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

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dc.contributor.authorGerotziafas, Grigoris
dc.contributor.authorCatalano, Mariella
dc.contributor.authorColgan, Mary Paula
dc.contributor.authorPecsvarady, Zsolt
dc.contributor.authorWautrecht, Jean Cladue
dc.contributor.authorFazeli, Bahare
dc.contributor.authorFarkas, Katalin
dc.date.accessioned2021-02-19T21:20:44Z
dc.date.available2021-02-19T21:20:44Z
dc.date.issued2020
dc.departmentALKÜ
dc.description.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. © 2020 Georg Thieme Verlag. All rights reserved.
dc.identifier.doi10.1055/s-0040-1715798
dc.identifier.endpage1628en_US
dc.identifier.issn0340-6245
dc.identifier.issue12en_US
dc.identifier.pmid32920811
dc.identifier.scopusqualityQ1
dc.identifier.startpage1597en_US
dc.identifier.urihttps://doi.org/10.1055/s-0040-1715798
dc.identifier.urihttps://hdl.handle.net/20.500.12868/643
dc.identifier.volume120en_US
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthor0-belirlenecek
dc.language.isoen
dc.publisherGeorg Thieme Verlag
dc.relation.ispartofThrombosis and Haemostasis
dc.relation.publicationcategoryDiğer
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectanticoagulants
dc.subjectantiplatelets
dc.subjectantithrombotic
dc.subjectcardiovascular disease
dc.subjectCOVID-19
dc.subjectdeep vein thrombosis
dc.subjectDOAC
dc.subjectlow-molecular-weight heparin
dc.subjectperipheral artery disease
dc.titleGuidance 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
dc.typeReview Article

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