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2020, Number 4

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Rev Hematol Mex 2020; 21 (4)

Anticoagulation strategies in patients with COVID-19

Jiménez-Soto R, Montiel-Romero S, Neme-Yunes Y, Demichelis-Gómez MR, Inclán-Alarcón SI

Language: Spanish
References: 55
Page: 210-224
PDF size: 428.72 Kb.


ABSTRACT

SARS-CoV-2 disease (COVID-19) is an emerging disease of global concern. The pathophysiology, spectrum of presentation, and complications are not fully described, among them is coagulopathy with a prothrombotic phenotype associated with a poor prognosis. There are various mechanisms involved such as excessive inflammation, hypoxemia, immobilization and disseminated intravascular coagulation (DIC), among others. Being a vascular disorder, anticoagulation is a key point in treatment; however, currently there is insufficient evidence to establish a standard of treatment for the management of anticoagulation in these patients. This paper is a narrative review of the literature in which 55 review papers were included. Recommendations for the management of coagulopathy associated with COVID-19 are issued in different evidence-based scenarios: standard prophylactic anticoagulation, intermediate prophylactic or therapeutic during hospitalization, at discharge, in outpatient management and other special conditions. We currently lack prospective clinical trials that evaluate these scenarios in COVID-19. It is recommended that all patients with admission criteria for this disease receive prophylactic anticoagulation and assess a more intensive scheme according to an individualized and dynamic strategy.


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