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
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.
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
推荐引用方式(GB/T 7714):
Gerotziafas Grigoris T.,Catalano Mariella,Colgan Mary-Paula,et al.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[J].THROMBOSIS and HAEMOSTASIS.2020,120(12):1597-1628.doi:10.1055/s-0040-1715798.
APA:
Gerotziafas, Grigoris T.,Catalano, Mariella,Colgan, Mary-Paula,Pecsvarady, Zsolt,Wautrecht, Jean Claude...&Zhai, Zhenguo.(2020).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.THROMBOSIS and HAEMOSTASIS,120,(12)
MLA:
Gerotziafas, Grigoris T.,et al."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".THROMBOSIS and HAEMOSTASIS 120..12(2020):1597-1628