key: cord-0737995-txnil3jp authors: Speed, V.; Patel, R.K.; Byrne, R.; Roberts, L.N.; Arya, R. title: A perfect storm: Root cause analysis of supra-therapeutic anticoagulation with vitamin K antagonists during the COVID-19 pandemic date: 2020-05-16 journal: Thromb Res DOI: 10.1016/j.thromres.2020.05.024 sha: dfa653641bebd626f97191d42b7542529e23aeba doc_id: 737995 cord_uid: txnil3jp nan epicentre of the COVID-19 outbreak in the UK 1 All INR results taken within our hospital and community anticoagulation service during a 6-week period were identified (01/03/2020 -17/04/2020) centred around the lockdown date of 23/03/2020. We then compared these to the results from the Our data reveals a significant increase in high INR results during the COVID-19 pandemic, with the majority occurring after the introduction of a lockdown. The reasons for this are likely multifactorial, however more than half of our cases had COVID-19 (possible or confirmed) and/or antibiotic use. The use of antibiotics in patients with COVID-19 appears to be common. Given the high prevalence of COVID-J o u r n a l P r e -p r o o f Coronavirus (COVID-19) in the UK Guidance for the safe switching of warfarin to direct oral anticoagulants (DOACs) for patients with non-valvular AF and venous thromboembolism (DVT/PE) during the coronavirus pandemic . Endorsed by the Royal College of General Practitioners and British Society of Haematology Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in nonsurgical patients: Communication from the SSC of the ISTH Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients COVID-19 -investigation and initial clinical management-of-possible-cases-of-wuhan-novel-coronavirus-wn-cov-infection#criteria Prominent changes in blood coagulation of patients with SARS-CoV-2 infection 1(ahead-of-print) Liver injury in COVID-19: Management and challenges Reduced vitamin K status as A potentially modifiable prognostic risk factor in COVID-19 MPs in plea to government over UK's covid-19 stockpiling. The Guardian Mitigating and learning from the impact of COVID-19 infection on addictive disorders Acetaminophen and other risk factors for excessive warfarin anticoagulation