Anticoagulation Challenges Amid COVID-19

ABSTRACT

The global health crisis of coronavirus disease 2019 (COVID-19) continues to challenge the standard of care in both the inpatient and outpatient setting. One area that has been heavily impacted is effective management of anticoagulation. COVID-19 has led to new and innovative ways to manage vitamin K-antagonist therapy in the ambulatory care clinics, with increased utilization of drive-through testing sites, home international normalized ratio monitoring, and conversions to direct oral anticoagulants. The COVID-19 infection has been found to have an increased risk in venous thromboembolism events due to its complex inflammatory response. Since 2019, multiple strategies have been trialed in the inpatient setting, including therapeutic, intermediate, and prophylaxis anticoagulation using heparin or low-molecular-weight heparin. Vaccines and therapeutics for COVID-19 have added complexity to the clinical situation, including an FDA warning for a vaccine-induced immune thrombocytopenia with the adenoviral vector vaccine (Ad26.COV2.S) and the potential for drug interactions between COVID-19 therapeutics and anticoagulation therapy. Copyright © 2022, Jobson Publishing Corporation. All rights reserved.