Abstract
This review discusses reasons for prolonged use of anticoagulants after discharge of patients with COVID-19 without additional indication for anticoagulation. Data regarding rate of thrombotic and thromboembolic complications in patients with COVID-19 after discharge from the hospital are presented. Large randomized controlled trials EXCLAIM, ADOPT, MAGELLAN, APEX and MARINER with prolonged use of anticoagulants in patients hospitalized with acute nonsurgical diseases before pandemia of COVID-19 are discussed. The first prospective randomized controlled trial MICHELLE with direct oral anticoagulant rivaroxaban in a dose 10 mg once daily after discharge of patients with COVID-19 with high risk at least venous thromboembolism are analyzed. It seems that the most relevant approach for the determination of indications for prolonged use of anticoagulants in doses dedicated for primary prevention of venous thromboembolism after discharge of patients with COVID-19 without apparent indication for anticoagulation is a modified IMPROVE VTE risk score with the addition of elevated in-hospital D-dimer level. And the most well-studied approach for anticoagulation in these patients is a direct peroral anticoagulant rivaroxaban 10 mg once daily for 35 (and possibly up to 45) days after discharge.
Highlights
В обзоре критически анализируются основания для продленного применения антикоагулянтов после выписки больных с COVID-19, не имеющих к ним других показаний
Anticoagulants after Discharge in Patients with COVID-19: What we Know at the End of 2021 Yavelov I.S.* National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
Large randomized controlled trials EXCLAIM, ADOPT, MAGELLAN, APEX and MARINER with prolonged use of anticoagulants in patients hospitalized with acute nonsurgical diseases before pandemia of COVID-19 are discussed
Summary
В обзоре критически анализируются основания для продленного применения антикоагулянтов после выписки больных с COVID-19, не имеющих к ним других показаний. В итоге по сумме случаев смерти от венозных тромбоэмболических осложнений, ТЭЛА с симптомами, ТГВ и симптомами или бессимптомного проксимального ТГВ (по данным рутинной ультрасонографии вен нижних конечностей в конце исследования) прием профилактической дозы апиксабана в течение 30 сут не превзошел 6-14-дневные инъекции профилактической дозы эноксапарина (2,71% против 3,06% соответственно; р=0,44).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
