Approach to Thromboprophylaxis for Prevention of Venous Thromboembolism in COVID-19: Global Updates and Clinical Insights from India

Abstract

Venous thromboembolism (VTE) frequently occurs in patients with coronavirus disease-19 (COVID-19) and is associated with increased mortality. Several global guidelines recommended prophylactic-intensity anticoagulation rather than intermediate-intensity or therapeutic-intensity anticoagulation for patients with COVID-19-related acute or critical illness without suspected or confirmed VTE. Even though standard doses of thromboprophylaxis are received, many cases of thrombotic complications are reported; hence, appropriate and adequate thromboprophylaxis is critical for the prevention of VTE in COVID-19. In spite of an increased prevalence of VTE in Indian patients, sufficient data on patient characteristics, diagnosis, and therapeutic approach for VTE in COVID is lacking. In this article, we review the available global literature (search conducted up to 31 May 2021) and provide clinical insights into our approach towards managing VTE in patients with COVID-19. Furthermore, in this review, we summarize the incidence and risk factors for VTE with emphasis on the thromboprophylaxis approach in hospitalized patients and special populations with COVID-19 and assess clinical implications in the Indian context.

Narrative Review on Prevalence of Venous Thromboembolism and Public Awareness in India

“…An outline was framed and concluded (Parakh, Kakkar & Kakkar, 2007). Ramakrishnan et al, (2022) had also suggested adherence to ACCP guidelines in VTE prevention. Shirol et al (2017) conducted a survey, where the majority of plastic surgeons admitted the usage of low molecular heparin after considering the patient's age, comorbidities, degree and percentage of burn and lower limb involvement.…”

ISTH guidelines for antithrombotic treatment in COVID‐19: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine

“…COVID‐19 infection is associated with a hypercoagulable state and risk of thromboembolism 1 . Variability exists in the prevention of venous thromboembolism among hospitalised patients with COVID‐19 2,3 . While several guidance documents have been published, 4–6 a formal clinical practice guideline using evidence from randomised clinical trials and well‐designed observational studies was recently issued by the International Society of Thrombosis and Haemostasis 7 …”

The Year 2022 in Cardiovascular Diseases—Clinics and Practice

“…Hence, appropriate and adequate thromboprophylaxis is critical for VTE prevention in COVID-19. In this journal, Ramakrishnan et al [ 4 ] reviewed the available global literature, providing clinical insights into our approach towards managing VTE in patients with COVID-19. Furthermore, they summarized the incidence and risk factors for VTE with an emphasis on the thromboprophylaxis approach in hospitalized patients and special populations with COVID-19, assessing clinical implications in their Indian context.…”