Coronavirus disease 2019 (COVID-19) is a viral infection that can, in severe cases, result in cytokine storm, systemic inflammatory response and coagulopathy that is prognostic of poor outcomes. While some, but not all, laboratory findings appear similar to sepsis-associated disseminated intravascular coagulopathy (DIC), COVID-19-induced coagulopathy (CIC) appears to be more prothrombotic than hemorrhagic. It has been postulated that CIC may be an uncontrolled immunothrombotic response to COVID-19, and there is growing evidence of venous and arterial thromboembolic events in these critically ill patients. Clinicians around the globe are challenged with rapidly identifying reasonable diagnostic, monitoring and anticoagulant strategies to safely and effectively manage these patients. Thoughtful use of proven, evidence-based approaches must be carefully balanced with integration of rapidly emerging evidence and growing experience. The goal of this document is to provide guidance from the Anticoagulation Forum, a North American organization of anticoagulation providers, regarding use of anticoagulant therapies in patients with COVID-19. We discuss in-hospital and post-discharge venous thromboembolism (VTE) prevention, treatment of suspected but unconfirmed VTE, laboratory monitoring of COVID-19, associated anticoagulant therapies, and essential elements for optimized transitions of care specific to patients with COVID-19.

Studies have demonstrated some P loss reduction following implementation of remedial strategies at field scales. However, there has been little coordinated evaluation of best management practices (BMPs) on a watershed scale to show where, when, and which work most effectively. Thus, it is still difficult to answer with a degree of certainty, critical questions such as, how long before we see a response and where would we expect to observe the greatest or least response? In cases where field and watershed scales are monitored, it is not uncommon for trends in P loss to be disconnected. We review case studies demonstrating that potential causes of the disconnect varies, from competing sources of P at watershed scales that are not reflected in field monitoring to an abundance of sinks at watershed scales that buffer field sources. To be successful, P-based mitigation strategies need to occur iteratively, involve stakeholder driven programs, and address the inherent complexity of all P sources within watersheds.

Poultry litter provides a rich nutrient source for crops, but the usual practice of surface-applying litter can degrade water quality by allowing nutrients to be transported from fields in surface runoff while much of the ammonia (NH3)-N escapes into the atmosphere. Our goal was to improve on conventional titter application methods to decrease associated nutrient losses to air and water while increasing soil productivity. We developed and tested a knifing technique to directly apply dry poultry litter beneath the surface of pastures. Results showed that subsurface litter application decreased NH3-N volatilization and nutrient losses in runoff more than 90% (compared with surface-applied litter) to levels statistically as low as those from control (no litter) plots. Given this success, two advanced tractor-drawn prototypes were developed to subsurface apply poultry litter in field research. The two prototypes have been tested in pasture and no-till experiments and are both effective in improving nutrient-use efficiency compared with surface-applied litter, increasing crop yields (possibly by retaining more nitrogen in the soil), and decreasing nutrient losses, often to near background (control plot) levels. A paired-watershed study showed that cumulative phosphorus losses in runoff from continuously grazed perennial pastures were decreased by 55% over a 3-yr period if the annual poultry litter applications were subsurface applied rather than surface broadcast. Results highlight opportunities and challenges for commercial adoption of subsurface poultry litter application in pasture and no-till systems.

Leaching of phosphorus (P) mobilizes edaphic and applied sources of P and is a primary pathway of concern in agricultural soils of the Delmarva Peninsula, which defines the eastern boundary of the eutrophic Chesapeake Bay. We evaluated P leaching before and after poultry litter application from intact soil columns (30 cm diameter × 50 cm depth) obtained from low- and high-P members of four dominant Delmarva Peninsula soils. Surface soil textures ranged from fine sand to silt loam, and Mehlich-3 soil P ranged from 64 to 628 mg kg. Irrigation of soil columns before litter application pointed to surface soil P controls on dissolved P in leachate (with soil P sorption saturation providing a stronger relationship than Mehlich-3 P); however, strong relationships between P in the subsoil (45-50 cm) and leachate P concentrations were also observed ( = 0.61-0.73). After poultry litter application (4.5 Mg ha), leachate P concentrations and loads increased significantly for the finest-textured soils, consistent with observations that well-structured soils have the greatest propensity to transmit applied P. Phosphorus derived from poultry litter appeared to contribute 41 and 76% of total P loss in leachate from the two soils with the finest textures. Results point to soil P, including P sorption saturation, as a sound metric of P loss potential in leachate when manure is not an acute source of P but highlight the need to factor in macropore transport potential to predict leaching losses from applied P sources.

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