Rapid Evidence Review Clinical evidence for thromboprophylaxis in the management of COVID-19 [v1.0]
| dc.contributor.author | National Centre for Pharmacoeconomics | |
| dc.contributor.author | COVID-19 Evidence Review Group for Medicines | |
| dc.date.accessioned | 2020-07-27T16:11:39Z | |
| dc.date.available | 2020-07-27T16:11:39Z | |
| dc.date.issued | 2020-05-07 | |
| dc.identifier.uri | http://hdl.handle.net/10147/627922 | |
| dc.description | Emerging evidence indicates that alteration in the coagulation profile of people with COVID19 may contribute to an increased risk of thromboembolic events (TEs). Factors contributing to this risk are multifactorial including the SARs-CoV-2 infection itself and its pathology, and hospital-related factors including immobilisation, respiratory failure, mechanical ventilation and central venous catheter use. The evidence suggests that while there may be an underlying risk of TEs in all patients infected with SARs-CoV-2, the risk in hospitalised patients increases if the disease progresses from moderate to severe stages of the condition, when hyperinflammation may be a key clinical feature. Evidence of the benefit conferred from thromboprophylaxis is limited to date but several international guidelines and consensus statements recommend thromboprophylaxis for all hospitalised patients admitted with COVID-19. In severe presentations of the infection and the critically ill patients, the optimal dose is not currently known. Dose escalation strategies may be considered on a case-by-case basis, while evidence for post-discharge thromboprophylaxis is not available. A number of on-going clinical trials will provide more robust evidence as to whether thromboprophylaxis leads to enhanced outcomes, such as improved survival. Conclusion The evidence indicates that there is a risk of thromboembolic events in hospitalised COVID-19 patients and consensus is that thromboprophylaxis is warranted in admitted patients with COVID-19 without underlying bleeding risk. While the suggestion is that patients with hyperinflammation may be at increased risk of thromboembolic events, there are currently insufficient studies to identify which patients may be at greater risk and whether increasing thromboprophylaxis to intermediate or treatment doses alters outcomes. | en_US |
| dc.language.iso | en | en_US |
| dc.publisher | National Centre for Pharmacoeconomics | en_US |
| dc.subject | PATIENT SAFETY | en_US |
| dc.subject | QUALITY | en_US |
| dc.subject | COVID-19 | en_US |
| dc.subject | CORONAVIRUS | en_US |
| dc.subject | THROMBOEMBOLISMS | en_US |
| dc.subject | MEDICINES | en_US |
| dc.title | Rapid Evidence Review Clinical evidence for thromboprophylaxis in the management of COVID-19 [v1.0] | en_US |
| dc.type | Other | en_US |
| refterms.dateFOA | 2020-07-27T16:11:41Z |
