Περίληψη:
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.
Συγγραφείς:
Gerotziafas, G.T.
Catalano, M.
Colgan, M.-P.
Pecsvarady, Z.
Wautrecht, J.C.
Fazeli, B.
Olinic, D.-M.
Farkas, K.
Elalamy, I.
Falanga, A.
Fareed, J.
Papageorgiou, C.
Arellano, R.S.
Agathagelou, P.
Antic, D.
Auad, L.
Banfic, L.
Bartolomew, J.R.
Benczur, B.
Bernardo, M.B.
Boccardo, F.
Cifkova, R.
Cosmi, B.
De Marchi, S.
Dimakakos, E.
Dimopoulos, M.A.
Dimitrov, G.
Durand-Zaleski, I.
Edmonds, M.
El Nazar, E.A.
Erer, D.
Esponda, O.L.
Gresele, P.
Gschwandtner, M.
Gu, Y.
Heinzmann, M.
Hamburg, N.M.
Hamadé, A.
Jatoi, N.-A.
Karahan, O.
Karetova, D.
Karplus, T.
Klein-Weigel, P.
Kolossvary, E.
Kozak, M.
Lefkou, E.
Lessiani, G.
Liew, A.
Marcoccia, A.
Marshang, P.
Marakomichelakis, G.
Matuska, J.
Moraglia, L.
Pillon, S.
Poredos, P.
Prior, M.
Salvador, D.R.K.
Schlager, O.
Schernthaner, G.
Sieron, A.
Spaak, J.
Spyropoulos, A.
Sprynger, M.
Suput, D.
Stanek, A.
Stvrtinova, V.
Szuba, A.
Tafur, A.
Vandreden, P.
Vardas, P.E.
Vasic, D.
Vikkula, M.
Wennberg, P.
Zhai, Z.
Bikdeli, B.
Guo, Y.
Harenberg, J.
Hu, Y.
Lip, G.Y.H.
Roldan, V.
