Clinical Pathways and Documentation
During the early stages of the pandemic, the HOMERuN Collaborative VTE Working Group developed key clinical questions. Many of these questions have subsequently been addressed by ongoing studies and may no longer be of central importance. We have archived these key clinical questions here for reference.
Click on the questions below for more information:
Summary of Key Takeaways, Gaps, and Future Directions
The working group reviewed international society guidelines, as well as protocols from HOMERuN institutions to develop this topic summary. Our review of guidance and protocols revealed several takeaways. There was general agreement that inpatients with COVID-19 should receive pharmacologic VTE prophylaxis (with LWMH or UFH) unless they have contraindications. There remains variability in the recommendations for which patients should be considered high-risk for VTE and the indications for escalated pharmacologic prophylaxis dosing or post-discharge pharmacologic prophylaxis. How elevated D-dimer should affect management decisions such as VTE prophylaxis or treatment also remains unclear. The best strategy to diagnose VTE, as well as indications for empiric therapeutic anticoagulation for VTE, also have not been definitively determined. These questions and many others remain an area of active ongoing research, with new data emerging rapidly, to address this area of great clinical importance and clear unmet need.