Guidance for anticoagulation management in venous thromboembolism during the coronavirus disease 2019 (COVID-19) pandemic in Poland: an expert opinion of the Section on Pulmonary Circulation of the Polish Cardiac Society.
Kardiol Pol. 2020 Jun 08;:
Authors: Kosior DA, Undas A, Kopeć G, Hryniewiecki T, Torbicki A, Mularek-Kubzdela T, Windyga J, Pruszczyk P
The COVID -19 pandemic affects anticoagulantion not only for those infected with SARS-CoV-2, but also for most patients who require daily anticoagulant therapy and are facing substantial limitations in medical care these days. Concomitant venous thromboembolism (VTE), a potential cause of unexplained deaths, has frequently been reported in COVID-19 cases, but its management is still challenging due to the complexity between antithrombotic therapy and hematological alterations. In the era of COVID-19 pandemic is strongly recommended for patients who require chronic anticoagulation to continue therapy to prevent thromboembolic events. To avoid regular and frequent blood tests and unnecessary exposure to SARS-CoV-2 during contacts with medical personnel DOACs should be strongly preferred whenever possible. Current evidence is insufficient to recommend routine pharmacological antithrombotic prophylaxis in all hospitalized patients with COVID-19. In COVID-19 patients suspected for VTE or in whom the diagnosis is confirmed parenteral therapy with LMWH should be initiated in the absence of contraindications. If heparin induced thrombocytopenia is suspected, nonheparin anticoagulants should be used such as bivalirudin or fondaparinux. When acute pulmonary embolism is confirmed, treatment should be guided by risk stratification as defined in the current guidelines.
PMID: 32515570 [PubMed - as supplied by publisher]