Тромбоз, гемостаз и реология

Tromboz, Gemostaz I Reologiya
scientific and practical journal

ISSN 2078–1008 (Print); ISSN 2687-1483 (online)
No. 84 (2021), Original papers
No. 84 (2021)

The realities of the anticoagulant therapy using 18 in COVID‐19: 16.411-003.971

Original papers
Published 2021-03-16
Eugene V. Roitman
Pirogov Russian National Research Medical University, Health Ministry of Russian Federation, Research Center of Neurology
ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской Федерации, ФГБНУ «Научный центр неврологии»
Tatyana V. Vavilova
Almazov National Medical Research Centre, Health Ministry of Russian Federation
ФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской Федерации
Sergey M. Markin
Saint Petersburg Clinical Hospital, Russian Academy of Sciences
ФГБУЗ «Санкт-Петербургская клиническая больница Российской академии наук»
Pavel F. Kravtsov
Samara State Medical University, Health Ministry of Russian Federation
ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации
Konstantin V. Mazayshvili
Surgut State University image/svg+xml

Keywords

COVID‐19
thrombotic incidence
low molecular weight heparins
direct oral anticoagulants
  Full Text

Abstract

Summary. Background. The SARS-CoV-2 virus invasion lead to COVID-19-associated coagulopathy accompanied with increased incidence of thrombotic complications. Current clinical guidelines give the main approaches to the treatment and prevention of them; however their implementation is not always possible in practice. In fact, there are a lot of violations including with a systemic genesis and associated either with the low understanding of infectious process pathogenesis aspects by clinicians or with their excessive desire to prevent coagulation disturbances. the revealing of real clinical practice conditions in the treatment and prevention of thrombotic complications in patients with coronavirus infection COVID-19. Materials/Methods. We provided an anonymous poll for 223 experts treating patients with chronic and acute vascular diseases. The questionnaire included 18 questions to identify as the experts attitude to this challenge as a whole as well as to their choice of treatment tactics, and anticoagulant drugs, and methods of laboratory monitoring of blood coagulation. Results. Most participants know the increased risk of throm- botic complications in COVID-19 and they are puzzled by it The treatment of COVID-19-associated coagulopathy is considered as the priority goal of anticoagulant therapy in the acute phase of COVID-19 whereas the prevention of venous thromboembolic complications is noted as main goal in convalescences. Low molecular weight heparins have gotten the highest confidence in the administration among anticoagulants. In turn, the most of experts use direct oral anticoagulants in outpatients even despite no confirmation is for DOAC’s effectiveness from randomized trials in this time. Besides it was revealed wide spread of opinions and low count of correct responses about laboratory control of the hemostatic system and anticoagulants. Conclusion. The analysis showed a serious inconsistency between the real anticoagulants administration in patients with COVID-19 and the recommen- dations of clinical guidelines. This circumstance obviates the need to raise educational level of physicians and surgeons in the field of blood coagulation.

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