Chinese and foreign guidelines jointly recommend that anticoagulation should be the basic treatment for hospitalized patients with new crowns

*For medical professionals only

Domestic and foreign guidelines jointly recommend that hospitalized patients with new crown with low bleeding risk should receive routine anticoagulation therapy to prevent venous thrombosis
.

Since the optimization and adjustment of epidemic prevention and control policies in early December 2022, the epidemic situation in various parts of China is generally in a stage of rapid rise
.
At present, most provinces and cities in the country are passing the peak of infection, and the number of severe cases related to the new coronavirus infection (COVID-19) continues to increase, and the task of medical treatment is facing great challenges
.

It is worth noting that COVID-19 has been widely found in clinical practice to increase the risk of thrombosis and arterial embolic events, and the higher the risk of thrombosis, some of these patients will even die suddenly due to secondary thrombosis during the progression of the disease, so thrombosis prevention and treatment of COVID-19 patients is urgent ^[1-2].

How to consider the new crown antithrombotic treatment plan?

See a collection of Chinese and foreign guides

In view of the fact that thrombotic events directly affect the prognosis of COVID-19 patients ^[3], 43 guidelines, consensus and expert recommendations have been issued by many academic societies at home and abroad in the past three years to help standardize the management of thrombosis in COVID-19 patients.

Here we summarize the relevant recommendations of Chinese and foreign authoritative guidelines/consensus on thromboprevention strategies for COVID-19 patients for your reference
.

Table 1 Recommended guidelines for domestic and foreign countries

Therefore, during the 3-year epidemic prevention and control period, the clinical information related to thromboprophylaxis in COVID-19 patients has been constantly updated and changed, but domestic and foreign guidelines still recommend that hospitalized patients with COVID-19 should receive anticoagulant therapy, among which low molecular weight heparin as the cornerstone of anticoagulant drugs has been recommended
by all guidelines.

summary

COVID-19 patients often have abnormal coagulation function, resulting in hypercoagulable blood and prone to secondary thrombosis and thromboembolic events, and the current authoritative guidelines at home and abroad emphasize the need to strengthen the management of
venous thrombosis in COVID-19 patients.
Enoxaparin is currently the most commonly used low molecular weight heparin in clinical practice, and it is also the only anticoagulant in China with indications for internal medicine venous thromboprophylaxis, which shows good advantages in meeting the current needs of thrombosis prevention and treatment, and provides a suitable drug choice
for optimizing clinical anticoagulation prevention strategies.

References:

[1] Huang C, Wang Y, Li X, et al.
Clinical features of patients infected with 2019 novel coronavirus in Wuhan , China[J].
The Lancet, 2020, 6736(20): 1-10.

[2] Chen N, Zhou M, Dong X, et al.
Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study[J].
The Lancet, 2020, 6736(20): 1-7.

[3] Zhang Li,Feng Xiaokai,Zhang Danqing et al.
Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome.
[J] .
Circulation, 2020, 142: 114-128.

[4] Kyriakoulis Konstantinos G,Dimakakos Evangelos,Kyriakoulis Ioannis G et al.
Practical Recommendations for Optimal Thromboprophylaxis in Patients with COVID-19: A Consensus Statement Based on Available Clinical Trials.
[J] .
J Clin Med, 2022, 11.

[5] Lisa K.
et al.
Thromboprophylaxis in Patients With COVID-19 A Brief Update to the CHEST Guideline and Expert Panel Report.
CHEST 2022; 162(1):213-225.

[6] Schulman Sam,Sholzberg Michelle,Spyropoulos Alex C et al.
"ISTH guidelines for antithrombotic treatment in COVID-19": Reply.
[J] .
J Thromb Haemost, 2022, 20: 2710-2711.

[7] Barnes Geoffrey D,Burnett Allison,Allen Arthur et al.
Thromboembolic prevention and anticoagulant therapy during the COVID-19 pandemic: updated clinical guidance from the anticoagulation forum.
[J] .
J Thromb Thrombolysis, 2022, 54: 197-210.

[8] Coronavirus Infec on in Pregnancy - The Royal College of Obstetricians and Gynaecologists (RCOG) 2022.

[9] London: National Institute for Health and Care Excellence (NICE), 2020.

[10] Cuker Adam,Tseng Eric K,Ni.
euwlaat Robby et al.
American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: January 2022 update on the use of therapeutic-intensity anticoagulation in acutely ill patients.
[J] .
Blood Adv, 2022, 6: 4915-4923.

[11] Pulmonary Embolism and Pulmonary Vascular Disease Group, Respiratory Disease Branch of Chinese Medical Association, Pulmonary Embolism and Pulmonary Vascular Disease Working Committee of Respiratory Physician Branch of Chinese Medical Doctor Association, National Collaborative Group for Prevention and Treatment of Pulmonary Embolism and Pulmonary Vascular Disease, etc.
Recommendations for the prevention and treatment of venous thromboembolism related to novel coronavirus pneumonia (trial)[J].
Chinese Medical Journal,2020,100(11):808-813.