Table 2.

Key Recommendations for Antithrombotic Therapies in Hospitalized Patients With COVID-19 From the National Institutes of Health (89)

Laboratory testing

In hospitalized patients with COVID-19, hematologic and coagulation parameters are commonly measured, although there are currently insufficient data to recommend for or against using these data to guide management decisions

Chronic anticoagulant and antiplatelet therapies

Patients who are receiving anticoagulant or antiplatelet therapies for underlying conditions should continue these medications if they receive a diagnosis of COVID-19

VTE prophylaxis and screening

Hospitalized adults with COVID-19 should receive VTE prophylaxis per the standard of care for other hospitalized adults

Anticoagulant or antiplatelet therapy should not be used to prevent arterial thrombosis outside of the usual standard of care for patients without COVID-19

There are currently insufficient data to recommend for or against the use of thrombolytic agents or increasing anticoagulant doses for VTE prophylaxis in hospitalized COVID-19 patients outside the setting of a clinical trial

Hospitalized patients with COVID-19 should not routinely be discharged on VTE prophylaxis. Extended VTE prophylaxis can be considered in patients who are at low risk for bleeding and high risk for VTE

There are currently insufficient data to recommend for or against routine deep vein thrombosis screening in COVID-19 patients without signs or symptoms of VTE, regardless of the status of their coagulation markers

Treatment

Patients with COVID-19 who experience an incident thromboembolic event or who are highly suspected to have thromboembolic disease at a time when imaging is not possible should be managed with therapeutic doses of anticoagulant therapy as per the standard of care for patients without COVID-19

Patients with COVID-19 who require extracorporeal membrane oxygenation or continuous renal replacement therapy or who have thrombosis of catheters or extracorporeal filters should be treated with antithrombotic therapy per the standard institutional protocols for those without COVID-19

COVID-19 = coronavirus disease 2019; VTE = venous thromboembolism.