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Deprecated: Implicit conversion from float 334.4 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Thromb+Haemost 2020 ; 120 (12): 1597-1628 Nephropedia Template TP
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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 #MMPMID32920811
Gerotziafas GT; Catalano M; Colgan MP; Pecsvarady Z; Wautrecht JC; Fazeli B; Olinic DM; Farkas K; Elalamy I; Falanga A; Fareed J; Papageorgiou C; Arellano RS; Agathagelou P; Antic D; Auad L; Banfic L; Bartolomew JR; Benczur B; Bernardo MB; Boccardo F; Cifkova R; Cosmi B; De Marchi S; Dimakakos E; Dimopoulos MA; Dimitrov G; Durand-Zaleski I; Edmonds M; El Nazar EA; Erer D; Esponda OL; Gresele P; Gschwandtner M; Gu Y; Heinzmann M; Hamburg NM; Hamade A; Jatoi NA; 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 DRK; 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 PE; Vasic D; Vikkula M; Wennberg P; Zhai Z
Thromb Haemost 2020[Dec]; 120 (12): 1597-1628 PMID32920811show ga
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.