Last updated: May 15, 2020
The following dosing recommendation chart apply to all COVID-19 positive and rule out adult patients at UMMC.
Anticoagulation Dosing Recommendations for COVID-19 Patients - PDF
Review prior to admission meds to ensure not previously on Therapeutic Anticoagulation
Repeat D-dimer and platelet count (CBC) daily
Consider checking TEG and fibrinogen as algorithm suggests or there is progressive organ failure or clinical thrombosis
Consider de-escalation of Enhanced to Standard prophylaxis when d-dimer <1000 and plts <100k
**Providers - Consider empirically continuing prophylaxis for 14d post-discharge in patients with hypercoagulability. Should consider if patient has ongoing VTE risk factors or may benefit from extended post-hospital VTE prophylaxis.
Serum Anti-Xa concentration peak (Heparin, Anti-Xa Lab Order) should be drawn 4 hours after the third or subsequent enoxaparin dose(s) (no sooner than the third dose). Repeat serum Anti-Xa concentration peaks should be performed with each dose adjustment, with any notable change in renal function, and at least once weekly for all ICU COVID-19 patients. (**When timing orders, consider timing of other meds or labs to minimize nurse exposure.)
*Results can be found in the Special Coag Studies Misc. under the Results Review.