE) prevention, treatment of suspected but unconfirmed VTE, laboratory monitoring of COVID-19, associated anticoagulant therapies, and essential elements for optimized transitions of care specific to patients with COVID-19.
Disclaimer
Answers to questions about COVID-19 published herein are provided by the International Society on Thrombosis and Haemostasis, Inc. (“ISTH”) for voluntary, informational use by providers in the rapidly evolving novel coronavirus crisis. This information does not constitute medical or legal advice, is not intended for use in the diagnosis or treatment of individual conditions, does not endorse products or therapies, recommend or mandate any particular course of medical care, and is not a statement of the standard of care. New evidence may emerge between the time information is developed and when it is published or read. The information is not comprehensive or continually updated. This information is not intended to substitute for the independent professional judgment of the treating provider in the context of treating the individual patient. ISTH provides this information on an “as is” basis, and makes no warranty, express or implied, regarding the information, including but not limited to its completeness or accuracy. ISTH specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. ISTH assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Use of the information is subject to the complete ISTH website Terms of Use.
The appearance of external hyperlinks does not constitute endorsement by ISTH of the linked websites, or the information, products or services contained therein. ISTH does not exercise any editorial control over the information you may find at these locations nor does ISTH make any representation of their accuracy or completeness. Please contact those websites with any questions.
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