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eConsult Clinical Question

26-year-old female with obesity who is had a non-intensive care unit (ICU) hospitalization for COVID-19 was on supplemental O2 at hospital without intubation. Patient was discharged on limited dexamethasone oral course. Patient is currently on Eliquis 2.5 mg twice daily prophylaxis. The plan is to continue for total of six weeks, would any extension of her Eliquis be recommended?

eConsult Response

A 26-year-old very obese female who was recently hospitalized for COVID-19 with respiratory issues. She did not develop a thrombosis while in the hospital. However, because she was in the hospital and was overweight and required supplemental oxygen, she was placed on prophylactic treatment with Eliquis 2.5 mg twice a day. The plan is to treat the patient for six weeks.

None of the society guidelines recommend treating post-hospital discharge COVID patients with anticoagulation. However, this patient presents risk factors. I would agree with treating the patient for six weeks. I would also want to know what her history is with respect to thrombosis as she has had clots before any family etc.… At the end of six weeks, you can get a duplex scan to make sure we are not missing anything then she is up and around and walking it can be stopped.

These real-life examples have some limitations. Given the evolving recommendations and guidance on COVID-19 care, these cases should not be considered complete or definitive and may not reflect the most up-to-date guidance.