Check all of the patient groups with COVID-19 that anticoagulation as VTE thromboprophylaxis (ie to prevent VTE) is currently being recommended at your institution.
(check all that apply)
No anticoagulant prophylaxis recommended
Non critically ill Hospitalized COVID-19 patients (ie wards)
Critically ill hospitalized patients (ie Intensive care unit)
Post discharge COVID patients
Fulfills criteria for prophylaxis based on my institution's VTE guideline
D-dimer or other inflammatory marker elevation
All patients with COVID-19 (outpatients and inpatients)
Other
Check all of the anticoagulation regimens you are recommending for prophylaxis in critically ill hospitalized (ie intensive care unit) COVID-19 patients. (do not consider heparin induced thrombocytopenia or adjustments for renal function, check all that apply)
Prophylactic fixed dose low molecular weight heparin
Intermediate dose low molecular weight heparin
Therapeutic low molecular weight heparin
Prophylactic fixed dose unfractionated heparin
Weight adjusted unfractionated heparin
Therapeutic unfractionated heparin
Prophylactic dose Fondaparinux
Therapeutic Fondaparinux
Prophylactic Direct oral anticoagulant
Therapeutic Direct oral anticoagulant
Low dose Aspirin
Full dose Aspirin
Other
Intermediate dose is more than fixed dose prophylaxis but less than therapeutic dose.
Check all of the anticoagulation regimens you are recommending for prophylaxis in non- critically ill hospitalized (ie wards) COVID-19 patients. (do not consider heparin induced thrombocytopenia or adjustments for renal function, check all that apply)
Prophylactic fixed dose low molecular weight heparin
Intermediate dose low molecular weight heparin
Therapeutic low molecular weight heparin
Prophylactic fixed dose unfractionated heparin
Weight adjusted unfractionated heparin
Therapeutic unfractionated heparin
Prophylactic dose Fondaparinux
Therapeutic Fondaparinux
Prophylactic Direct oral anticoagulant
Therapeutic Direct oral anticoagulant
Low dose Aspirin
Full dose Aspirin
Other
Intermediate dose is more than fixed dose prophylaxis but less than therapeutic dose.
In which patient populations are you recommending escalation to intermediate dose anticoagulation for prophylaxis (ie to prevent VTE)? (check all that apply)
None
All hospitalized patients
Critically Ill (i.e. Intensive Care Unit)
Elevated SOFA score (specify threshold level in "other" field)
Elevated Sepsis Induced Coagulopathy Score (specify threshold level in "other" field)
Elevated DIC Score (specify threshold level in "other" field)
D-dimer 2-3X Upper limit of normal
D-dimer 4-5X Upper limit of normal
D-dimer >6X Upper limit of normal
Elevated fibrinogen (specify threshold level in "other" field)
Elevated ferritin (specify threshold level in "other" field)
Rising high-sensitivity troponin (specify threshold level in "other" field)
Obese patients
Additional VTE risk factor (i.e. Cancer, prior VTE)
Other
Intermediate dose is defined as more than prophylactic but less than therapeutic dose.
In which patient populations are you recommending escalation to therapeutic dose anticoagulation for prophylaxis (ie to prevent VTE) ? (check all that apply)
None
All hospitalized patients
Critically Ill (i.e. Intensive Care Unit)
Elevated SOFA score (specify threshold level in "other" field)
Elevated Sepsis Induced Coagulopathy Score (specify threshold level in "other" field)
Elevated DIC Score (specify threshold level in "other" field)
D-dimer 2-3X Upper limit of normal
D-dimer 4-5X Upper limit of normal
D-dimer >6X Upper limit of normal
Elevated fibrinogen (specify threshold level in "other" field)
Elevated ferritin (specify threshold level in "other" field)
Rising high-sensitivity troponin (specify threshold level in "other" field)
Obese patients
Additional VTE risk factor (i.e. Cancer, prior VTE)
Other
If you are using therapeutic dose for thromboprophylaxis in COVID-19 patients, what regimen are you recommending?
