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April 17, 2020

AVF Issues White Paper on Considerations in Prophylaxis and Treatment of VTE in COVID-19 Patients

April 17, 2020—The COVID-19 subcommittee of the American Venous Forum (AVF) has produced a white paper on the considerations in prophylaxis and treatment of venous thromboembolism (VTE) in COVID-19 patients.

As stated in the document, these considerations are formed from responses to questions posed to a group of venous specialists who have reviewed the currently available evidence and have communicated with specialists in high-volume centers in the United States and internationally.

The best available responses of these specialists were formed in the rapidly COVID-19 pandemic in which there is usually insufficient evidence available to make true practice guidelines. Some areas are controversial, and best patient management depends on individual patient situations. The paper highlights these areas and provides the evidence that is available in the literature summary/references.

The document advises that patients under investigation for COVID-19 due to suggestive signs/symptoms should generally be treated as COVID-19 positive until testing results are received.

The paper addresses the following areas of managing patients admitted with COVID-19:

  • The necessity of VTE risk assessment using one of the risk models (ie, Caprini)
  • Obtaining hematologic laboratory tests
  • Using prophylaxis in patients at risk for VTE
  • Performing venous duplex
  • Considering therapeutic anticoagulation
  • Recommending anticoagulants and dosages for VTE treatment
  • Discharging patients, follow-up visits, and use of anticoagulants in outpatients

AVF noted that the paper represents opinions and should not be considered informed practice guidelines. AVF will attempt to update this document frequently as new information becomes available. Any questions or comments may be sent to COVID-19@veinforum.com.

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