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Mandatory Fields
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;Hamadé 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; ;
Journal Of Thrombosis And Haemostasis
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.
Optional Fields
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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