With input from Dr Monica Vasudev

1181: Thrombosis in COVID-19

1. The risk of arterial and venous thrombosis in patients with COVID-19 is a major issue.
2. One has to be proactive about prevention.
3. It is increasingly being recognized that there is a heightened risk of thrombosis in COVID-19 patients.
4. The risk appears to be the greatest in patients in the intensive care unit (ICU), though it is also increased in patients hospitalized with COVID-19, not in ICU.
5. The risk is in non-hospitalized COVID-19 patients is not known, but is much lower than hospitalized patients.
6. Every patient hospitalized with COVID-19 may receive some type of thromboprophylaxis. This would mainly be with anticoagulation.
7. A recent US registry study reported thrombotic complication rates of 2.6% in noncritically ill hospitalized patients with COVID-19 and 35.3% in critically ill patients.
8. The ACCP guidelines are conservative and follow the evidence base for medical patients. The ISTH guidelines, being more aggressive, recommend increased levels of anticoagulation in both ICU and hospitalized non-ICU patients and also extend prophylaxis following discharge.

[Medscape]

1182: At present, neither the ISTH nor ACCP recommend D-dimer measurement to screen for venous thromboembolism or for evaluating intensity of prophylaxis or treatment. [Medscape]]

1183: The European Medicines Agency (EMA) stated that it received applications for conditional marketing authorization for COVID-19 vaccines BNT162b2 and mRNA-1273.  According to the EMA, the assessments of BNT162b2 and mRNA-1273 will "proceed under an accelerated timeline," and the opinions on approval could be issued within weeks, based on whether the data are robust enough and complete to demonstrate the quality, safety and effectiveness of the vaccine.

1184: U.S. donor blood collected in December and early January tested positive for SARS-CoV-2 antibodies, thus pointing to an earlier arrival of SARS-CoV-2 infection than previously thought. (NPR)

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA