COVID-19 coagulopathy and thrombosis: Analysis of hospital protocols in response to the rapidly evolving pandemic

the Hospital Medicine Reengineering Network (HOMERuN)

doi:10.1016/j.thromres.2020.09.018

COVID-19 coagulopathy and thrombosis: Analysis of hospital protocols in response to the rapidly evolving pandemic

the Hospital Medicine Reengineering Network (HOMERuN)

Medicine, Hospital Medicine Division

Research output: Contribution to journal › Letter › peer-review

12 Scopus citations

Abstract

As the Coronavirus disease 2019 (COVID-19) pandemic spread to the US, so too did descriptions of an associated coagulopathy and thrombotic complications. Hospitals created institutional protocols for inpatient management of COVID-19 coagulopathy and thrombosis in response to this developing data. We collected and analyzed protocols from 21 US academic medical centers developed between January and May 2020. We found greatest consensus on recommendations for heparin-based pharmacologic venous thromboembolism (VTE) prophylaxis in COVID-19 patients without contraindications. Protocols differed regarding incorporation of D-dimer tests, dosing of VTE prophylaxis, indications for post-discharge pharmacologic VTE prophylaxis, how to evaluate for VTE, and the use of empiric therapeutic anticoagulation. These findings support ongoing efforts to establish international, evidence-based guidelines.

Original language	English (US)
Pages (from-to)	355-358
Number of pages	4
Journal	Thrombosis research
Volume	196
DOIs	https://doi.org/10.1016/j.thromres.2020.09.018
State	Published - Dec 2020

Funding

Dr. Fang reports that research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number K24HL141354. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Auerbach reports that research reported in this publication was supported by the Gordon and Betty Moore Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Gordon and Betty Moore Foundation.

Keywords

Anticoagulation
Coagulopathy
Coronavirus
Deep vein thrombosis (DVT)
Pulmonary embolism (PE)
Thrombosis
Venous thromboembolism (VTE)

ASJC Scopus subject areas

Hematology

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10.1016/j.thromres.2020.09.018

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@article{4b9a48c705644ea0834bee177229f51b,

title = "COVID-19 coagulopathy and thrombosis: Analysis of hospital protocols in response to the rapidly evolving pandemic",

abstract = "As the Coronavirus disease 2019 (COVID-19) pandemic spread to the US, so too did descriptions of an associated coagulopathy and thrombotic complications. Hospitals created institutional protocols for inpatient management of COVID-19 coagulopathy and thrombosis in response to this developing data. We collected and analyzed protocols from 21 US academic medical centers developed between January and May 2020. We found greatest consensus on recommendations for heparin-based pharmacologic venous thromboembolism (VTE) prophylaxis in COVID-19 patients without contraindications. Protocols differed regarding incorporation of D-dimer tests, dosing of VTE prophylaxis, indications for post-discharge pharmacologic VTE prophylaxis, how to evaluate for VTE, and the use of empiric therapeutic anticoagulation. These findings support ongoing efforts to establish international, evidence-based guidelines.",

keywords = "Anticoagulation, Coagulopathy, Coronavirus, Deep vein thrombosis (DVT), Pulmonary embolism (PE), Thrombosis, Venous thromboembolism (VTE)",

author = "{the Hospital Medicine Reengineering Network (HOMERuN)} and Parks, {Anna L.} and Auerbach, {Andrew D.} and Schnipper, {Jeffrey L.} and Anstey, {James E.} and Sterken, {David G.} and Hecht, {Todd E.H.} and Fang, {Margaret C.} and Vaughn, {Valerie M.} and Dunn, {Andrew S.} and Linker, {Anne S.} and Hunt, {Daniel P.} and Choi, {Justin J.} and Brotman, {Daniel J.} and Streiff, {Michael B.} and Mattison, {Melissa L.P.} and Pappas, {Matthew A.} and Greysen, {S. Ryan} and Hemsey, {David F.} and Kwame Dapaah-Afriyie and Neera Ahuja and Collins, {William J.} and Herzig, {Shoshana J.} and Sanjay Bhandari and Schumacher, {Eric R.} and Duggirala, {Vijay S.} and O'Leary, {Kevin J.} and Menard, {Geraldine E.} and Lin, {Michael Y.}",

