Evidence suggests coronavirus disease 2019 (COVID-19) is associated with an increased incidence of thromboembolic manifestations. Various guidelines on managing antithrombotics in COVID-19 either provided conflicting guidance or unclear recommendations for post-discharge thromboprophylaxis. The investigators aim to collect the current practices in India among physicians on antithrombotic therapy for hospitalised patients with COVID-19 and after discharge from the hospital.
Immune dysregulation plays a crucial role in the development of severe coronavirus disease
2019 (COVID-19). The autopsy of lungs in deceased COVID-19 patients showed micro thrombosis
and inflammatory infiltrates similar to acute respiratory distress syndrome (ARDS). Reports
of increased incidence of arterial or venous thrombosis with COVID-19 made initial
recommendations regarding using higher doses of anticoagulation. The markers of thrombosis
like D-dimer, platelet count, fibrinogen are also increased in patients with COVID-19 along
with other inflammatory markers. The pathophysiology of coagulopathy of COVID-19 is still
under research. It is likely multi-factorial involving Inflammation, hypoxia, endothelial
dysfunction, direct viral cytopathic effect, platelets and complement activation, derangement
of the renin-angiotensin-aldosterone pathway.
From the inception of the pandemic, the physicians started using various antithrombotic with
higher than prophylactic doses to treat the prothrombotic state. In the absence of clear
guidance with conflicting evidence, there is considerable variation in the practices of
physicians managing COVID-19.
The investigators are planning for a nationwide multicentre cross-sectional survey on
understanding participating physicians practices on the choice of different antithrombotics
available in India as of August 2021.
The survey will have three sections: 1. Demographics 2. Antithrombotics in hospitalised
patients 3. Antithrombotics after discharge from the hospital
The investigators intend to involve 1000 physicians from different specialities with the help
of the steering committee.
Behavioral: Current clinical practices of participating physicians
Current clinical practice of participating physicians on management of antithrombotics for COVID-19 during hospitalisation and post-discharge
Inclusion Criteria:
• Physicians involved in the management of adult hospitalised patients with COVID-19 in
India
Exclusion Criteria:
- Pediatricians
- Physicians involved in the out-patient management of COVID-19
- Refused to participate
Reliance Hospital
Mumbai, Mumbai, Mahrastra, India
Prashant Nasa, MD EDICM, Principal Investigator
NMC Specialty Hospital, Dubai, UAE