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. 2021 Oct 22;13(11):2128. doi: 10.3390/v13112128

Table 1.

Domains to be addressed with their respective PICO questions.

Domain PICO Question
Domain 1: thromboprophylaxis in COVID-19 patients not requiring hospital admission. PICO 1: Which patients with COVID-19 not requiring hospital admission should receive standard-doses of pharmacological thromboprophylaxis?
P: COVID-19 patient without hospital admission criteria
I: standard-doses of pharmacological thromboprophylaxis
C: recommend mobilization (avoid sedentarism) but without pharmacological thromboprophylaxis
O: symptomatic VTE
Domain 2: thromboprophylaxis in hospitalized COVID-19 patients. PICO 2: In hospitalized patients for COVID-19 who were receiving anticoagulation with oral anticoagulants prior to admission, should we substitute them with LMWH?
P: COVID-19 patients admitted in a conventional ward who received previous oral anticoagulant treatment
I: LMWH at anticoagulant dose
C: the same oral anticoagulant treatment prior to admission
O: the same goal of oral anticoagulation (prevent arterial or venous thrombosis)
PICO 3: What is the optimal dose of LMWH for most COVID-19 patients admitted to a conventional hospital ward?
P: COVID-19 patients admitted to a conventional hospital ward
I: intermediate or therapeutic doses of LMWH
C: standard doses of pharmacological thromboprophylaxis
O: symptomatic VTE/need for NIMV-IOT-ECMO/mortality/major bleeding
PICO 4: What is the optimal dose of LMWH for most COVID-19 patients admitted to an Intensive Care Unit (ICU)?
P: COVID-19 patients admitted to an ICU
I: intermediate or therapeutic doses of LMWH
C: standard-doses of pharmacological thromboprophylaxis
O: symptomatic VTE/need for NIMV-IOT-ECMO/mortality/major bleeding
Domain 3: diagnosis and treatment guide of vte in COVID-19 hospitalized patients. PICO 5: Which is the significance of high D-dimer levels in hospitalized patients for COVID-19?
P: patients admitted for COVID-19
I: does the D-dimer have other utilities (diagnostic or therapeutic) in this context?
C: continue using D-dimer in the context of low clinical suspicion due to its high negative predictive value
O: symptomatic VTE/COVID-19 severity/mortality
Domain 4: follow-up after discharge of patients admitted for COVID-19 with and without a vte event. PICO 6. Which patients without COVID-19-associated VTE should receive extended standard-doses thromboprophylaxis after hospital discharge?
P: patients without VTE during hospitalization for COVID-19 at hospital discharge
I: extended thromboprophylaxis after discharge
C: thromboprophylaxis during hospitalization
O: symptomatic VTE/major bleeding/mortality
PICO 7. Which is the optimal duration of anticoagulant treatment for patients with COVID-19 associated VTE?
P: patient suffering VTE (proximal DVT and/or PE) associated with COVID-19
I: extended anticoagulant treatment (beyond the first 3 months)
C: anticoagulant treatment for 3 months
O: symptomatic recurrent VTE/major bleeding/clinically relevant non-major bleeding/mortality

Abbreviations. COVID-19: coronavirus disease 2019; PICO: Patient, Intervention, Comparison, Outcomes; VTE: venous thromboembolic disease; LMWH: low molecular weight heparins; NIMV-IOT-ECMO: non-invasive mechanical ventilation-orotracheal intubation-extracorporeal membrane oxygenation; ICU: Intensive Care Units.