Table 1.
Current Guideline Recommendations
| Source | Recommendation | Date published | Date accessed |
|---|---|---|---|
| Guidance specific to COVID-19 | |||
| World Health Organization11 | Use pharmacological prophylaxis (LMWH [preferred if available] or heparin 5000 units subcutaneously twice daily) in adolescents and adults without contraindications. For those with contraindications, use mechanical prophylaxis (intermittent pneumatic compression devices). | 3-13-2020 | 4-12-2020 |
| International Society of Thrombosis and Haemostasis14 | Consider prophylactic dose LMWH in all patients (including non-critically ill) who require hospital admission for COVID-19 infection, in the absence of any contraindications. | 3-25-2020 | 4-12-2020 |
| Centers for Disease Control and Prevention12 | No specific comment on anticoagulation in COVID-19 patients; refers to WHO guidance | 4-3-2020 | 4-12-2020 |
| Department of Defense13 | No specific comment on anticoagulation in COVID-19 patients; refers to WHO guidance | 3-23-2020 | 4-12-2020 |
| Infectious Disease Society of America19 | No specific comment on anticoagulation in COVID-19 patients | 4-11-2020 | 4-12-2020 |
| The Italian Society on Thrombosis and Haemostasis10 |
- Use LMWH, UFH, or fondaparinux at doses indicated for prophylaxis of VTE in all COVID-19 hospitalized patients; patients with anticoagulant contraindications should be treated with limb compression. - Thromboprophylaxis should be administered for the entire hospital stay and maintained at home for 7–14 days after hospital discharge or in the pre-hospital phase, in case of pre-existing or persisting VTE risk factors. - The use of intermediate-dose LMWH (i.e., enoxaparin 4000 IU subcutaneously every 12 h) can be considered on an individual basis in patients with multiple risk factors for VTE. - Use of therapeutic doses of UFH or LMWH is not recommended as a standard treatment. |
4-8-2020 | 4-14-2020 |
| Guidance published prior to COVID-19 | |||
| American Society of Hematology15 | Use UFH, LMWH, or fondaparinux rather than no parenteral anticoagulant in acutely ill medical patients and UFH or LMWH in critically ill medical patients. | 11-2018 | 4-12-2020 |
| Society of Critical Care Medicine18 | Recommends against the use of antithrombin for the treatment of sepsis and septic shock. No recommendation regarding the use of thrombomodulin or heparin for the treatment of sepsis or septic shock | 03-2020 | 4-12-2020 |