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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

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单位: [1]Sorbonne Univ, Hop Univ Est Parisien, Hop Tenon, AP HP,Fac Med,Hematol & Thrombosis Ctr, Paris, France [2]Sorbonne Univ, Ctr Rech St Antoine, Inst Univ Cancerol,U938,Fac Med, Res Grp Canc,Haemostasis & Angiogenesis,INSERM, Paris, France [3]Univ Milan, L Sacco Hosp, Res Ctr Vasc Dis, Milan, Italy [4]Univ Milan, L Sacco Hosp, Angiol Unit, Dept Biomed Sci, Milan, Italy [5]Trinity Coll Dublin, St Jamess Hosp, Dept Vasc Surg, Dublin, Ireland [6]Flor Ferenc Teaching Hosp, Dept Vasc Med, Kistarcsa, Hungary [7]Univ Libre Bruxelle, Hop ERASME, Serv Pathol Vasc, Brussels, Belgium [8]Mashhad Univ Med Sci, Avicenna BuAli Res Inst, Dept Immunol, Mashhad, Razavi Khorasan, Iran [9]Univ Med & Pharm, Med Clin 1, Cluj Napoca, Romania [10]St Imre Univ Teaching Hosp, Dept Angiol, Budapest, Hungary [11]Sechenov Univ, IM Sechenov First Moscow State Med Univ, Dept Obstet & Gynecol, Moscow, Russia [12]Hosp Papa Giovanni XXIII, Dept Immunohematol & Transfus Med, Bergamo, Italy [13]Hosp Papa Giovanni XXIII, Ctr Thrombosis & Hemostasis, Bergamo, Italy [14]Loyola Univ Med Ctr, Dept Pathol, Maywood, IL 60153 USA [15]Sorbonne Univ, Hop Univ Est Parisien, Serv Anesthesie Reanimat & Med Perioperatoire, Hop Tenon,AP HP,Fac Med, Paris, France [16]Philippine Soc Vasc Med, Manila, Philippines [17]Amer Heart Inst Cyprus, Dept Inrtervent Cardiol, Nicosia, Cyprus [18]Univ Belgrade, Clin Ctr Serbia, Fac Med, Clin Hematol, Belgrade, Serbia [19]Univ Catolica Cordoba, Sanatorio Allende Cordoba, Ciencias Med, Med Vasc, Cordoba, Argentina [20]Univ Zagreb, Sch Med, Univ Hosp Ctr, Zagreb, Croatia [21]Cleveland Clin, Cleveland, OH 44106 USA [22]Balassa Janos Cty Hosp, Univ Med Sch, Szeged, Hungary [23]Univ Genoa, S Martino Hosp, Dept Cardiothoracvasc & Endovasc Surg, Unit Lymphat Surg,IRCCS, Genoa, Italy [24]Thomayer Teaching Hosp, Dept Prevent Cardiol, Prague, Czech Republic [25]Univ Bologna, S Orsola Malpighi Univ Hosp, Dept Specialty Diagnost & Expt Med, Angiol & Blood Coagulat, Bologna, Italy [26]Verona Univ Hosp, Angiol Unit, Cardiovasc & Thorac & Med Dept, Verona, Italy [27]Natl & Kapodistrian Univ Athens, Sotiria Hosp, Dept Internal Med 3, Vasc Unit, Athens, Greece [28]Hellen Soc Hematol, Athens, Greece [29]Natl & Kapodistrian Univ Athens, Sch Med, Dept Clin Therapeut, Athens, Greece [30]Univ Paris, Hop Hotel Dieu, AP HP, CRESS,INSERM,INRA,URCEco, Paris, France [31]Kings Coll Hosp London, Diabet Foot Clin, London, England [32]Minist Hlth, Dept Surg, Riyadh, Saudi Arabia [33]Gazi Univ, Fac Med, Dept Cardiovasc Surg, Besevler, Turkey [34]Hosp Perea, Dept Internal Med, Mayaguez, PR USA [35]Univ Perugia, Dept Med, Sect Internal & Cardiovasc Med, Perugia, Italy [36]Med Univ Wien, Univ Klin Innere Med 2, Vienna, Austria [37]Capital Med Univ, Xuanwu Hosp, Dept Vasc Surg, Beijing, Peoples R China [38]Boston Univ, Sch Med, Whitaker Cardiovasc Inst, Dept Med, Boston, MA 02118 USA [39]Imam Abdulrahman Bin Faisal Univ, King Fahad Univ Hosp, Dept Internal Med, Vasc Med Unit, Dammam, Saudi Arabia [40]Mulhouse Hosp Ctr, Dept Vasc Med, Mulhouse, France [41]Alaaddin Keykubat Univ, Sch Med, Dept Cardiovasc Surg, Alanya, Turkey [42]Charles Univ Prague, Dept Cardiovasc Med, Dept Med 2, Prague, Czech Republic [43]Concord Repatriat Gen Hosp, Dept Vasc Med, Sydney, NSW, Australia [44]Ernst von Bergmann Klinikum, Zentrum Innere Med 2, Klin Angiol, Potsdam, Germany [45]Univ Med Ctr Ljubljana, Med Fac Ljubljana, Dept Vasc Dis, Ljubljana, Slovenia [46]Inst Study & Educ Thrombosis & Antithrombot Thera, Athens, Greece [47]Citta St Angelo Hosp, AUSL 03, Dept Internal Med, Angiol Unit, Pescara, Italy [48]Natl Univ Ireland Galway NUIG, Soalta Univ Hlth Care Grp, Portiuncula Univ Hosp, Galway, Ireland [49]CRIIS Ctr Riferimento Interdisciplinare Sclerosi, Unita Med Vasc & Autoimmunita, Rome, Italy [50]Cent Hosp Bolzano, Dept Internal Med, Bolzano, Italy [51]Evangelismos Gen Hosp, Angiol Unit, Athens, Greece [52]Private Angiol Facil, MATMED Sro, Hodonin, Czech Republic [53]Med Vasc Travail, Angiol Ctr Cours Medoc, Bordeaux, France [54]Natl Hlth Inst ISS, San Camillo Forlanini Hosp, UOSD Angiol, Rome, Italy [55]Slovenian Med Acad, Slovenia Acad Res Ctr, Med Assoc Slovenia & SMA, Ljubljana, Slovenia [56]Azienda Osped Univ Integrata Verona, Angiol Unit, Verona, Italy [57]Med Univ Vienna, Dept Internal Med 2, Div Angiol, Vienna, Austria [58]Med Univ Silesia, Dept Internal Med Angiol & Phys Med, Katowice, Poland [59]Jan Dlugosz Univ, Specialist Hosp, Czestochowa, Poland [60]Karolinska Inst, Danderyd Hosp, Div Cardiovasc Med, Dept Clin Sci, Stockholm, Sweden [61]Feinstein Inst Med Res, Donald & Barbara Zucker Sch Med Hofstra Northwell, Northwell Hlth Lenox Hill Hosp, Dept Med Anticoagulat & Clin Thrombosis Serv, New York, NY USA [62]Univ Hosp Sart Tilman, Dept Cardiol, Liege, Belgium [63]Univ Ljubljana, Fac Med, Ctr Clin Physiol, Ljubljana, Slovenia [64]Med Univ Silesia, Fac Med Sci Zabrze, Dept Internal Med Angiol & Phys Med, Bytom, Poland [65]Comenius Univ, Fac Med, Bratislava, Slovakia [66]Wroclaw Med Univ, Dept Angiol Hypertens & Diabetol, Wroclaw, Poland [67]US Army, Vasc Med Univ Chicago, Northshore Cardiovasc Inst, Skokie, IL USA [68]Univ Crete, Med Sch Crete, Athens, Greece [69]Hellen Healthcare Grp, Heart Sect, Athens, Greece [70]Clin Ctr Serbia, Clin Vasc & Endovasc Surg, Dept Noninvas Vasc Lab, Belgrade, Serbia [71]Univ Louvain, de Duve Inst, Human Mol Genet, Brussels, Belgium [72]Mayo Clin, Gonda Vasc Ctr, Dept Cardiovasc Med, Rochester, MN USA [73]Capital Med Univ, Peking Univ Hlth Sci Ctr, China Japan Friendship Hosp, Dept Pulm & Crit Care Med,Ctr Resp Med, Beijing, Peoples R China [74]Chinese Acad Med Sci, Inst Resp Med, Beijing, Peoples R China
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关键词: COVID-19 cardiovascular disease peripheral artery disease deep vein thrombosis antithrombotic antiplatelets anticoagulants low-molecular-weight heparin DOAC

