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Effectiveness of antithrombotic prophylaxis in hospitalised patients with SARS-CoV-2 infection
  1. Helena Quiros Ambel1,
  2. Paloma Crespo-Robledo1,
  3. Karmele Arribalzaga Juaristi2,
  4. Isabel Plo-Seco1,
  5. Jose Javier Martínez Simón1,
  6. Elia Pérez Fernández3,
  7. Monserrat Perez Encinas1
  1. 1Pharmacy, Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain
  2. 2Hematology, Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain
  3. 3Biostatistics, Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain
  1. Correspondence to Dr Helena Quiros Ambel, Pharmacy, Hospital Universitario Fundacion Alcorcon, Alcorcon 28922, Spain; quiros.helena{at}gmail.com

Abstract

Background Antithrombotic prophylaxis in hospitalised patients with SARS-CoV-2 acute infection has increased. Currently, most of the evidence relates to patients in intensive care units; however, there is little information on patients admitted to hospital wards and there is no consensus protocol on thromboprophylaxis during admission and after discharge.

Objective To assess the effectiveness of antithrombotic prophylaxis in patients admitted with COVID-19 and 30 days after discharge.

Method A prospective observational study was conducted of patients admitted with COVID-19 in which the hospital thromboprophylaxis protocol was applied, classifying the patients as having a standard or high risk of thrombosis. Pharmacists performed a daily follow-up and actively intervened during admission and at discharge. The main outcome measure was the global incidence of symptomatic venous thromboembolism (VTE) related to hospitalisation.

Results A total of 113 patients were included, 98.23% of whom were admitted to a hospital ward. The incidence of hospital-acquired VTE was 1.77%. In 75.22% of the subjects, thromboprophylaxis was adjusted to the protocol during admission. A total of 23 pharmaceutical interventions were conducted, with an adherence of 52.17%. At discharge, 94.28% of the patients who had no haemorrhage and ≥4 points on the Padua Prediction Score required thromboprophylaxis, aligning with the protocol. The global incidence of haemorrhagic events during the follow-up period was 0.88%.

Conclusion The incidence of hospital-acquired VTE was lower than that described in the literature. Although it cannot be certain that it is directly related to the instituted protocol, the data can show that the management of prevention of VTE is being optimally performed at the hospital. Long-term studies are needed to evaluate the incidence after discharge, as well as to agree on a specific protocol in the COVID-19 population for the prevention of these events during hospitalisation and post-discharge.

  • thromboembolism
  • anticoagulants
  • COVID-19
  • pharmacy service
  • hospital
  • drug-related side effects and adverse reactions

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

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