Prevention of blood clots in COVID-19

This information has been produced by the hospital Thrombosis and Thromboprophylaxis Group to help explain how to prevent blood clots in COVID-19 infection. It will also discuss the signs and symptoms of blood clots. We hope it answers some of the questions you may have.

Venous thromboembolism (VTE)

VTE is where a blood clot (called a thrombus) forms in a vein which can block off or reduce blood flow. The most common form is a blood clot in the deep veins of the legs known as a deep vein thrombosis (DVT). The DVT can break off and travel to the arteries of the lung where it will cause a pulmonary embolism (PE). DVT and PE are known under the collective term of VTE.

Prevention of blood clots in COVID-19 infection

Patients with COVID-19 infection may be at increased risk of a blood clot. You may be prescribed an anticoagulant medication to reduce your risk of developing a blood clot. An anticoagulant, also known as ‘blood thinners’ increases the time it takes your blood to clot.

What are the risk factors for blood clots?

  • Age greater than 60 years
  • Personal or family history of VTE
  • Medical conditions such as lung disease or infections, active cancer, heart failure
  • Reduced mobility especially if confined to hospital bed
  • Obesity
  • Pregnancy
  • Certain contraceptive pill or hormone replacement therapy

What can you do to help reduce your risk of developing blood blots?

It is important to:

  • Keep mobile (move around)
  • Exercise
  • Keep well-hydrated by drinking plenty of water

Follow the latest Government advice on hand washing, face covering and social distancing

Anticoagulant Medication

The choice of anticoagulant medication given to you will be based on various factors e.g. kidney function, body weight, other medications that you are taking.

Please be aware that some blood thinners are derived from animal (pig origin). Please discuss this with your doctor or nurse if you have any concerns.

You will be prescribed any one of the following:

  • Rivaroxaban tablet, 10mg once a day - taken at approximately the same time each day. Rivaroxaban is not licensed for the prevention of blood clots in people with COVID-19, but is used for other indications to prevent blood clots
  • Enoxaparin injection, dose dependent on your weight and kidney function - taken at approximately the same time each day. You, a relative or a carer will be shown how to give the injections, and will be provided with a sharps bin to dispose of any sharps (needles) safely

Please refer to the manufacturers information leaflet for further information.

How long do you need to take anticoagulant medication for?

You will be provided with details of how long you should take anticoagulant medication for, with instructions on the medicine label and hospital documentation.

It is important you take your medication for the length of time advised and you complete the course.

The hospital will provide the full supply of medication.

What should you do if you miss a dose?

If you miss a dose and remember on the same day, take the missed dose as soon as you remember on that day. Take the next dose on the following day and continue to take once a day. Do not take a double dose to make up for the missed dose.

What are the main side effects?

Anticoagulant medication can increase the risk of bleeding and bruising.

Contact your GP or NHS 111 if you experience any of the following:

  • Prolonged nose bleeds
  • Bleeding from your gums
  • Unusual or extensive bruising

Seek immediate medical attention if you experience any of the following:

  • Pink or brown urine
  • Red or black, tarry stools
  • Coughing up blood
  • Vomiting blood, or vomit that looks like coffee grounds
  • Excessive on-going bleeding that does not stop on its own

How will you know if you have DVT or PE?

The symptoms of DVT in the leg include:

  • Swelling
  • Pain
  • Warm skin
  • Tenderness
  • Redness (particularly at the back of your leg below the knee)

In some cases, there may be no signs or symptoms of DVT at all in the leg

The symptoms of PE include:

  • Shortness of breath
  • Pain in your chest that is worse when you breathe in
  • Collapse (in severe cases)

Both DVT and PE are serious conditions and require urgent investigation and treatment.

If you suspect you may have DVT or PE, you should seek medical advice immediately either from your GP or nearest A&E (Emergency Department)

Who can you contact for more information?

If you would like any more information or have any questions, please ask a doctor, nurse or pharmacist. Further information can be found from NHS website or Thrombosis UK.