Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Hospital Medicine


Dr. Tom Colletti




The emergence of Coronavirus-19 (COVID-19) sparked an epidemic across the globe and due to its novelty, there was initial obscurity surrounding many clinical questions. However, as more evidence was published, there appeared to be an increased risk of venous thromboembolism (VTE) with COVID-19. To mitigate the risk of VTE, clinicians use pharmacologic prophylaxis and most clinical guidelines support the use of VTE prophylaxis for patients admitted into the hospital with moderate to severe COVID-19. However, it was unclear if these patients should continue to receive VTE prophylaxis on hospital discharge.


The pathogenesis of COVID-19 could lead to a prothrombotic state and may lead to an increased prevalence of VTE, both as an inpatient and following discharge from the hospital. Clinical guidelines from several societies suggest that certain patient populations could benefit from extended prophylaxis, but this requires an individualized approach. Further, there is an evidence-based, validated risk assessment model, IMPROVEDD, that has been used to assess an individual’s risk of VTE on discharge.

Conclusions and Relevance

Clinicians should familiarize themselves with the latest clinical guidelines surrounding the risks and benefits of extended VTE prophylaxis on hospital discharge. There are validated risk assessment models that can aid in this decision, namely the IMPROVEDD score. Further research is needed to help identify the population that would benefit from extended VTE prophylaxis on hospital discharge.


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