In this section : Covid-19
Molnupiravir
Sotrovimab
Conscious Proning
Covid-19 Basics
Remdesivir
Thromboprophylaxis
Identifying Patients in the Highest Risk Groups
Steroids for Patients with Covid-19 Infection
IL-6 Inhibitors – Tocilizumab or Sarilumab
Baricitinib
Paxlovid (Nirmatrelvir/Ritonavir)
Covid-19 Sick Day Rules for Patients with Primary Adrenal Insufficiency
Thromboprophylaxis
Last updated 26th June 2023
Please ensure you have read the information on the Covid-19 Basics page before proceeding.
Advice for Hospital Inpatients with COVID-19 Pneumonia
- If already on anticoagulant, continue unless contraindicated. Consider switch to LMWH if clinically worsening.
- If not already on anticoagulant, prescribe appropriate thromboprophylaxis:
- Prescribe prophylactic dose LWMH see handbook page on LMWH for at least 7 days or until discharge if longer.
- If signs or symptoms of thrombosis, consider treatment dose LMWH while awaiting investigations – see handbook page on LMWH
- Consider withholding on HEPMA if likely to have invasive procedure within next few hours.
Abnormal Clotting
- Discuss with haematology if any of:
- Platelets <50×109/L
- PT or APTT >2s above normal range
- Fibrinogen <1.0 g/L
- Patient may need blood product support or dose adjustment of thromboprophylaxis
Bleeding Risk
- Discuss patients with a bleeding risk with a senior physician before prescribing thromboprophylaxis:
- Underlying inherited or acquired bleeding disorder
- Recent stroke (previous 3 months)
- Alcohol excess
- Advanced liver disease or known portal hypertension
- Recent neuro or ophthalmic surgery or significant trauma
- Hypertension (>230mmHg systolic and/or >120mmgHg diastolic)
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Content by Alison Moore