Recommendations for research

We have made the following recommendations for research.

1 Standard-dose compared with intermediate-dose pharmacological VTE prophylaxis

What is the effectiveness and safety of standard-dose compared with intermediate‑dose pharmacological VTE prophylaxis for patients with COVID-19 pneumonia, with or without additional risk factors for VTE?

Suggested PICO (population, interventions, comparators, outcomes)

Population

Patients aged 16 and over being treated for COVID-19 pneumonia in hospital or the community who have:

  • no additional risk factors for VTE

  • additional risk factors for VTE

Interventions

Intermediate-dose:

  • LMWH

  • UFH

  • fondaparinux sodium

  • direct-acting anticoagulant

  • vitamin K antagonists

Comparators

Standard-dose:

  • LMWH

  • UFH

  • fondaparinux sodium

  • direct-acting anticoagulants

  • vitamin K antagonists

  • antiplatelets

Outcomes

  • incidence of VTE

  • mortality (all-cause, inpatient, COVID‑19 related)

  • admission to critical care (including use of advanced organ support)

  • serious adverse events such as major bleeding or admission to hospital

For a short explanation of why we made this recommendation see the rationale section on patients with COVID-19 pneumonia managed in hospital.

Full details of the evidence and the panel's discussion are in the evidence reviews.

For a short explanation of why we made this recommendation see the rationale section on patients with COVID-19 and additional risk factors.

Full details of the evidence and the panel's discussion are in the evidence reviews.

2 Extending pharmacological VTE prophylaxis after discharge

What is the effectiveness and safety of extended pharmacological VTE prophylaxis for patients who have been discharged after treatment for COVID-19 pneumonia?

Suggested PICO (population, interventions, comparators, outcomes)

Population

Patients aged 16 and over who have been discharged after treatment for COVID-19 pneumonia

Interventions

Extended (2 to 6 weeks) pharmacological VTE prophylaxis with standard-dose:

  • LMWH

  • UFH

  • fondaparinux sodium

  • direct-acting anticoagulant

  • vitamin K antagonists

Comparator

No extended pharmacological VTE prophylaxis

Outcomes

Incidence of VTE

  • mortality (all-cause, inpatient, COVID‑19 related)

  • admission to critical care (including use of advanced organ support)

  • serious adverse events such as major bleeding or admission to hospital

For a short explanation of why we made this recommendation see the rationale section on patients with COVID-19 pneumonia managed in hospital.

Full details of the evidence and the panel's discussion are in the evidence reviews.

For a short explanation of why we made this recommendation see the rationale section on patients with COVID-19 pneumonia managed in community settings.

Full details of the evidence and the panel's discussion are in the evidence reviews.