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Anticoagulation practice patterns in COVID-19: A global survey.
Rosovsky, Rachel P; Sanfilippo, Kristen M; Wang, Tzu Fei; Rajan, Sandeep K; Shah, Surbhi; Martin, Karlyn A; Ní Áinle, Fionnuala; Huisman, Menno; Hunt, Beverley J; Kahn, Susan R; Kevane, Barry; Lee, Agnes Y Y; McLintock, Claire; Baumann Kreuziger, Lisa.
  • Rosovsky RP; Department of Medicine Massachusetts General Hospital Harvard Medical School Boston MA USA.
  • Sanfilippo KM; Department of Medicine Washington University St. Louis School of Medicine and John Cochran Veterans Administration Medical Center St. Louis MO USA.
  • Wang TF; Department of Internal Medicine Ohio State University Wexner Medical Center Columbus OH USA.
  • Rajan SK; Department of Medicine University of Nebraska Medical Center College of Medicine Memphis TN USA.
  • Shah S; Department of Medicine University of Minnesota Minneapolis MN USA.
  • Martin KA; Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL USA.
  • Ní Áinle F; Department of Hematology Mater Misericordiae University Hospital and Rotunda Hospital University College Dublin (UCD) School of Medicine Dublin Ireland.
  • Huisman M; Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden The Netherlands.
  • Hunt BJ; Department of Haematology King's College Pathology & Rheumatology Guy's & St Thomas' NHS Foundation Trust London England.
  • Kahn SR; Department of Medicine McGill University Montreal QC Canada.
  • Kevane B; Division of Internal Medicine & Center for Clinical Epidemiology Jewish General Hospital Montreal QC Canada.
  • Lee AYY; Department of Hematology Mater University Hospital University College of Dublin (UCD) School of Medicine Dublin Ireland.
  • McLintock C; Department of Medicine University of British Columbia Vancouver BC Canada.
  • Baumann Kreuziger L; National Women's Health Auckland City Hospital Auckland New Zealand.
Res Pract Thromb Haemost ; 4(6): 969-983, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-2278800
ABSTRACT

Background:

Best practice for prevention, diagnosis, and management of venous thromboembolism (VTE) in patients with coronavirus disease 2019 (COVID-19) is unknown due to limited published data in this population.

Objectives:

We aimed to assess current global practice and experience in management of COVID-19-associated coagulopathy to identify information to guide prospective and randomized studies.

Methods:

Physicians were queried about their current approach to prophylaxis, diagnosis, and treatment of VTE in patients with COVID-19 using an online survey tool distributed through multiple international organizations between April 10 and 14, 2020.

Results:

Five hundred fifteen physicians from 41 countries responded. The majority of respondents (78%) recommended prophylactic anticoagulation for all hospitalized patients with COVID-19, with most recommending use of low-molecular-weight heparin or unfractionated heparin. Significant practice variation was found regarding the need for dose escalation of anticoagulation outside the setting of confirmed or suspected VTE. Respondents reported the use of bedside testing when unable to perform standard diagnostic imaging for diagnosis of VTE. Two hundred ninety-one respondents reported observing thrombotic complications in their patients, with 64% noting that the complication was pulmonary embolism. Of the 44% of respondents who estimated incidence of thrombosis in patients with COVID-19 in their hospital, estimates ranged widely from 1% to 50%. One hundred seventy-four respondents noted bleeding complications (34% minor bleeding, 14% clinically relevant nonmajor bleeding, and 12% major bleeding).

Conclusion:

Well-designed epidemiologic studies are urgently needed to understand the incidence and risk factors of VTE and bleeding complications in patients with COVID-19. Randomized clinical trials addressing use of anticoagulation are also needed.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Language: English Journal: Res Pract Thromb Haemost Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Language: English Journal: Res Pract Thromb Haemost Year: 2020 Document Type: Article