Venous thromboembolism prophylaxis of a patient with MYH-9 related disease and COVID-19 infection: A case report

Table 2 Summary of exclusion criteria regarding thrombocytopenia and bleeding risk in major clinical trials on coronavirus disease 2019 thromboprophylaxis

Trial	Anticoagulant	Thrombocytopenia	Bleeding risk
mpRCT (REMAP-CAP, ACTIV-4a, and ATTAC)[17]	Enoxaparin, Dalteparin, Tinzaparin, UFH	Platelet count < 50 × 109/L	ATTAC: DAPT therapy, intracranial surgery or stroke within 3 mo, history of intracerebral AVM, brain aneurysm of CNS mass lesion, intracranial malignancy, history of intracranial bleeding, history of bleeding disorder, GI bleed within 3 mo, thrombolysis within 7 d, current epidural/spinal catheter, major surgery within 14 d, uncontrolled hypertension or other physician perceived contraindications to anticoagulation
			ACTIV-4a: bleed within last 30 d
			REMAP-CAP: clinical and/or laboratory bleeding risk to contraindicate anticoagulation
INSPIRATION[18]	Enoxaparin, UFH	Platelet count < 50 × 109/L	Major bleeding within 30 d, major surgery or ischemic stroke within 2 wk, head trauma within 30 d, neurosurgery within 3 mo, intracranial malignancy or AVM
HEP-COVID[21]	Enoxaparin, UFH	Platelet count < 25 × 109/L	Recent bleed within 1 mo, active GI or intracranial malignancy, DAPT therapy, IMPROVE bleed score of ≥ 7
ACTION[19]	Rivaroxaban, enoxaparin, UFH	Platelet count < 50 × 109/L	Use of ASA (> 100 mg) or P2Y12 inhibitor, chronic NSAIDS use, active bleeding, liver failure, blood dyscrasia, prohibitive hemorrhage risk, history of intracranial bleed, DIC, active cancer
RAPID[20]	Enoxaparin, dalteparin, tinzaparin, UFH	Platelet count < 50 × 109/L within 72 h	History of an inherited or active acquired bleeding disorder, bleeding within 30 d requiring hospital presentation, DAPT therapy, Hgb < 80 g/L

ASA: Aspirin; AVM: Arteriovenous malformation; CNS: Central nervous system; DAPT: Dual antiplatelet therapy; DIC: Disseminated intravascular coagulation; GI: Gastrointestinal; Hgb: Hemoglobin; IMPROVE: International Medical Prevention Registry on Venous Thromboembolism; NSAIDS: Nonsteroidal anti-inflammatory drugs; UFH: Unfractionated heparin.