COVID-19 thromboprophylaxis: New evidences

Autores de IIS La Fe

• Raquel Ferrandis Comes

  Autor

Participantes ajenos a IIS La Fe

• Sierra, P.
• Gomez-Luque, A.

Grupos

• Anestesia y Cuidados Críticos

  Investigador Principal

  María Azucena Pajares Moncho

• Medicina Perioperatoria, Anestesiología y Reanimación

  

  Leader

  Óscar Díaz Cambronero

Abstract

Recent publications have questioned the efficacy of using therapeutic or intermediate doses of low molecular weight heparin (LMWH) in COVID-19 patients, especially in the most severe patients. In order to update these recommendations, a non-systematic review has been carried out in the main medical databases. A total of 14 randomized clinical trials, 14 metaanalyses and the recommendations of 12 scientific societies were selected, stratified according to the type of patient (outpatient, hospitalized, admitted to critical care or post -discharge). The efficacy of LMWH and other therapeutic approaches (rivaroxaban, apixaban, sulodexide, acetylsalicylic acid and P2Y12 inhibitors) has been analyzed. The findings recommend using standard doses of LMWH as thromboprophylaxis in critically hospitalized COVID-19 patients and therapeutic doses in non-critically hospitalized patients with low bleeding risk. In outpatients and those discharged from the hospital, LMWH could be used at a prophylactic dose if there are thrombotic risk factors, and the bleeding risk is low. It is not recommended to associate antiplatelet agents with LMWH unless previously indicated. (c) 2023 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor.

Keywords

• COVID-19; Thromboprophylaxis; Low molecular weight heparin