EDITORthat, since then, it has frequently been suggested that higher doses of LMWH be given to Covid-19 patients to prevent venous thromboembolism. However, there is no demonstration that standard prophylactic doses are insufficient to prevent it. Pulmonary vessel occlusions that are observed in severe Covid-19 patients are caused by pulmonary thrombi, whose pathogenesis is unclear but likely to be associated with the severe pulmonary inflammation.Concerning the type of heparin, we cannot be certain that one type is better than the other; in other words, it is difficult to say UFH is better than LMWH. LMWH was chosen in the guidance because of the ease of use, no need for laboratory monitoring, and familiarity among the spectrum of doctors with varying experience. The question of whether therapeutic doses of either UFH or LMWH should be considered for all patients is currently unknown and the authors would currently reserve such a dose for those who have confirmed thrombosis including filter thrombosis. We are aware however that therapeutic dose is being administered in some centers where there is very high suspicion of pulmonary embolism and imaging is impractical. Although these approaches are reasonable, we stress that these approaches are undertaken in a trial setting.
The available evidence allows us to conclude that all of the infliximab monitoring assays correlate well and may be used for IFX monitoring; albeit variations in measured IFX concentration among different assays remain present, these assays could be interchangeable. The ATI monitoring techniques are all capable of detecting ATI-positive patients, but because of the difference in the positivity limits and the measurement units, it is better to follow a patient rate with one definite kit.
We have recently published in the Journal of Thrombosis and Haemostasis the presence of lupus anticoagulant (LAC) at high frequency in Covid‐19 patients (1). Different authors had confirmed these results (2). Connell and colleagues had discussed, in the Journal, technical points concerning LAC as well as anti‐phospholipids (aPL) auto‐antibodies detection (3).
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