ANTICOAGULATION FOR COVID-19: ROLE OF ANTICOAGULATION THERAPY IN THROMBOTIC COMPLICATIONS IN COVID-19 PATIENTS

Objective: COVID-19 patients are more likely to experience thrombotic issues, which has generated an intense debate on how to manage their anticoagulation.The objective of this study was to examine the clinical outcomes of anticoagulant medication in thrombotic events in patients hospitalized with COVID-19. Method:The study was a cross sectional prospective study conducted on patients with confirmed COVID-19. The subjects were divided into 2 groups based on severity of COVID-19. All the parameters and outcomes were compared between the groups, effect and use of anticoagulation was studied. Results:The results revealed increased D-dimer was reported in all the cases. The thrombotic events reported were pulmonary embolism in 33.3% subjects, deep vein thrombosis in 21.4% subjects, stroke in 32.1% subjects and myocardial infarction in 16.7% subjects. The anticoagulation management used was unfractionated heparin, low molecular weight heparin enoxaparin, direct oral anticoagulants and dalteparin during hospitalization whereas apixaban, clopidogrel and rivaroxaban was used as discharge medication for maintenance. Conclusion:Anticoagulation appears to have a dose-dependent effect because there is a stepwise rise in the survival benefit seen with prophylactic regimens and a brief course of therapeutic anticoagulation compared to no anticoagulation. There is less evidence to support the empirical treatment of microthrombi than there is to support its use in the treatment of macrovascular events.