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Guidance for anticoagulation management in venous thromboembolism during the coronavirus disease 2019 pandemic in Poland: an expert opinion of the Section on Pulmonary Circulation of the Polish Cardiac Society.
Kardiol Pol. 2020 06 25; 78(6):642-646.KP

Abstract

The coronavirus disease 2019 (COVID-19) pandemic affects anticoagulation not only in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but also in 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 patients with COVID-19, but its management is still challenging due to the complexity between antithrombotic therapy and hematological alterations. In the era of COVID-19 pandemic, it is highly 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, direct oral anticoagulants should be strongly preferred whenever possible. Current evidence is insufficient to recommend routine pharmacological antithrombotic prophylaxis in all hospitalized patients with COVID-19. In patients with COVID-19 who are suspected of VTE or in whom the diagnosis is confirmed, parenteral therapy with low-molecular-weight heparin should be initiated in the absence of contraindications. If heparin-induced thrombocytopenia is suspected, nonheparin anticoagulants should be used such as bivalirudin or fondaparinux. In case of confirmed acute pulmonary embolism, treatment should be guided by risk stratification as defined in the current guidelines.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Kosior DA
Mossakowski Medical Research Centre Polish Academy of Science, Warsaw, Poland; Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland. dariusz.kosior@cskmswia.pl
Undas A
Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
Kopeć G
Department of Cardiac and Vascular Diseases, John Paul II Hospital, Jagiellonian University Medical College, Kraków, Poland
Hryniewiecki T
Department of Acquired Cardiac Defect, Institute of Cardiology, Warsaw, Poland
Torbicki A
Department of Pulmonary Circulation and Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, ECZ-Otwock, Poland
Mularek-Kubzdela T
1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
Windyga J
Department of Hemostasis Disorders and Internal Medicine Laboratory of Hemostasis and Metabolic Diseases Institute of Hematology and Transfusion Medicine, Warsaw, Poland
Pruszczyk P
Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland

MeSH

AnticoagulantsBetacoronavirusBlood CoagulationCOVID-19Coronavirus InfectionsExpert TestimonyHospitalizationHumansPandemicsPneumonia, ViralPolandPractice Guidelines as TopicPulmonary EmbolismRisk FactorsSARS-CoV-2Societies, MedicalVenous Thromboembolism

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32515570

Citation

Kosior, Dariusz A., et al. "Guidance for Anticoagulation Management in Venous Thromboembolism During the Coronavirus Disease 2019 Pandemic in Poland: an Expert Opinion of the Section On Pulmonary Circulation of the Polish Cardiac Society." Kardiologia Polska, vol. 78, no. 6, 2020, pp. 642-646.
Kosior DA, Undas A, Kopeć G, et al. Guidance for anticoagulation management in venous thromboembolism during the coronavirus disease 2019 pandemic in Poland: an expert opinion of the Section on Pulmonary Circulation of the Polish Cardiac Society. Kardiol Pol. 2020;78(6):642-646.
Kosior, D. A., Undas, A., Kopeć, G., Hryniewiecki, T., Torbicki, A., Mularek-Kubzdela, T., Windyga, J., & Pruszczyk, P. (2020). Guidance for anticoagulation management in venous thromboembolism during the coronavirus disease 2019 pandemic in Poland: an expert opinion of the Section on Pulmonary Circulation of the Polish Cardiac Society. Kardiologia Polska, 78(6), 642-646. https://doi.org/10.33963/KP.15425
Kosior DA, et al. Guidance for Anticoagulation Management in Venous Thromboembolism During the Coronavirus Disease 2019 Pandemic in Poland: an Expert Opinion of the Section On Pulmonary Circulation of the Polish Cardiac Society. Kardiol Pol. 2020 06 25;78(6):642-646. PubMed PMID: 32515570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Guidance for anticoagulation management in venous thromboembolism during the coronavirus disease 2019 pandemic in Poland: an expert opinion of the Section on Pulmonary Circulation of the Polish Cardiac Society. AU - Kosior,Dariusz A, AU - Undas,Anetta, AU - Kopeć,Grzegorz, AU - Hryniewiecki,Tomasz, AU - Torbicki,Adam, AU - Mularek-Kubzdela,Tatiana, AU - Windyga,Jerzy, AU - Pruszczyk,Piotr, Y1 - 2020/06/08/ PY - 2020/6/10/pubmed PY - 2020/7/14/medline PY - 2020/6/10/entrez SP - 642 EP - 646 JF - Kardiologia polska JO - Kardiol Pol VL - 78 IS - 6 N2 - The coronavirus disease 2019 (COVID-19) pandemic affects anticoagulation not only in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but also in 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 patients with COVID-19, but its management is still challenging due to the complexity between antithrombotic therapy and hematological alterations. In the era of COVID-19 pandemic, it is highly 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, direct oral anticoagulants should be strongly preferred whenever possible. Current evidence is insufficient to recommend routine pharmacological antithrombotic prophylaxis in all hospitalized patients with COVID-19. In patients with COVID-19 who are suspected of VTE or in whom the diagnosis is confirmed, parenteral therapy with low-molecular-weight heparin should be initiated in the absence of contraindications. If heparin-induced thrombocytopenia is suspected, nonheparin anticoagulants should be used such as bivalirudin or fondaparinux. In case of confirmed acute pulmonary embolism, treatment should be guided by risk stratification as defined in the current guidelines. SN - 1897-4279 UR - https://www.unboundmedicine.com/medline/citation/32515570/Guidance_for_anticoagulation_management_in_venous_thromboembolism_during_the_coronavirus_disease_2019_pandemic_in_Poland:_an_expert_opinion_of_the_Section_on_Pulmonary_Circulation_of_the_Polish_Cardiac_Society_ DB - PRIME DP - Unbound Medicine ER -