Extended post-discharge thromboprophylaxis in hospitalized COVID-19 patients. Issue 7 (3rd July 2022)

• Record Type: Journal Article
• Authors: Spyropoulos, Alex C
• Is Part Of: Expert review of hematology. Volume 15:Issue 7(2022)
• Page Start: 597
• Page End: 605
• Publication Date: 2022-07-03
• Subjects: Coronavirus disease 2019 -- SARS-CoV-2 -- anticoagulant -- direct oral anticoagulant -- extended thromboprophylaxis -- hospitalization -- post-discharge -- medically ill -- thromboembolism; Hematology -- Periodicals; 616.15005
• DOI: 10.1080/17474086.2022.2098104
• Languages: English
• ISSNs: 1747-4086

Abstract

ABSTRACT: Introduction: Hospitalized COVID-19 patients, particularly those with high-risk features, are at risk for venous and arterial thromboembolic events for approximately 30 days or more after hospital discharge. Extended post-hospital discharge thromboprophylaxis has potential to reduce this risk. Areas Covered: Recent cohort, registry, and randomized trial data on the topic of extended post-discharge thromboprophylaxis in COVID-19 inpatients are reviewed, and key patient subgroups at high thrombotic risk are highlighted, with antithrombotic guidelines on the topic discussed. Expert Opinion: COVID-19 inpatients with cardiovascular risk factors, advanced age, intensive care unit stay, or an IMPROVE VTE score of 4 or more or a score of 2 or 3 plus elevated D-dimers (> twice the upper limit of normal) or an IMPROVE-DD VTE score of ≥4 are at high thrombotic risk in the post-discharge period. These high-risk patient subgroups benefit from extended post-discharge thromboprophylaxis, specifically with rivaroxaban 10 mg daily for 35 days. Recent NIH and ISTH guidelines recommend or suggest this approach. Results from other clinical trials are pending.