@article{3103516,
    title = "Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine",
    author = "Gerotziafas, G.T. and Catalano, M. and Colgan, M.-P. and Pecsvarady, Z. and Wautrecht, J.C. and Fazeli, B. and Olinic, D.-M. and Farkas, K. and Elalamy, I. and Falanga, A. and Fareed, J. and Papageorgiou, C. and Arellano, R.S. and Agathagelou, P. and Antic, D. and Auad, L. and Banfic, L. and Bartolomew, J.R. and Benczur, B. and Bernardo, M.B. and Boccardo, F. and Cifkova, R. and Cosmi, B. and De Marchi, S. and Dimakakos, E. and Dimopoulos, M.A. and Dimitrov, G. and Durand-Zaleski, I. and Edmonds, M. and El Nazar, E.A. and Erer, D. and Esponda, O.L. and Gresele, P. and Gschwandtner, M. and Gu, Y. and Heinzmann, M. and Hamburg, N.M. and Hamadé, A. and Jatoi, N.-A. and Karahan, O. and Karetova, D. and Karplus, T. and Klein-Weigel, P. and Kolossvary, E. and Kozak, M. and Lefkou, E. and Lessiani, G. and Liew, A. and Marcoccia, A. and Marshang, P. and Marakomichelakis, G. and Matuska, J. and Moraglia, L. and Pillon, S. and Poredos, P. and Prior, M. and Salvador, D.R.K. and Schlager, O. and Schernthaner, G. and Sieron, A. and Spaak, J. and Spyropoulos, A. and Sprynger, M. and Suput, D. and Stanek, A. and Stvrtinova, V. and Szuba, A. and Tafur, A. and Vandreden, P. and Vardas, P.E. and Vasic, D. and Vikkula, M. and Wennberg, P. and Zhai, Z. and Bikdeli, B. and Guo, Y. and Harenberg, J. and Hu, Y. and Lip, G.Y.H. and Roldan, V.",
    journal = "Thrombosis and Haemostasis",
    year = "2020",
    volume = "120",
    number = "12",
    pages = "1597-1628",
    publisher = "Georg Thieme Verlag",
    issn = "0340-6245",
    doi = "10.1055/s-0040-1715798",
    keywords = "acetylsalicylic acid;  angiotensin receptor antagonist;  anticoagulant agent;  antivirus agent;  apixaban;  apolipoprotein E;  argatroban;  betrixaban;  blood clotting factor 10;  clopidogrel;  creatinine;  cytochrome P450 3A4;  D dimer;  dabigatran;  dalteparin;  dermatan sulfate;  dexamethasone;  eculizumab;  edoxaban;  enoxaparin;  ferritin;  fibrinogen;  fondaparinux;  gamma interferon;  heparin;  hydroxymethylglutaryl coenzyme A reductase inhibitor;  inflammasome;  intercellular adhesion molecule 1;  lopinavir;  low molecular weight heparin;  pentasaccharide;  phosphatidylserine;  prasugrel;  prekallikrein;  procalcitonin;  prothrombin;  prothrombin complex;  ritonavir;  rivaroxaban;  serine proteinase inhibitor;  sulodexide;  thrombocyte factor 4;  thromboplastin;  ticagrelor;  tinzaparin;  tirofiban;  troponin;  tumor necrosis factor;  von Willebrand factor;  anticoagulant agent;  low molecular weight heparin;  rivaroxaban, activated partial thromboplastin time;  acute coronary syndrome;  acute kidney failure;  acute kidney tubule necrosis;  adult respiratory distress syndrome;  anemia;  angiology;  anticoagulant therapy;  anticoagulation;  antiinflammatory activity;  aortic dissection;  apoptosis;  artery embolism;  artery thrombosis;  artificial ventilation;  atrial fibrillation;  autopsy;  bleeding;  bleeding tendency;  blood clot lysis;  blood clotting;  blood clotting time;  body mass;  brain ischemia;  cardiovascular disease;  cardiovascular risk;  cardiovascular risk factor;  chronic kidney failure;  chronic obstructive lung disease;  complement activation;  computer assisted tomography;  continuous hemofiltration;  contraindication;  convalescence;  coronary artery disease;  coronavirus disease 2019;  creatinine clearance;  critical limb ischemia;  cytokine production;  deep vein thrombosis;  diabetes mellitus;  disease severity;  disseminated intravascular clotting;  drug choice;  drug therapy;  dual antiplatelet therapy;  extracellular trap;  ferritin blood level;  fibrin formation;  glucose blood level;  health care system;  heart arrhythmia;  heart failure;  histochemistry;  home care;  hospital discharge;  hospital mortality;  hospital patient;  hospitalization;  human;  hypercoagulability;  hyperlipidemia;  hypertension;  hypofibrinogenemia;  hypotension;  hypoxia;  immune response;  inflammation;  innate immunity;  intensive care unit;  kidney biopsy;  length of stay;  livedo reticularis;  lung alveolus epithelium cell;  lung embolism;  lung perfusion;  lymphocyte count;  lymphocytopenia;  microangiopathy;  mobile application;  mortality;  obesity;  patient education;  peripheral occlusive artery disease;  physical activity;  platelet count;  prevalence;  primary health care;  protein assembly;  proteinase inhibition;  prothrombin time;  pyroptosis;  respiratory failure;  Review;  risk assessment;  risk factor;  sepsis;  Sequential Organ Failure Assessment Score;  social distancing;  telehealth;  thrombocyte;  thrombocyte activation;  thrombocytopenia;  thrombocytosis;  thromboelastography;  thrombophilia;  thrombosis;  thrombosis prevention;  thrombotic thrombocytopenic purpura;  urticaria;  vascular disease;  venous thromboembolism;  virus replication;  cardiology;  cardiovascular disease;  Europe;  medical society;  physiology;  practice guideline, Anticoagulants;  Cardiology;  Cardiovascular Diseases;  COVID-19;  Europe;  Heparin, Low-Molecular-Weight;  Humans;  Inflammation;  Practice Guidelines as Topic;  Risk Factors;  Rivaroxaban;  SARS-CoV-2;  Societies, Medical;  Thrombophilia;  Thrombosis",
    abstract = "COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital discharge using the IMPROVE-D-dimer score and prolonged post-discharge thromboprophylaxis with rivaroxaban, betrixaban, or LMWH. © 2020 Georg Thieme Verlag. All rights reserved."
}