Table 3:
Summary of Findings Pertaining to Prevention, Treatment, and Diagnosis of Thromboembolic Events associated with COVID-19
| Endpoint | Study | Country of Origin |
Design | Centers | No. of COVID D-19 Patients |
Relevant Findings |
|---|---|---|---|---|---|---|
| Outpatient Anti coagulation | Beun et al. (57) | Netherlands | Retrospective | Single | 75 | VTE patients required unusually high dose UFH > 35,000 IU/day for goal aPTT |
| Taccone et al. (69) | Belgium | Retrospective | Single | 40 | High dose chemoprophylaxis associated with ↓ PE | |
| Roberts et al. (85) | UK | Retrospective | Single | 1,877 | ↑ Post-discharge VTE (OR 1.6) | |
| Tang et al. (121) | China | Retrospective | Single | 449 | Lower mortality in patients with a SIC score ≥ 4 treated with heparin for ≥ 7 days | |
| Maatman et al. (123) | USA | Retrospective | Multi | 109 | Critically ill patients with D-dimer level > 2,600 ng/mL should get screening duplex | |
| Tremblay et al. (126) | USA | Retrospective | Multi | 3,772 | No difference in survival or time to mechanical ventilation with prior anticoagulant or anti-platelet | |
| White et al. (132) | UK | Retrospective | Single | 69 | ↑ Heparin dosing needed to achieve therapeutic levels in 15 patients | |
| Rossi et al. (134) | Italy | Retrospective | Single | 70 | Chronic DOAC use independently predicts survival | |
| VTE Screening Thresholds | Yuriditsky et al. (53) | USA | Retrospective | Single | 64 | Recommend therapeutic anticoagulation for ICU patients w/D-dimer level > 2,000 ng/mL or ↑ 6x-10x admission level |
| Trigonis et al. (76) | USA | Retrospective | Single | 45 | Recommend ultrasound for D-dimer level > 2,000 ng/mL & consider therapeutic anticoagulation for D-dimer level > 5,500 ng/mL | |
| Use of Anti-Platelet Agents | Russo et al. (124) | Italy | Retrospective | Multi | 192 | No change in ARDS or in-hospital mortality associated with anti-platelet or anticoagulation |
| Viecca et al. (125) | Italy | Case Series | Single | 5 | Hypoxia improvement in ICU patients treated with specific anti-platelet regimen | |
| Use of Fibrinolytic Agents | Bona et al. (128) | Italy | Case Series | Single | 4 | Clinical improvement in 3 of 4 patients treated with tPA for bedside diagnosis of PE |
| Goyal et al. (129) | India | Case Series | Single | 3 | 3 patients treated with tPA for respiratory failure weaned from oxygen within 3-7 days. | |
| Christie et al. (130) | USA | Case Series | Single | 5 | TPA given for worsening respiratory failure; improved respiratory status in all 5 patients |