Zhu Zhang1,2,3, Linfeng Xi1,2,3,4, Shuai Zhang1,2,3, Yunxia Zhang1,2,3, Wenyi Pang1,2,3,5, Yimin Wang1,2,3, Chenghong Li6, Zhenguo Zhai1,2,3, Chen Wang1,2,3,5. 1. Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital. 2. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences. 3. National Clinical Research Center for Respiratory Diseases. 4. Capital Medical University. 5. Chinese Academy of Medical Sciences, Peking Union Medical College. 6. Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University.
Abstract
AIM: Patients with acute infectious diseases are at an increased risk of venous thromboembolism (VTE). Clinicians should be aware of the VTE risk in patients with COVID-19, many of whom present with severe coagulation disorders. METHOD: We used an online platform to conduct a cross-sectional questionnaire survey among doctors in mainland China in March 2020. The questionnaire was designed to figure out the clinician's current awareness of VTE prevention and detection rates, as well as the current status of VTE prophylaxis in patients with COVID-19. RESULTS: We collected 1,636 replies, of which 1,579 were valid. Among these, 991 (63%) clinicians were involved directly in frontline treatment. Most of the clinicians (1,492, or 94%) thought it was necessary to assess the VTE risk in patients with COVID-19. However, only 234 (24%) clinicians performed appropriate assessment during the COVID-19 outbreak. For patients with mild/moderate COVID-19, 752 (76%) clinicians would prescribe exercise and water to prevent VTE. For patients with severe COVID-19, 448 (45%) clinicians would prescribe mechanical devices if the patient had a high bleeding risk, and 648 (65%) clinicians would choose LMWH as prophylaxis if the patient had a low bleeding risk. The VTE detection rate was not that high in both mild/moderate and severe patients. CONCLUSION: Although most clinicians recommended prescribing VTE prophylaxis to patients with COVID-19, the practice still needs to be improved. A real-world registry to investigate the true incidence of VTE, and the effect of prescribing appropriate prophylaxis for patients with COVID-19, is necessary in the future.
AIM: Patients with acute infectious diseases are at an increased risk of venous thromboembolism (VTE). Clinicians should be aware of the VTE risk in patients with COVID-19, many of whom present with severe coagulation disorders. METHOD: We used an online platform to conduct a cross-sectional questionnaire survey among doctors in mainland China in March 2020. The questionnaire was designed to figure out the clinician's current awareness of VTE prevention and detection rates, as well as the current status of VTE prophylaxis in patients with COVID-19. RESULTS: We collected 1,636 replies, of which 1,579 were valid. Among these, 991 (63%) clinicians were involved directly in frontline treatment. Most of the clinicians (1,492, or 94%) thought it was necessary to assess the VTE risk in patients with COVID-19. However, only 234 (24%) clinicians performed appropriate assessment during the COVID-19 outbreak. For patients with mild/moderate COVID-19, 752 (76%) clinicians would prescribe exercise and water to prevent VTE. For patients with severe COVID-19, 448 (45%) clinicians would prescribe mechanical devices if the patient had a high bleeding risk, and 648 (65%) clinicians would choose LMWH as prophylaxis if the patient had a low bleeding risk. The VTE detection rate was not that high in both mild/moderate and severe patients. CONCLUSION: Although most clinicians recommended prescribing VTE prophylaxis to patients with COVID-19, the practice still needs to be improved. A real-world registry to investigate the true incidence of VTE, and the effect of prescribing appropriate prophylaxis for patients with COVID-19, is necessary in the future.
Authors: Dominique Farge; Henri Bounameaux; Benjamin Brenner; Francis Cajfinger; Philippe Debourdeau; Alok A Khorana; Ingrid Pabinger; Susan Solymoss; James Douketis; Ajay Kakkar Journal: Lancet Oncol Date: 2016-10 Impact factor: 41.316
Authors: Dominic Wichmann; Jan-Peter Sperhake; Marc Lütgehetmann; Stefan Steurer; Carolin Edler; Axel Heinemann; Fabian Heinrich; Herbert Mushumba; Inga Kniep; Ann Sophie Schröder; Christoph Burdelski; Geraldine de Heer; Axel Nierhaus; Daniel Frings; Susanne Pfefferle; Heinrich Becker; Hanns Bredereke-Wiedling; Andreas de Weerth; Hans-Richard Paschen; Sara Sheikhzadeh-Eggers; Axel Stang; Stefan Schmiedel; Carsten Bokemeyer; Marylyn M Addo; Martin Aepfelbacher; Klaus Püschel; Stefan Kluge Journal: Ann Intern Med Date: 2020-05-06 Impact factor: 25.391