(do not consider heparin induced thrombocytopenia or adjustments for renal function, check all that apply)
Low Molecular Weight Heparin
Unfractionated Heparin
Fondaparinux
Direct oral anticoagulant
Vitamin K antagonist
Intravenous Direct Thrombin Inhibitor (i.e. bivalirudin or argatroban)
Other
In which patient populations are you recommending extended VTE prophylaxis ? (i.e. after hospital discharge, check all that apply)
I am not recommending VTE prophylaxis after hospital discharge
Critically ill (ICU) patients
All hospitalized patients
Based upon age (note age cut off under other)
D-dimer >2X upper limit of normal
History of VTE
History of Cancer
Combination of risk factors used in clinical trials (e.g. MARINER, APEX, etc)
Obesity
Pregnancy
Other
Which prophylactic anticoagulant are you recommending for extended VTE prophylaxis?
(check all that apply)
Apixaban
Rivaroxaban
Betrixaban
Low molecular weight heparin
Edoxaban
Dabigatran
Warfarin
Other anticoagulant
For how long are you recommending prophylactic anticoagulant for extended VTE prophylaxis in COVID-19 patients being discharged from the hospital? (check all that apply)
7 days
30 days
60 days
90 days
Other
In which COVID-19 patients does your hospital perform compression ultrasound to screen for deep vein thrombosis in hospitalized patients? (check all that apply)
All patients upon hospital admission
All ICU patients
Only patients with clinical symptoms of deep vein thrombosis (extremity swelling/pain, line malfunction)
Based on D-dimer results
Ultrasound not possible because of patient isolation
Other
In which situations would you initiate empiric treatment for VTE in case objective tests such as CTPA, VQ scan, or CUS were not available? (check all that apply)
High risk based on assessment by clinical scoring tools (e.g. Wells, YEARS, Geneva)
Unilateral extremity swelling
Intravenous line malfunction
Worsening respiratory status (oxygenation, respiratory rate)
Hemodynamic decompensation (hypotension, tachycardia)
Rising D-dimer elevation
Require Prone positioning
Change in dead space fraction during mechanical ventilation
Right heart strain on bedside echocardiogram
Other
CTPA - CT pulmonary angiogram; VQ scan - ventilation/perfusion scan; CUS - compression ultrasound
Which of the following tests are you getting at baseline in COVID-19 patients? (check all that apply)
CBC
Basic metabolic panel
Comprehensive metabolic panel
D-dimer
Creatinine kinase (CPK)
PT/INR
aPTT
Fibrinogen
Thromboelastography (TEG) or ROTEM Antithrombin activity
Ferritin
C-reactive protein
Sedimentation rate (ESR)
Procalcitonin
Lactate dehydrogenase
Lactate/lactic acid
IL-6
ADAMTS-13
von Willebrand factor activity
Antiphospholipid antibodies
Other
Which of the following tests are you monitoring in COVID-19 patients 3 or more times a week ? (check all that apply)
CBC
Basic metabolic panel
Complete metabolic panel
D-dimer
Creatinine kinase (CPK)
PT/INR
aPTT
Fibrinogen
Thromboelastography (TEG) or ROTEM Antithrombin activity
Ferritin
C-reactive protein
Sedimentation rate (ESR)
Procalcitonin
Lactate dehydrogenase
Lactate/lactic acid
IL-6
ADAMTS-13
von Willebrand factor activity
Other
Which bleeding complications have your patients with COVID-19 experienced? (check all that apply)
None of my patients have had bleeding
Minor bleeding
Major bleeding (i.e. overt bleeding with hemoglobin dropped at least 2 gram/dL or requiring transfusion of 2 units PRBC, bleeding in critical site such as intracranial, retroperitoneal, intraspinal, fatal bleeding)
Clinically relevant non-major bleeding (i.e. requires intervention not meeting major bleeding criteria)
Refers to ISTH bleeding categories
In what sites have bleeding occurred in COVID -19 patients at your institution?
(check all that apply)
Mucous membranes (i.e. epistasis, gum bleeding)
Skin (i.e. bruising or line related)
Lungs (i.e. hemoptysis or alveolar hemorrhage)
Gastrointestinal (i.e. hematemesis, melena, hematochezia)
Genitourinary (i.e. hematuria, vaginal bleeding)
Intracranial or intraspinal
Retroperitoneal
Other
At what dose of anticoagulation have bleeding complications occurred in COVID -19 patients at your institution? (check all that apply)
No anticoagulation
Prophylactic dose
Intermediate dose
Therapeutic dose
Which thromboembolic complications have occurred in your COVID-19 patients?
