The COVID-19 subcommittee of the American Venous Forum (AVF) has issued a white paper on considerations in prophylaxis and treatment of venous thromboembolism (VTE) in COVID-19 patients.
Jeffrey Mendola, director of Mission Advancement at the AVF, emphasises the importance of this document: “VTE and COVID-19 is probably the most critical aspect of the virus that is not receiving a lot of exposure.”
The paper comprises a set of question responses representing the opinion of a group of venous specialists who have reviewed the available evidence and have communicated with specialists in high volume sites in the USA and internationally.
In the opinion of these specialists, these responses represent “the best available responses based on current knowledge”.
The document acknowledges: “Some areas are controversial and best patient management depends on individual patient situations. We have attempted to highlight these areas and provide the evidence available in the literature summary/references.”
The white paper addresses the following questions:
- Is VTE risk assessment using one of the risk models (i.e. Caprini) necessary in admitted patients with COVID-19?
- What haematologic laboratory tests should be obtained in patients with COVID-19?
- What should we use as prophylaxis in patients with COVID-19 at risk for VTE?
- When should venous duplex be performed in patients with COVID-19?
- If venous duplex is required, what type of test is needed and how should it be performed?
- Which patients with COVID-19 should be considered for therapeutic anticoagulation?
- What anticoagulants and dosages are recommended for VTE treatment in COVID-19 patients?
- What to do with patients after discharge?
The AVF note that they will attempt to update the document frequently as new information becomes available.