Tutorial presented by Professor Beverley Hunt, a national and international expert in thrombosis and acquired bleeding disorders, Consultant of Thrombosis and Haemostasis, St Thomas’ Hospital, London, and Professor of Thrombosis and Haemostasis at King’s College London. Beverley sits on the NICE guideline development group, she chairs the steering committee of World Thrombosis Day campaign, and is co-founder and medical director of Thrombosis UK, a charity working to increase awareness, support research, extend understanding and improve care for all those affected by thrombosis.

In this tutorial, Beverley discussed blood clots in acute COVID-19 infection, including who is at risk, the types of thrombosis seen, and what preventative measures are recommended for moderately and severely unwell patients.

The risk of blood clots is associated with COVID-19 pneumonia; those admitted to hospital who are moderately or severely unwell. Patients with COVID-19 infection who experience mild symptoms or are asymptomatic, do not have an increased risk of blood clots.

There are two types of thrombosis occurring:

1. Pulmonary emboli
2. Microvascular emboli

The management of thrombotic risk has been the focus of a number of randomised trials, including the INSPIRATION trial (linked below). According to the findings, patients who are critically ill should receive standard thromboprophylaxis. In contract, those who are moderately unwell on the wards should receive full dose Low Molecular Weight Heparin. This guidance is reflected in NICE, also linked below (see page 43).