Breakthrough venous thromboembolic events in five patients with COVID-19 on direct oral anticoagulants.

Journal of Clinical Pharmacy and Therapeutics
Paul Lewis, Jennifer L Tharp

Abstract

Coronavirus disease 2019 (COVID-19) is associated with increased risk of venous thromboembolism (VTE). Guidance for VTE prophylaxis continues to evolve, including addressing direct oral anticoagulants (DOACs) continued upon hospitalization. We present 5 patients hospitalized for COVID-19 while on DOACs. Four patients had atrial fibrillation and had a previous VTE. Four patients developed acute VTE and one developed stroke-like symptoms. Monitoring D-dimer assisted with the detection of VTE. Three patients died, and two were discharged alive. Therapeutic failure with DOACs appears to be commonplace in COVID-19. Further research is needed to determine whether there is an underlying cause to this association.

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Citations

Mar 25, 2021·Expert Review of Clinical Pharmacology·Claudia Stöllberger, Josef Finsterer
Mar 17, 2021·Journal of Thrombosis and Haemostasis : JTH·Jecko ThachilMarc Carrier
Aug 18, 2021·Expert Review of Clinical Pharmacology·Valerio LangellaVincenzo Russo

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