Last updated: Dec. 9, 2020
The following dosing recommendation chart apply to all COVID-19 positive and rule out adult patients at UMMC.
Anticoagulation Dosing Recommendations for COVID-19 Patients - PDF
Review prior to admission meds to ensure not previously on Therapeutic Anticoagulation
Repeat platelet count (CBC) 1-2x weekly
If patient labeled ‘Resolved’ or considered convalescing, discuss possibility of reducing to standard prophylaxis
If dosing reduced to standard prophylaxis dosing, pharmacy to sign off
**Providers - Consider empirically continuing prophylaxis for post-discharge in patients with hypercoagulability. Should consider if patient has ongoing VTE risk factors or may benefit from extended post-hospital VTE prophylaxis
Serum Anti-Xa peak (Heparin, Anti-Xa Lab Order) should be drawn 4 hours after the third or subsequent enoxaparin dose (no sooner than the third dose). Repeat serum Anti-Xa peak with each dose adjustment, and with any significant change in renal function.
*Results can be found in the Special Coag Studies Misc. under the Results Review.
Anti-Xa < 0.2 IU/mL: Increase enoxaparin dose by 10 - 20 mg to the nearest syringe size
Anti-Xa 0.2 - 0.5 IU/mL: no change
Anti-Xa > 0.5 IU/mL: Decrease enoxaparin dose by 10 - 20 mg to the nearest syringe size