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Antithrombotic therapy in patients with COVID-19: indications, pharmacotherapy and controversy

David Wang, Christopher Leo, Liping Liu, Li Huang, Lisa Huang, Yun Lu
DOI: 10.1136/svn-2023-002321 Published 16 February 2023
David Wang
1Department of Neurology, Petznick Stroke Center, Barrow Neurological Institute, Phoenix, Arizona, USA
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Christopher Leo
2Department of Medicine/Division of General Internal Medicine/Hospital Medicine, Duke University, Durham, North Carolina, USA
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Liping Liu
3Neurosurgical Intensive Care Unit (NICU), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
4China National Clinical Research Center for Neurological Diseases, Beijing, China
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Li Huang
5Doctors Medical Center, Modesto, California, USA
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Lisa Huang
6Chesapeake Regional Medical Center, Chesapeake, Virginia, USA
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Yun Lu
7Hennepin Healthcare System and the University of Minnesota, Minneapolis, Minnesota, USA
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Article Figures & Data

Tables

  • Table 1

    Wells’ score and criteria for DVT and PE

    Wells’ score for DVT
    Clinical characteristicsScore
    Active cancer receiving cancer treatment within the past 6 months or currently under palliative care1
    Paralysis, paresis or recent cast immobilisation of the lower extremities1
    Recently bedridden for >3 days, or major surgery within the past 3 months1
    Localised tenderness along the distribution of deep venous systems1
    Entire leg swelling1
    Calf swelling at 3 cm larger than that on the asymptomatic side (measure 10 cm below tibial tuberosity)1
    Pitting oedema confined to the symptomatic leg1
    Collateral superficial veins1
    Previously diagnosed DVT1
    Alternative diagnosis at least as likely as DVT−2
    Wells scoring system for DVT: −2 to 0: low probability; 1–2 points: Moderate probability; 3–8 points: high probability.
    Wells’ score for PE
    CriteriaPoints
    Clinical signs of symptoms of VTE3
    No alternative diagnosis3
    Heart rate >100 beat/min1.5
    Immobilisation >3 days or surgery in past 4 weeks1.5
    Previous history of PE or VTE1.5
    Haemoptysis1
    Malignancy with active treatment in past 6 months or palliative care1
    Wells scoring system for PE: <2 points: low probability; 2–6 points: moderate probability; >6 points: high probability
    • DVT, deep vein thrombosis; PE, pulmonary embolism; VTE, venous thromboembolism.

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Stroke and Vascular Neurology: 10 (1)
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Antithrombotic therapy in patients with COVID-19: indications, pharmacotherapy and controversy
David Wang, Christopher Leo, Liping Liu, Li Huang, Lisa Huang, Yun Lu
Stroke and Vascular Neurology Feb 2023, svn-2023-002321; DOI: 10.1136/svn-2023-002321

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Antithrombotic therapy in patients with COVID-19: indications, pharmacotherapy and controversy
David Wang, Christopher Leo, Liping Liu, Li Huang, Lisa Huang, Yun Lu
Stroke and Vascular Neurology Feb 2023, svn-2023-002321; DOI: 10.1136/svn-2023-002321
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Antithrombotic therapy in patients with COVID-19: indications, pharmacotherapy and controversy
David Wang, Christopher Leo, Liping Liu, Li Huang, Lisa Huang, Yun Lu
Stroke and Vascular Neurology Feb 2023, svn-2023-002321; DOI: 10.1136/svn-2023-002321
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    • Stratification of thromboembolic risk for patients with COVID-19 infection
    • Monitoring of coagulation parameters in patients with COVID-19 infection
    • Prophylaxis and treatment of thromboembolism in patients with COVID-19
    • COVID-19 infection and thromboembolism of the central nervous system
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