Author : PSVM Board's Version 2: Updates on Coagulation Use in COVID19 and Safety Protocols in the Performance of Vascular Procedures.
Role of Anticoagulation in COVID-19: Recommendations on its Use, (an UPDATE) There has been rapid accumulation of additional data since our last interim guideline. These only further strengthen the current theory of thrombosis and coagulopathy contributing significantly to the pathogenesis and morbidity in Covid-19. More autopsy and histologic studies have also unraveled the striking incidence of venous thromboses in the deep veins of the lower extremities, widespread microthrombi (in-situ) in the pulmonary arterioles, and macro-emboli in the pulmonary arteries.1,2 More recent data continue to support the discriminatory and predictive ability of d-dimer levels in terms of the need for critical care support, in-hospital mortality, and occurrence of venous thromboembolism (VTE) and other thrombotic events.3-9 VTE incidence has been shown to be significantly high in hospitalized covid-19 patients,6,11 and has been demonstrated to occur despite prophylactic anticoagulation.9-13 Two studies have demonstrated mortality benefit of anticoagulation use in Covid-19 patients.14-15 Nevertheless, majority of these data still come from observational or retrospective studies, and the medical community still awaits data from large, randomized controlled trials to finally settle some or most of the remaining issues.
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