摘要:
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.

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中科院(CAS)分区:
出版当年[2019]版:
大类 | 2 区 医学
小类 | 2 区 血液学 2 区 外周血管病
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 血液学 2 区 外周血管病
JCR分区:
出版当年[2018]版:
Q1 HEMATOLOGY Q1 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q1 HEMATOLOGY Q1 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2018版] 出版当年五年平均[2014-2018] 出版前一年[2017版] 出版后一年[2019版]

第一作者:
第一作者单位: [1]Sorbonne Univ, Hop Univ Est Parisien, Hop Tenon, AP HP,Fac Med,Hematol & Thrombosis Ctr, Paris, France [2]Sorbonne Univ, Ctr Rech St Antoine, Inst Univ Cancerol,U938,Fac Med, Res Grp Canc,Haemostasis & Angiogenesis,INSERM, Paris, France [*1]Hop St Antoine, VAS European Independent Fdn Angiol Vasc Med, INSERM U938, VAS Board, Batiment Kourilsky,34 Rue Crozatier, F-75012 Paris, France
通讯作者:
通讯机构: [1]Sorbonne Univ, Hop Univ Est Parisien, Hop Tenon, AP HP,Fac Med,Hematol & Thrombosis Ctr, Paris, France [2]Sorbonne Univ, Ctr Rech St Antoine, Inst Univ Cancerol,U938,Fac Med, Res Grp Canc,Haemostasis & Angiogenesis,INSERM, Paris, France [*1]Hop St Antoine, VAS European Independent Fdn Angiol Vasc Med, INSERM U938, VAS Board, Batiment Kourilsky,34 Rue Crozatier, F-75012 Paris, France
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