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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
GT. Gerotziafas, M. Catalano, MP. Colgan, Z. Pecsvarady, JC. Wautrecht, B. Fazeli, DM. Olinic, K. Farkas, I. Elalamy, A. Falanga, J. Fareed, C. Papageorgiou, RS. Arellano, P. Agathagelou, D. Antic, L. Auad, L. Banfic, JR. Bartolomew, B. Benczur,...
Language English Country Germany
Document type Journal Article, Review
- MeSH
- Anticoagulants therapeutic use MeSH
- COVID-19 diagnosis epidemiology MeSH
- COVID-19 Drug Treatment MeSH
- Heparin, Low-Molecular-Weight therapeutic use MeSH
- Cardiology * MeSH
- Cardiovascular Diseases diagnosis drug therapy epidemiology MeSH
- Humans MeSH
- Rivaroxaban therapeutic use MeSH
- Risk Factors MeSH
- SARS-CoV-2 physiology MeSH
- Practice Guidelines as Topic MeSH
- Societies, Medical MeSH
- Thrombophilia MeSH
- Thrombosis MeSH
- Inflammation MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Europe MeSH
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.
Angiologie Centre Cours du Médoc Médecine Vasculaire Travail Bordeaux France
Angiology Unit Azienda Ospedaliera Universitaria Integrata di Verona Verona Italy
Angiology Unit Evangelismos General Hospital Athens Greece
Angiology Unit Internal Medicine Department Città Sant' Angelo Hospital AUSL 03 Pescara Italy
Balassa Janos County Hospital University Medical School Szeged Hungary
Cardiology Department University Hospital Sart Tilman Liege Belgium
Center for Clinical Physiology Faculty of Medicine University of Ljubljana Ljubljana Slovenia
Cleveland Clinic Cleveland Ohio United States
Departement of Surgery Ministry of Health Saudi Arabia
Department of Angiology Hypertension and Diabetology Wroclaw Medical University Wroclaw Poland
Department of Angiology St Imre University Teaching Hospital Budapest Hungary
Department of Cardiovascular Surgery Faculty of Medicine Gazi University Besevler Ankara Turkey
Department of Inrterventional Cardiology American Heart Institute of Cyprus Nicosia Cyprus
Department of Internal Medicine Central Hospital of Bolzano Bolzano Italy
Department of Pathology Loyola University Medical Center Maywood Illinois United States
Department of Preventive Cardiology Thomayer Teaching Hospital Prague Czech Republic
Department of Vascular Medicine Concord Repatriation General Hospital Sydney Australia
Department of Vascular Medicine Flor Ferenc Teaching Hospital Kistarcsa Hungary
Department of Vascular Surgery St James's Hospital Trinity College Dublin Dublin Ireland
Department of Vascular Surgery Xuanwu Hospital Capital Medical University Beijing China
Department Vascular Medicine Mulhouse Hospital Center Mulhouse France
Diabetic Foot Clinic King's College Hospital London United Kingdom
Division of Angiology Department of Internal Medicine 2 Medical University of Vienna Vienna Austria
Faculty of Medicine Comenius University Bratislava Slovak Republic
Hellenic Society of Hematology Athens Greece
Human Molecular Genetics de Duve Institute University of Louvain Brussels Belgium
Immunology Department Avicenna Research Institute Mashhad University of Medical Sciences Iran
Institute of Respiratory Medicine Chinese Academy of Medical Sciences Beijing China
Internal Medicine Department Hospital Perea Mayaguez Puerto Rico United States
Klinik für Angiologie Zentrum für Innere Medizin 2 Ernst von Bergmann Klinikum Potsdam Germany
MATMED s r o Private Angiology Facility Hodonin Czech Republic
Medical Clinic No 1 University of Medicine and Pharmacy Cluj Napoca Romania
Medical School of Crete University of Crete and Heart Sector Hellenic Healthcare Group Athens Greece
Philippine Society of Vascular Medicine Manila Philippine
Service de Pathologie Vasculaire Hôpital ERASME Université Libre de Bruxelle Brussels Belgium
Specialist Hospital Bytom Jan Długosz University in Częstochowa Częstochowa Poland
Université de Paris CRESS INSERM INRA URCEco AP HP Hôpital de l'Hôtel Dieu Paris France
University Hospital Center School of Medicine University of Zagreb Croatia
UOSD Angiology San Camillo Forlanini Hospital National Health Institute ISS Rome Italy
Vascular Medicine University of Chicago Northshore Cardiovascular Institute Skokie Illinois US Army
References provided by Crossref.org
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