Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
A Systematic Review on Post-Discharge Venous Thromboembolism Prophylaxis in Patients With Covid-19 Publisher



Amanibeni R1 ; Kermanialghoraishi M2 ; Darouei B3 ; Reid CM4
Authors
Show Affiliations
Authors Affiliations
  1. 1. Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Centre of Clinical Research and Education, Curtin University, Perth, WA, Australia

Source: Egyptian Heart Journal Published:2023


Abstract

Background: Coronavirus disease of 2019 (COVID-19) is associated with venous thromboembolism (VTE), not only during hospitalization but also after discharge, raising concerns about anticoagulant (AC) use for post-discharge COVID-19 patients. We aimed to systematically review the current literature on the possible benefits or risks regarding extended thromboprophylaxis. Main body: We searched related databases from December 1, 2019, to October 6, 2022, including studies on the necessity, duration, and selection of the ideal AC regarding extended thromboprophylaxis for post-discharge COVID-19 patients. The screening of the selected databases led to 18 studies and 19 reviews and guidelines. Studies included 52,927 hospitalized COVID-19 patients, with 19.25% receiving extended thromboprophylaxis. VTE events ranging from 0 to 8.19% (median of 0.7%) occurred in a median follow-up of 49.5 days. All included studies and guidelines, except four studies, recommended post-discharge prophylaxis after an individual risk assessment indicating high thrombotic and low bleeding risk. Studies used risk assessment models (RAMs), clinical evaluation, and laboratory data to identify COVID-19 patients with a high risk of VTE. IMPROVE-DD was the most recommended RAM. Direct oral anticoagulants (DOACs) and low molecular weight heparins (LMWHs) were the most used AC classes. Conclusions: Post-discharge prophylaxis for COVID-19 patients is recommended after an individual assessment. The IMPROVE-DD model can help predict VTE risk. After distinguishing patients who need post-discharge AC therapy, DOACs for 30–35 days and LMWHs for 40–45 days can be the drug of choice. Further studies, particularly the results of the ongoing randomized controlled trials (RCTs), are required. Also, to properly handle such patients, every physician should consider lifestyle modification in addition to pharmacological treatment for post-discharge VTE prophylaxis. © 2023, Egyptian Society of Cardiology.
Related Docs
View other Related Docs
1. On-Admission Versus In-Hospital Thromboembolism Due to Covid-19 Infection. What Is the Particular Characteristic of Those With Early Thrombotic Events?, Advances in Respiratory Medicine (2021)
2. A Review of Pathophysiological Mechanism, Diagnosis, and Treatment of Thrombosis Risk Associated With Covid-19 Infection, IJC Heart and Vasculature (2022)
3. Anticoagulation Therapy in Covid-19 Patients With Chronic Kidney Disease, Journal of Research in Medical Sciences (2021)
4. An Investigation to Find the Correlation Between Lupus Anticoagulant and Coagulation Abnormalities in Covid-19 Patients; a Narrative Review, Journal of Nephropathology (2024)
5. On Admission Hemoglobin and Albumin, As the Two Novel Factors Associated With Thrombosis in Covid-19 Pneumonia, Journal of Renal Injury Prevention (2022)
6. Thrombocytopenia and Coronavirus: A Prognosis and Progression of the Coronavirus Disease, Iranian Journal of Pediatric Hematology and Oncology (2022)
7. D-Dimer Levels in Predicting Severity of Infection and Outcome in Patients With Covid-19, Tanaffos (2022)
8. Covid-19-Associated Coagulopathy: A Concise Review on Pathogenesis and Clinical Implications, Infezioni in Medicina (2021)
Experts (# of related papers)
View all Related Experts
Ramin Sami (12)
Marjan Mansourian (8)
Other Related Docs
9. The Demographic, Clinical, and Medical Manifestations of Pulmonary Thromboembolism Development in Covid-19, Blood Research (2021)
10. A Review of Coronary Artery Thrombosis: A New Challenging Finding in Covid-19 Patients and St-Elevation Myocardial Infarction, Current Problems in Cardiology (2021)
11. New-Onset Acute Ischemic Stroke Following Covid-19: A Case-Control Study, Journal of Research in Medical Sciences (2022)
12. Bleeding Diathesis or Prothrombotic State, Which One Predict the Covid-19 Prognosis in Pregnancy?, Journal of Obstetrics, Gynecology and Cancer Research (2021)
13. Covid-19 Pneumonia and Pulmonary Embolism: Presentation of Four Cases, Indian Journal of Critical Care Medicine (2020)
14. The Pragmatic Role of Covid-19 on the Thrombus Grade of Patients With Contemporary St-Segment-Elevation Myocardial Infarction, Journal of Tehran University Heart Center (2022)
15. Continuous Infusion Versus Intermittent Intravenous Heparin Injection Effect on Coagulation State After Peripheral Vascular Surgery, Journal of Isfahan Medical School (2011)
16. Infliximab and Intravenous Gammaglobulin in Hospitalized Severe Covid-19 Patients in Intensive Care Unit, Archives of Iranian Medicine (2021)
17. Risk Factors for the Mortality in Hospitalized Patients With Covid-19: A Brief Report, Iranian Journal of Medical Sciences (2021)
