High-risk COVID-19 patients discharged from the hospital may benefit from post-acute anticoagulation therapy to reduce the likelihood of blood clots, the results of a new study suggest.
It is well-known that COVID-19 is associated with a high incidence of dangerous thrombotic events (blood clots), but the need for blood clot-reducing therapy after hospitalization has been unclear and has even provoked some controversy, wrote study lead Laila Poisson, Ph.D., of the Henry Ford Health System in Detroit.
To address the questions surrounding this issue, Poisson and colleagues conducted a cohort study involving more than 2,800 adult patients hospitalized with COVID-19. The results showed that hospitalized COVID-19 patients with a history of venous thromboembolism (VTE) — one type of blood clot — and certain levels of standardized blood clot risk measurements are more likely to experience new onset of VTE after discharge. In addition, patients who experienced arterial thromboembolism (arterial blood clots) after discharge were more likely to have a history of atherosclerotic cardiovascular disease, and therefore at high risk of such events.
But they also found that anticoagulation therapy delivered after discharge was associated with a reduced risk of VTE in all patients with COVID-19 requiring hospitalization. Because high-risk patients with COVID-19 were more likely to have venous blood clots after discharge when compared with other subpopulations, post-discharge anticoagulation therapy may be especially helpful in reducing these patients’ risk of these clots and associated adverse events, the authors theorized.
“Although extended thromboprophylaxis (anticoagulation therapy) in unselected patients with COVID-19 is not supported, these findings suggest that postdischarge anticoagulation may be considered for high-risk patients who have a history of venous thromboembolism, peak D-dimer level greater than 3 μg/mL, and predischarge C-reactive protein level greater than 10 mg/dL, if their bleeding risk is low,” they explained.
“Our findings may help inform the future policy of post-discharge anticoagulation for patients hospitalized with COVID-19,” they concluded.
Full findings were published in JAMA Network Open.
