Clinical Guidance of Prevention of Venous Thromboembolism in COVID-19

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  • Mo Makoto
    Japanese Society of Phlebology, Taskforce of VTE and COVID-19 in Japan Study Japanese Society of Pulmonary Embolism Research Department of Cardiovascular Surgery, Yokohama Minami Kyosai Hospital
  • Yamada Norikazu
    Japanese Society of Phlebology, Taskforce of VTE and COVID-19 in Japan Study Japanese Society of Pulmonary Embolism Research Department of Cardiovascular Medicine, Kuwana City Medical Center
  • Yamashita Yugo
    Japanese Society of Phlebology, Taskforce of VTE and COVID-19 in Japan Study Japanese Society of Pulmonary Embolism Research Department of Cardiovascular Medicine, Kyoto University Hospital
  • Kobayashi Takao
    Japanese Society of Pulmonary Embolism Research Hamamatsu Medical Center

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  • 新型コロナウイルス感染症（COVID-19）における静脈血栓塞栓症予防の診療指針2021年4月5日版（Version 2.0）

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Abstract

<p>The COVID-19 is frequently associated with thrombosis, mainly venous thromboembolism (VTE). Therefore, based on the questionnaire survey in Japan, we revised the Clinical Guidance of Prevention of Venous Thromboembolism in COVID-19 VTE preventive medical care guidelines for COVID-19 and propose preventive methods with reference to the medical care guides and other guidelines. “Mild disease”: Basically, anticoagulant therapy is not required and physical therapy (ambulation, lower limb exercise, elastic stockings) is the main focus. Physical therapy is the basis of VTE prevention. “Moderate disease I” (shortness of breath, pneumonia findings): Anticoagulant therapy is not required, and physical therapy (including intermittent pneumatic compression) is the main focus. “Moderate disease II” (requires oxygen administration): Consider the use of low-dose unfractionated heparin, which is a prophylactic dose. No dose adjustment by APTT measurement is required. Concomitant physical therapy during anticoagulant therapy is not mandatory. “Severe disease” (ICU management or mechanical ventilation): Administer unfractionated heparin. The dose should be a preventive dose in consideration of the risk of bleeding. Conduct continuous monitoring of D-dimer.</p><p>This guideline will be revised in the future.</p>

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