18. Favipiravir in the Treatment of Outpatient Covid-19: A Multicenter, Randomized, Triple-Blind, Placebo-Controlled Clinical Trial, Advances in Respiratory Medicine (2023)
19. Rehabilitation, a Necessity in Hospitalized and Discharged People Infected With Covid-19: A Narrative Review, Physical Therapy Reviews (2021)
20. The Frequency of Antithrombotic Therapy in Management of Non-Valvular Atrial Fibrillation in Hospitalized Patients, Journal of Isfahan Medical School (2023)
21. Catastrophic Retroperitoneal Hemorrhage in Covid-19 Patients Under Anticoagulant Prophylaxis, Urology Case Reports (2021)
22. Efficacy and Safety of Apixaban for the Prevention of Thrombosis in Arteriovenous Grafts, European Journal of Translational Myology (2024)
23. Potential Factors Related to Post-Covid-19 Persistent Symptoms; Khorshid Covid Cohort Study, Immunopathologia Persa (2023)
24. Long-Term Clinical Outcomes of the Left Ventricular Thrombus in Patients With St Elevation Anterior Myocardial Infarction, ARYA Atherosclerosis (2015)
25. The Prediction Role of D-Dimer in Recurrence of Venous Thromboembolism 1-Year After Anticoagulation Discontinuing Following Idiopathic Deep Vein Thrombosis, Journal of Research in Medical Sciences (2014)
26. Anticoagulant Therapy for Ischemic Stroke: A Review of Literature, Journal of Research in Medical Sciences (2012)
27. Covid-19-Associated Thrombotic Thrombocytopenic Purpura (Ttp); a Case Report, Journal of Nephropharmacology (2023)
28. Comparison of Survival Rate and Complications of Percutaneous Coronary Intervention, Coronary Artery Bypass Graft, and Medical Treatment in Patients With Left Main And/Or Three Vessel Diseases, ARYA Atherosclerosis (2020)
29. A Study on the Effect of Aspirin on Clinical Symptoms, Laboratory Indices, and Outcomes in Patients With Covid-19, Journal of Nephropharmacology (2023)
30. Electrolyte Abnormalities in Hospitalized Covid-19 Patients at Tertiary Referral Centers in Tehran: Hypermagnesemia As a Marker of Fatality: A Retrospective Cross-Sectional Study, Health Science Reports (2023)
31. Assessment of Lytic Therapy Effect in Patients With Intermediate-High Risk Pulmonary Embolism for Prevention of Chronic Thromboembolic Pulmonary Hypertension: A Randomized, Double-Blind Trial, Health Science Reports (2024)
32. Risk Factors for In-Hospital Mortality Among Patients With Coronavirus-19 in Isfahan City, Iran, Advanced Biomedical Research (2022)
33. Case Report: Barotrauma in Covid-19 Case Series, American Journal of Tropical Medicine and Hygiene (2021)
34. Outcomes of Cerebral Venous Thrombosis Due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase, Stroke (2022)
35. The Severity of Symptoms and Outcomes of Patients Admitted With Rheumatic Diseases and Covid-19; a Prospective Cohort Study in Iran, Immunopathologia Persa (2021)
36. Association Between Clinical Characteristics and Laboratory Findings With Outcome of Hospitalized Covid-19 Patients: A Report From Northeast Iran, Interdisciplinary Perspectives on Infectious Diseases (2021)
37. Covid-19 Management in the Emergency Ward, Journal of Research in Medical Sciences (2021)
38. Baseline Socioeconomic Status Predicting Post-Covid-19 Symptoms: Results From Isfahan Covid Cohort (Icc) Study, Preventive Medicine Reports (2024)
39. Covid-19, an Early Investigation From Exposure to Treatment Outcomes in Tehran, Iran, Journal of Research in Medical Sciences (2021)
40. Covid-19 Infection Risk Following Elective Arthroplasty and Surgical Complications in Covid-19-Vaccinated Patients: A Multicenter Comparative Cohort Study, Arthroplasty Today (2022)
41. Evaluation of the Association Between Antiphospholipid Antibodies and Icu Admission Outcome in Critically Ill Covid-19 Patients in Iranian Population, International Journal of Preventive Medicine (2022)
42. The Clinical Manifestation and Outcome of Covid-19 in Patients With a History of Ischemic Heart Disease; a Retrospective Case-Control Study, BMC Cardiovascular Disorders (2023)
43. Efficacy of Hydroxychloroquine in Pre-Exposure Severe Acute Respiratory Syndrome Coronavirus 2 Prophylaxis Among High-Risk Healthcare Workers: A Multicenter Study, Advanced Biomedical Research (2023)
44. Efficacy of Plasmapheresis in Neutropenic Patients Suffering From Cytokine Storm Because of Severe Covid-19 Infection, Blood Research (2023)
45. The Role of Manual Thrombectomy in Cardiovascular Outcome Among Patients With Total Cutoff Vessel Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention, ARYA Atherosclerosis (2017)
46. Cerebral Venous Sinus Thrombosis Associated With Sars-Cov-2; a Multinational Case Series, Journal of the Neurological Sciences (2020)
47. Evaluation of Rivaroxaban Versus Warfarin for the Treatment of Cerebral Vein Thrombosis: A Case-Control Blinded Study, Current Journal of Neurology (2021)
48. Isfahan Covid Cohort Study: Rationale, Methodology, and Initial Results, Journal of Research in Medical Sciences (2022)
49. Thalidomide for the Treatment of Covid-19 Pneumonia: A Randomized Controlled Clinical Trial, Advanced Biomedical Research (2023)
50. The Assessment of No-Reflow Phenomenon Incidence in Early Versus Delayed Percutaneous Coronary Intervention Following a Primary Fibrinolysis, ARYA Atherosclerosis (2024)