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Open Access 01-08-2020 | Anticoagulant | IM-Point of view

Managing anticoagulation in the COVID-19 era between lockdown and reopening phases

Authors: Daniela Poli, Alberto Tosetto, Gulatiero Palareti, Doris Barcellona, Antonio Ciampa, Elvira Grandone, Cesare Manotti, Marco Moia, Alessandro Squizzato, Vincenzo Toschi, Sophie Testa, On the behalf of Italian Federation of Anticoagulation Clinics (FCSA)

Published in: Internal and Emergency Medicine | Issue 5/2020

Abstract

Patients on anticoagulant treatment are constantly increasing, with an estimated prevalence in Italy of 2% of the total population. The recent spreadout of the COVID-19 pandemic requires a re-organization of Anticoagulation Clinics to prevent person-to-person viral diffusion and continue to offer the highest possible quality of assistance to patients. In this paper, based on the Italian Federation of Anticoagulation Clinics statements, we offer some advice aimed at improving patient care during COVID-19 pandemic, with particular regard to the lockdown and reopening periods. We give practical guidance regarding the following points: (1) re-thinking the AC organization, (2) managing patients on anticoagulants when they become infected by the virus, (3) managing anticoagulation surveillance in non-infected patients during the lockdown period, and (4) organizing the activities during the reopening phases.

Prisco D, Ageno W, Becattini C, D’Angelo A, Davì G, De Cristofaro R, Dentali F, Di Minno G, Falanga A, Gussoni G, Masotti L, Palareti G, Pignatelli P, Santi RM, Santilli F, Silingardi M, Tufano A, Violi F, SIMI (Italian Society of Internal Medicine), FADOI (Federation of Associations of Hospital Doctors on Internal Medicine), SISET (Italian Society for the Study of Haemostasis and Thrombosis) (2017) Italian intersociety consensus on DOAC use in internal medicine. Intern Emerg Med 12(3):387–406CrossRef

Tosetto A, Testa S, Palareti G, Paoletti O, Nichele I, Catalano F, Morandini R, Di Paolo M, Tala M, Esteban P, Cora’ F, Mannino S, Maroni A, Sessa M, Castaman G (2019) The effect of management models on thromboembolic and bleeding rates in anticoagulated patients: an ecological study. Intern Emerg Med 14(8):1307–1315CrossRef

European Centre for Disease Prevention and Control (2020) Infection prevention and control for COVID-19 in healthcare settings—third update. 31 March 2020. Stockholm, ECDC

Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, Nigoghossian C, Ageno W, Madjid M, Guo Y, Tang LV, Hu Y, Giri J, Cushman M, Quéré I, Dimakakos EP, Gibson CM, Lippi G, Favaloro EJ, Fareed J, Caprini JA, Tafur AJ, Burton JR, Francese DP, Wang EY, Falanga A, McLintock C, Hunt BJ, Spyropoulos AC, Barnes GD, Eikelboom JW, Weinberg I, Schulman S, Carrier M, Piazza G, Beckman JA, Steg PG, Stone GW, Rosenkranz S, Goldhaber SZ, Parikh SA, Monreal M, Krumholz HM, Konstantinides SV, Weitz JI, Lip GYH (2020) cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. JACC. https://doi.org/10.1016/j.jacc.2020.03.031CrossRefPubMed

Testa S, Prandoni P, Paoletti O, Morandini R, Tala M, Dellanoce C, Giorgi-Pierfranceschi M, Betti M, Danzi GB, Pan A, Palareti G (2020) Direct oralanticoagulant plasma levels striking increase in severe COVID-19 respiratory syndrome patients treated with antiviral agents. The Cremona experience. J ThrombHaemost. https://doi.org/10.1111/jth.14871CrossRef

Tang N, Bai H, Chen X, Gong J, Li D, Sun Z (2020) Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Heamost. 18(5):1094–1099. https://doi.org/10.1111/jth.14817CrossRefPubMed

Han H, Yang L, Liu R, Liu F, Wu KL, Li J, Liu XH, Zhu CL (2020) Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. CCLM/FESCC. https://doi.org/10.1515/cclm-2020-0188CrossRef

Testa S, Paoletti O, Giorgi-Pierfranceschi M, Pan A (2020) Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients. Intern Emerg Med. https://doi.org/10.1007/s11739-020-02331-1CrossRefPubMedPubMedCentral

Schulman S, Parpia S, Stewart C, Rudd-Scott L, Julian JA, Levine M (2011) Warfarin dose assessment every 4 weeks versus every 12 weeks in patients with stable international normalized ratios: a randomized trial. Ann Intern Med 155:653–659CrossRef

10.

Barnes GD, Kong X, Cole D, Haymart B, Kline-Rogers E, Almany S, Dahu M, Ekola M, Kaatz S, Kozlowski J, Froehlich JB (2018) Extended international normalized ratio testing intervals for warfarin-treated patients. J Thromb Haemost 16(7):1307–1312CrossRef

Title: Managing anticoagulation in the COVID-19 era between lockdown and reopening phases
Authors: Daniela Poli
Alberto Tosetto
Gulatiero Palareti
Doris Barcellona
Antonio Ciampa
Elvira Grandone
Cesare Manotti
Marco Moia
Alessandro Squizzato
Vincenzo Toschi
Sophie Testa
On the behalf of Italian Federation of Anticoagulation Clinics (FCSA)
Publication date: 01-08-2020
Publisher: Springer International Publishing
Keywords: Anticoagulant
Direct Oral Anticoagulant
Oral Anticoagulant
Warfarin
COVID-19
Direct Oral Anticoagulant
Published in: Internal and Emergency Medicine / Issue 5/2020
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-020-02391-3

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