The ACTIV-4b Trial: Antithrombotics For Treatment of Outpatient COVID-19
Background: Severely ill patients diagnosed with COVID-19 have an increased risk of cardiovascular complications, especially thromboembolic events (Bikdeli 2020). The overall incidence of developing venous thromboembolism (VTE) is approximately 17% in patients diagnosed with COVID-19, with a significantly higher rate in the ICU setting (Jiménez 2021). Multiple studies have investigated the use of antithrombotic agents in patients with COVID-19 admitted to various hospital settings (Talasaz 2021). Some of these papers have been reviewed on REBEL EM. However, there is currently no evidence to support the use of antithrombotics in stable patients who are treated in the outpatient setting. Some clinicians have extrapolated inpatient data and are using antithrombotics in the outpatient setting without evidence. How should we manage those symptomatic but stable patients with COVID-19 that are discharged home without an inpatient stay? Investigators of the ACTIV-4b trial sought to answer this question.