Citations 1
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
Gerotziafas, Grigoris , Catalano, Mariella, Pécsvárady, Zsolt, Wautrecht, Jean Claude, Olinic, Dan-Mircea , Farkas, Katalin , Elalamy, Ismaı̈l , Fareed, Jawed , Papageorgiou, Chryssa, Arellano, Rosella S., Agathagelou, Petros, Antic, Darco, Auad, Luciana, Banfić, Ljiljana , Bartolomew, John R., Benczúr, Béla , Bernardo, M., Boccardo, Francesco M., Cifkova, Renate, Marchi, Sergio De , Dimakakos, Evangelos , Dimitrov, Gabriel, Edmonds, Michael , Nazar, Essam Abo El, Erer, Dilek , Esponda, Omar L. , Gschwandtner, Michael E., Gu, Yongquan , Heinzmann, Mónica, Hamadé, A. , Jatoi, Noor-Ahmed, Karahan, Oğuz , Karplus, Thomas E., Klein‐Weigel, Peter, Kolossváry, Endre , Kozak, Matija, Lefkou, Eleftheria , Lessiani, Gianfranco , Marcoccia, Antonella , Marshang, Peter, Marakomichelakis, George , Matuška, Jiří , Moraglia, Luc, Pillon, Sergio , Poredoš, Pavel , Salvador, David Raymund K., Schlager, Oliver , Schernthaner, G. , Sieron, Alexander, Spaak, Jonas , Spyropoulos, Alex C. , Stanek, Agata , Štvrtinová, Viera, Tafur, Alfonso , Dreden, Patrick Van , Vardas, Panagiotis E., Vasić, Dragan , Wennberg, Paul W. , Zhai, Zhenguo , Committee, Scientific Reviewer, Catalano, M. , Gerotziafas, Grigoris T , Wennberg, Paul, Catalano, Mariella , Dimakakos, Evangelos , Farkas, Katalin , Stanek, Agata , Colgan, Mary Paula , Fazeli, Bahare , Falanga, Anna , Cosmi, Benilde , Dimopoulos, Meletios Α. , Durand‐Zaleski, Isabelle , Gresele, Paolo , Hamburg, Naomi M. , Karetová, Debora , Liew, Aaron , Marschang, Peter , Prior, Manlio , Sprynger, Muriel , Šuput, Dušan , Szuba, Andrzej , Vardas, Panagiotis E., Vikkula, Miikka , Committee, Scientific Reviewer
Thrombosis and Haemostasis | September 13, 2020 | Volume: 120 | Issue: 12 | Pages: 1597-1628
AbstractCOVID-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.