Introduction As the COVID-19 pandemic progressed, it became apparent that worldwide these patients had a predisposition to thrombotic complications such as pulmonary embolisms, deep vein thromboses and circuit clotting in those receiving renal replacement therapy.1 At the start of the epidemic in the UK there was little trial evidence, and no national or international guidelines, to assist clinicians in optimising venous thromboembolism prevention and treatment for COVID-19 patients. There were 21 thrombosis cases (17=pulmonary emboli, 2 - deep vein thrombosis, 2 - other thrombosis) and 12 bleeding event cases (2=minor (no intervention required), 9 = clinically relevant but non-major (requiring some intervention but not lifethreatening), 1=major (life-threatening)). Conclusion By using real-time data collection during the course of the COVID-19 outbreak, we have been able to develop and refine our response in terms of our local venous thromboembolism guidelines.