American Society of Hematology | ||
CHEST Guideline and Expert Panel Report | Extended prophylaxis 45 days to consider if post-discharge risk of VTE and bleeding indicate a net benefit of such prophylaxis. | |
Statement of Chinese Thoracic Society & Chinese Association of Chest Physicians | Assess whether the patient has VTE or whether the patient still has VTE risk factors after discharge. If the patient is still at elevated risk of VTE on discharge, subcutaneous injection of LMWH can be considered with a prolonged thromboprophylaxis over DOACs use. | |
Consideration of extended prophylaxis (for up to 45 days) for patients with elevated risk of VTE (e.g., reduced mobility, comorbidities such as active cancer, and elevated D-dimer >2 times the upper limit of normal) who have low risk of bleeding. | ||
Standardization Committee of the International Society on Thrombosis and Haemostasis |
Extended post discharge thromboprophylaxis should be considered for all hospitalized patients with COVID-19 that meet high VTE risk criteria. The duration of post discharge thromboprophylaxis can be approximately 14 days at least and up to 30 days. Either LMWH or a DOAC can be for extended duration thromboprophylaxis. |
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Guidelines Scottish Intercollegiate Guidelines Network (SIGN) & Thrombosis UK |
Extended thromboprophylaxis considering in patients at elevated risk for VTE and low risk of bleeding. Options for treatment include a LMWH or DOAC for 14 days; however, choice and duration of extended thromboprophylaxis will depend on clinical judgement. |
Retrospective 175 patients | 42 | – | 0.71% (95% CI 0–2,1%) | – | |
Retrospective 163 patients | 30 | – | – | 0.6% (95% CI, 0.1–4.6) | |
Retrospective 145 patients | 59 | 0.7% | 0.7% | 1.4% | |
Retrospective 1877 | 68 | – | – | 4.8 per 1000 discharges (0.47%) | |
Prospective, multicenter 1529 patients | 45 | – | – | 0.2% (95% CI 0.1%–0.6%) | |
Retrospective 370 patients | 30 | – | – | 1.08% | |
Prospective 146 patients | 42 | 0.7% | 0.7% | 1.4% | |
Registry 4906 | 90 | 0.90% | 0.85% | 1.55% | |
Retrospective 447 patients | 30 | 1% | 1% | 2.0% (1.1% in those discharged on anticoagulation and 2.7% in those discharged without anticoagulation - OR, 0.52; 95% CI, 0.08–2.26) | |
Meta-analysis 18,949 patients | 61.7 mean length of follow-up (21 to 180) | Pooled incidence 0.9% (95% CI:0.3 to 2.1) | Pooled incidence 1.5% (95% CI: 0.5–4.0) | Pooled incidence 1.8% (95% CI: 0.8–4.1%) | |
Ongoing Recruiting | – | – | – | – | |
Ongoing - Recruiting | – | – | – | – |