(check all that apply)
None of my patients have had thromboembolism
Pulmonary embolism
Lower extremity deep vein thrombosis
Upper extremity deep vein thrombosis
Superficial vein thrombosis
Intracardiac thrombosis
Splanchnic vein thrombosis
Cerebral vein thrombosis
Dialysis or Continuous Renal Replacement Therapy (filter loss or line occlusions)
Mechanical circulatory support (i.e. ECMO, VAD; oxygenator or cannula thrombosis)
Myocardial infarction
Ischemic stroke
Peripheral artery embolus
Sudden death with concern for thrombosis
High clinical suspicion for VTE but unable to undertake diagnostic testing
Other
What is the approximate incidence of VTE in all hospitalized COVID-19 patients at your institution?Â
1-5%
6-10%
11-15%
16-20%
21-30%
31-40%
41-50%
>50%
I don't know
Incidence of VTE is defined as new VTE event not diagnosed prior to hospital admission
What is the approximate incidence of VTE in ICU patients with COVID-19 at your institution?
1-5%
6-10%
11-15%
16-20%
21-30%
31-40%
41-50%
>50%
I don't know
Incidence of VTE is defined as new VTE event not diagnosed prior to hospital admission
At what dose of anticoagulation have thromboembolic complications occurred?
(check all that apply)
No anticoagulation
Prophylactic dose
Intermediate dose
Therapeutic dose
Which COVID VTE guidelines do you follow?
(check all that apply)
I follow no guidelines
American College of Chest Physicians (ACCP)
American College of Cardiology (ACC)
American Society of Hematology (ASH)
NIH COVID-19 guidelines
Anticoagulation Forum (ACF)
Center for Disease Control (CDC)
International Society of Thrombosis and Hemostasis (ISTH)
NICE guidelines
World Health Organization guidelines
My institution's developed guidelines
Other
Have you been involved in developing any COVID VTE guidelines?
(Check all that apply)
I am not involved in developing guidelines
American College of Chest Physicians (ACCP)
American College of Cardiology (ACC)
American Society of Hematology (ASH)
NIH COVID-19 guidelines
Anticoagulation Forum (ACF)
Center for Disease Control (CDC)
International Society of on Thrombosis and Haemostasis (ISTH)
NICE guidelines
World Health Organization guidelines
My institution's guidelines
Other
Where do you learn about the most up to date information related to COVID and VTE?
(Check all that apply )
Colleagues
Facebook
Twitter
Medical journals
Medical conference
Newspapers/TV News
Doximity
Webinars
Other
Are or have there been any COVID-19 thromboprophylaxis trials conducted at your institution?
(check all that apply)
None are open at my institution
Outpatient thromboprophylaxis trial
Inpatient thromboprophylaxis trial
Post discharge thromboprophylaxis trial
Not sure
Other
Have you adopted any other practices related to the evaluation or treatment of COVID-19 patients for hematological issues?
How many COVID-19 patients have been admitted to your hospital since the start of the pandemic?
<100
100-250
251-500
501-1000
1001-3000
>3000
I don't know
How many COVID-19 patients have you taken care of personally or been consulted on since the start of the pandemic?
<10
11-25
26-50
51-100
101-250
251-500
>500
In what country do you practice?
Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic (CAR) Chad Chile China Colombia Comoros Republic of the Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czechia Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (formerly Swaziland) Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar (formerly Burma) Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria North Korea North Macedonia (formerly Macedonia) Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates (UAE) United Kingdom (UK) United States of America (USA) Uruguay Uzbekistan Vanuatu Vatican City (Holy See) Venezuela Vietnam Yemen Zambia Zimbabwe Other
What region of the United States do you practice?
Northeast
Southeast
Midwest
South
Northwest
Southwest
Other
How many years have you been in practice?
< 5 years
5-10 years
11-15 years
16-20 years
21-25 years
26-30 years
31-35 years
>35 years
What types of patients do you see?
Pediatrics
Adults
Both Pediatrics and Adults
What is your specialty?
(check all that apply)
Hematology
Medical Oncology
Vascular Medicine
Cardiology
Pulmonary/Critical Care/Intensivist
General Internal Medicine/Hospitalist
General Pediatrics
Other
What is the name of your hospital?
(this is so we can identify experience within or between institutions)