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How to Build the Plane While Flying: VTE/PE Thromboprophylaxis Clinical Guidelines for COVID-19 Patients.
Costa, Alessandro; Weinstein, Eric S; Sahoo, D Ruby; Thompson, Stanley C; Faccincani, Roberto; Ragazzoni, Luca.
  • Costa A; CRIMEDIM, Research Center in Emergency and Disaster Medicine, Novara, NO, Italy.
  • Weinstein ES; CRIMEDIM, Research Center in Emergency and Disaster Medicine, Novara, NO, Italy.
  • Sahoo DR; TEAMHealth Hospitalist Services, Grand Strand Medical Center, Clinical Faculty, Edward Via College of Osteopathic Medicine, HCA Healthcare Journal of Medicine, Grand Strand Medical Center, Myrtle Beach, South Carolina.
  • Thompson SC; TEAMHealth Lifepoint Group, Brentwood, Tennessee.
  • Faccincani R; Emergency Department, IRCCS San Raffaele, Milano, Italy.
  • Ragazzoni L; CRIMEDIM, Research Center in Emergency and Disaster Medicine, Novara, NO, Italy.
Disaster Med Public Health Prep ; 14(3): 391-405, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1028321
ABSTRACT
Over the years, the practice of medicine has evolved from authority-based to experience-based to evidence-based with the introduction of the scientific process, clinical trials, and outcomes-based data analysis (Tebala GD. Int J Med Sci. 2018;15(12)1397-1405). The time required to perform the necessary randomized controlled trials, a systematic literature review, and meta-analysis of these trials to then create, accept, promulgate, and educate the practicing clinicians to use the evidence-based clinical guidelines is typically measured in years. When the severe acute respiratory syndrome novel coronavirus-2 (SARS-nCoV-2) pandemic commenced in Wuhan, China at the end of 2019, there were few available clinical guidelines to deploy, let alone adapt and adopt to treat the surge of coronavirus disease 2019 (COVID-19) patients. The aim of this study is to first explain how clinical guidelines, on which bedside clinicians have grown accustomed, can be created in the midst of a pandemic, with an evolving scientific understanding of the pathophysiology of the hypercoagulable state. The second is to adapt and adopt current venous thromboembolism diagnostic and treatment guidelines, while relying on the limited available observational reporting of COVID-19 patients to create a comprehensive clinical guideline to treat COVID-19 patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Fibrin Fibrinogen Degradation Products / Coronavirus Infections / Venous Thromboembolism / Pre-Exposure Prophylaxis Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Disaster Med Public Health Prep Journal subject: Public Health Year: 2020 Document Type: Article Affiliation country: Dmp.2020.195

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Fibrin Fibrinogen Degradation Products / Coronavirus Infections / Venous Thromboembolism / Pre-Exposure Prophylaxis Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Disaster Med Public Health Prep Journal subject: Public Health Year: 2020 Document Type: Article Affiliation country: Dmp.2020.195