note = "Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",

year = "2020",

month = dec,

doi = "10.1016/j.thromres.2020.09.018",

language = "English (US)",

volume = "196",

pages = "355--358",

journal = "Thrombosis research",

issn = "0049-3848",

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TY - JOUR

T1 - COVID-19 coagulopathy and thrombosis

T2 - Analysis of hospital protocols in response to the rapidly evolving pandemic

AU - the Hospital Medicine Reengineering Network (HOMERuN)

AU - Parks, Anna L.

AU - Auerbach, Andrew D.

AU - Schnipper, Jeffrey L.

AU - Anstey, James E.

AU - Sterken, David G.

AU - Hecht, Todd E.H.

AU - Fang, Margaret C.

AU - Vaughn, Valerie M.

AU - Dunn, Andrew S.

AU - Linker, Anne S.

AU - Hunt, Daniel P.

AU - Choi, Justin J.

AU - Brotman, Daniel J.

AU - Streiff, Michael B.

AU - Mattison, Melissa L.P.

AU - Pappas, Matthew A.

AU - Greysen, S. Ryan

AU - Hemsey, David F.

AU - Dapaah-Afriyie, Kwame

AU - Ahuja, Neera

AU - Collins, William J.

AU - Herzig, Shoshana J.

AU - Bhandari, Sanjay

AU - Schumacher, Eric R.

AU - Duggirala, Vijay S.

AU - O'Leary, Kevin J.

AU - Menard, Geraldine E.

AU - Lin, Michael Y.

PY - 2020/12

Y1 - 2020/12

N2 - As the Coronavirus disease 2019 (COVID-19) pandemic spread to the US, so too did descriptions of an associated coagulopathy and thrombotic complications. Hospitals created institutional protocols for inpatient management of COVID-19 coagulopathy and thrombosis in response to this developing data. We collected and analyzed protocols from 21 US academic medical centers developed between January and May 2020. We found greatest consensus on recommendations for heparin-based pharmacologic venous thromboembolism (VTE) prophylaxis in COVID-19 patients without contraindications. Protocols differed regarding incorporation of D-dimer tests, dosing of VTE prophylaxis, indications for post-discharge pharmacologic VTE prophylaxis, how to evaluate for VTE, and the use of empiric therapeutic anticoagulation. These findings support ongoing efforts to establish international, evidence-based guidelines.

AB - As the Coronavirus disease 2019 (COVID-19) pandemic spread to the US, so too did descriptions of an associated coagulopathy and thrombotic complications. Hospitals created institutional protocols for inpatient management of COVID-19 coagulopathy and thrombosis in response to this developing data. We collected and analyzed protocols from 21 US academic medical centers developed between January and May 2020. We found greatest consensus on recommendations for heparin-based pharmacologic venous thromboembolism (VTE) prophylaxis in COVID-19 patients without contraindications. Protocols differed regarding incorporation of D-dimer tests, dosing of VTE prophylaxis, indications for post-discharge pharmacologic VTE prophylaxis, how to evaluate for VTE, and the use of empiric therapeutic anticoagulation. These findings support ongoing efforts to establish international, evidence-based guidelines.

KW - Anticoagulation

KW - Coagulopathy

KW - Coronavirus

KW - Deep vein thrombosis (DVT)

KW - Pulmonary embolism (PE)

KW - Thrombosis

KW - Venous thromboembolism (VTE)

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U2 - 10.1016/j.thromres.2020.09.018

DO - 10.1016/j.thromres.2020.09.018

M3 - Letter

C2 - 32977136

AN - SCOPUS:85091226383

SN - 0049-3848

VL - 196

SP - 355

EP - 358

JO - Thrombosis research

JF - Thrombosis research

ER -

COVID-19 coagulopathy and thrombosis: Analysis of hospital protocols in response to the rapidly evolving pandemic

Abstract

Funding

Keywords

ASJC Scopus subject areas

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