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Year 2020 Vol. 28 No 3

REVIEWS

V.YA. KHRYSHCHANOVICH

MANAGEMENT PRINCIPLES OF PATIENTS WITH VENOUS THROMBOEMBOLISM DURING THE COVID-19 PANDEMIC

Belarusian State Medical University, Minsk,
The Republic of Belarus

The spread of the new SARS-CoV-2 infection, now classified as COVID-19, has become global. The physician who treats patients with COVID-19 face daily new serious problems. One of them is a high prevalence of venous thromboembolic complications, especially in the group of patients with a severe course of the infectious process. Current recommendations allow an empirical approach to prescribing anticoagulation in the case of a reasonable suspicion on the pulmonary embolism/deep vein thrombosis, if the assumed waiting period for visualization is >4/24 hours, respectively. The use of prophylactic doses of low-molecular-weight or unfractionated heparin or fondaparinux is mandatory for all COVID-19-positive inpatients throughout the entire period of hospitalization. If there are the absolute contraindications to anticoagulation, it is recommended to use compression therapy or to perform vena cava filter implantation . Most patients with the confirmed COVID-19-associated venous thromboembolism (VTE) or those with its reasonable suspicion should be prescribed a full treatment dose of anticoagulant. In ambulatory conditions for secondary long-term thromboprophylaxis the preference should be given to direct oral anticoagulants. Patients who had a ≥3-fold elevation of D-dimer level upon admission should continue the therapeutic anticoagulation after discharge. This literature review summarizes the latest recommendations on prevention, diagnosis, and treatment of COVID-19-associated VTE. Further research should focus on developing optimal management strategies for both inpatients and outpatients with COVID-19-associated venous thromboembolism (VTE ).

Keywords: venous thromboembolism, COVID-19, thromboprophylaxis, diagnosis, treatment
p. 329-338 of the original issue
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Address for correspondence:
220116, Republic of Belarus,
Minsk, pr. Dzerzhinskii, 83,
Belarusian State Medical University,
tel. +375 17277-11-55,
e-mail: scienceprorektor@bsmu.by,
Khryshchanovich Vladimir Ya.
Information about the authors:
Khryshchanovich Vladimir Ya., MD, Professor, Vice-Rector for Scientific Work, Professor of the 2nd Department of Surgical Diseases, Belarusian State Medical University, Minsk, Republic of Belarus.
http://orcid.org/0000-0001-5353-205X
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