ISTH Antithrombotic Treatment in COVID-19 Guideline Summary

Recommendations

3.1 Antithrombotic therapy for non-hospitalized patients

In non-hospitalized patients with symptomatic COVID-19, initiation of antiplatelet therapy is not effective to reduce risk of hospitalization, arterial or venous thrombosis, or mortality. (III - No Benefit, B-R)

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In non-hospitalized patients with symptomatic COVID-19, initiation of direct oral anticoagulant (DOAC) therapy is not effective to reduce risk of hospitalization, arterial or venous thrombosis, or mortality. (III - No Benefit, B-R)

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In non-hospitalized patients with COVID-19 at higher risk of disease progression, initiation of oral sulodexide therapy within 3 days of symptom onset may be considered to reduce risk of hospitalization. (IIb, B-R)

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Tables and Figures

TABLE 1. Dose levels of the anticoagulants used in the studies cited in the guideline

Drug	Prophylactic	Intermediate	Therapeutic
UFH	000 U SQ BID or TID	7500 U SQ BID or TID	Intravenous, adjusted to APTT or anti-Xa
LMWH	Enoxaparin 40 mg SQ QD, dalteparin 5000 IU SQ QD, tinzaparin 4500 IU SQ QD, bemiparin 3500 IU SQ QD	Enoxaparin 40 mg SQ BID or 80 mg SQ QD, or 0.5 mg/kg SQ QD	Enoxaparin 1 mg/kg SQ BID, dalteparin 200 IU/kg SQ QD, tinzaparin 175 IU/kg SQ QD, bemiparin 115 IU/kg SQ QD
DOAC	Rivaroxaban 10 mg PO QD, apixaban 2.5 mg PO BID	Not applicable	Rivaroxaban 20 mg PO QD, apixaban 5 mg PO BID

Overview

Title

Antithrombotic Treatment in COVID-19