COVID-19 and Venous Thromboembolism Pharmacologic Thromboprophylaxis.

Abstract

Coagulopathy has emerged as a hallmark issue of the coronavirus 2019 (COVID-19). Medical facilities are faced with the challenge of developing institutional thromboprophylaxis protocols; however, due to the novelty of the disease, there is a dearth of high-quality, prospective evidence for decision making. The US National Institutes of Health along with 4 leading societies in the fields of thrombosis and hemostasis have published guidance based on expert consensus that helps provide a framework for local policy development. While there is agreement in a few areas, there are notable and sometimes considerable differences in recommendations that facilities should discuss when developing local guidance. This document aims to streamline and simplify the available guidance so health care providers can readily identify consensus and divergence of COVID-19 thromboprophylaxis recommendations. Additionally, the authors provide and briefly highlight the COVID-19 thromboprophylaxis protocol of the US Department of Veterans Affairs Tennessee Valley Healthcare System in Nashville and Murfreesboro to serve as an example of a guideline-directed approach for order-set development.