Anticoagulation in Hospitalized Patients with Covid-19

This interactive feature presents a case-based discussion exploring anticoagulation strategies for a 78-year-old man hospitalized with worsening Covid-19. The case includes elevated D-dimer levels and increasing oxygen requirements without documented venous thromboembolism. Two expert viewpoints are presented: one advocating for continued prophylactic anticoagulation during hospitalization only, citing insufficient evidence for benefit from dose escalation and risks of bleeding; and another supporting escalation to intermediate-dose anticoagulation and post-discharge prophylaxis, referencing higher VTE risk in critically ill Covid-19 patients and retrospective data suggesting benefit. The piece highlights the ongoing uncertainty in optimal anticoagulation dosing for Covid-19, the importance of individualized decision-making, and the need for randomized controlled trial data.

This interactive feature presents a case-based discussion exploring anticoagulation strategies for a 78-year-old man hospitalized with worsening Covid-19. The case includes elevated D-dimer levels and increasing oxygen requirements without documented venous thromboembolism. Two expert viewpoints are presented: one advocating for continued prophylactic anticoagulation during hospitalization only, citing insufficient evidence for benefit from dose escalation and risks of bleeding; and another supporting escalation to intermediate-dose anticoagulation and post-discharge prophylaxis, referencing higher VTE risk in critically ill Covid-19 patients and retrospective data suggesting benefit. The piece highlights the ongoing uncertainty in optimal anticoagulation dosing for Covid-19, the importance of individualized decision-making, and the need for randomized controlled trial data.