Effect of anticoagulant therapy on the course of COVID-19 in comorbid patients
- 作者: Ruzhentsova T.A.1, Khavkina D.A.2, Chukhliaev P.V.2, Garbuzov A.A.2, Ploskireva A.A.2
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隶属关系:
- FSBI Gabrichevsky research institute for epidemiology and microbiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
- FSBI Central Research Institute for Epidemiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
- 期: 卷 66, 编号 1 (2021)
- 页面: 40-46
- 栏目: ORIGINAL RESEARCH
- URL: https://journals.rcsi.science/0507-4088/article/view/118163
- DOI: https://doi.org/10.36233/0507-4088-14
- ID: 118163
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Introduction. Analysis of the pathogenesis of coronavirus infection caused SARS-CoV-2 indicates a significant impact of hemorheological disorders on its course and outcomes. It is known that chronic cardiovascular diseases are associated with the risk of severe course and lethal outcomes both in COVID-19 and other infectious diseases. Therefore, in each case it is necessary to study the interaction and mutual influence of different components of the treatment program prescribed to such patients.
The purpose of this work was to evaluate the effect of coagulation activity on the course of a novel coronavirus infection (COVID-19) and to justify the management of comorbid patients having been received novel oral anticoagulants (NOACs) in previously selected doses according to indications in concomitant somatic diseases.
Material and methods. Total 76 cases of confirmed coronavirus infection in patients who had been received initial therapy on an outpatient basis were analyzed. 26 patients who received NOACs (rivaroxaban, apixaban, dabigatran) made up the main group and 50 - the comparison (control) group in which patients had not been administered any drugs that affect blood clotting until the episode of COVID-19. All patients have been prescribed therapy following the Provisional guidelines «Prevention, diagnosis and treatment of coronavirus infection (COVID-19)» (https://static-0.minzdrav.gov.ru/system/attachments/attaches/).
Results and discussion. The number of hospitalizations was significantly fewer in the group of patients who had been received NOACs (19 vs. 66% in the control group). No deaths or cases of severe respiratory and/or renal failure were observed in the main group, while adverse outcomes were noted in 14% of patients who had not been administered these drugs.
Conclusion. Taking NOACs reduces the probability of severe course and adverse outcomes in the development of coronavirus infection caused by SARS-CoV-2, which indicates a significant contribution of coagulation mechanisms to the pathogenesis in COVID-19. There were no indications for drug replacement and correction of anticoagulant therapy regimens in patients who received adequate therapy with oral anticoagulants for treating a non-severe form of coronavirus infection in ambulatory patient settings.
作者简介
T. Ruzhentsova
FSBI Gabrichevsky research institute for epidemiology and microbiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
编辑信件的主要联系方式.
Email: ruzhencova@gmail.com
ORCID iD: 0000-0002-6945-2019
Tatiana A. Ruzhentsova - Ph.D., D.Sci. (Med.), Head of Clinical Research Department, Professor of the Educational Center.
Moscow, 125212
俄罗斯联邦D. Khavkina
FSBI Central Research Institute for Epidemiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
Email: havkina@gmail.com
ORCID iD: 0000-0001-5919-9841
Darya A. Khavkina - Statistician of the Clinical Research Department
Moscow, 111123
俄罗斯联邦P. Chukhliaev
FSBI Central Research Institute for Epidemiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
Email: pafachka@gmail.com
ORCID iD: 0000-0003-1210-1215
Pavel V. Chukhliaev - Methodologist of the Clinical Research Department.
Moscow, 111123
俄罗斯联邦A. Garbuzov
FSBI Central Research Institute for Epidemiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
Email: os.vertebra@mail.ru
ORCID iD: 0000-0002-3378-8418
Alexander A. Garbuzov - Methodologist of the Clinical Research Department.
Moscow, 111123
俄罗斯联邦A. Ploskireva
FSBI Central Research Institute for Epidemiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
Email: antonina@ploskireva.com
ORCID iD: 0000-0002-3612-1889
Antonina A. Ploskireva - Ph.D., D.Sci. (Med.), Assistant Professor, Associate Director for Clinical Affairs.
Moscow, 111123
俄罗斯联邦参考
- Paranjpe I., Fuster V, LalaA., RussakA.J., Glicksberg B.S., Levin M.A., et al. Association of treatment dose anticoagulation with in-hospital survival among hospitalized patients with COVID-19. J. Am. Coll. Cardiol. 2020; 76(1): 122-9. https://doi.org/10.1016/).jacc.2020.05.001.
- Lillicrap D. Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia. J. Thromb. Haemost. 2020; 18(4): 786-7. https://doi.org/10.1111/jth.14781.
- Tang N., Bai H., Chen X., Gong J., Li D., Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavi-rus disease 2019 patients with coagulopathy. J. Thromb. Haemost. 2020; 18(5): 1094-9. https://doi.org/10.1111/jth.14817.
- Wu J., Liu J., Zhao X., Liu C., Wang W., Wang D., et al. Clinical characteristics of imported cases of COVID-19 in Jiangsu Province: A multicenter descriptive study. Clin. Infect. Dis. 2020; 71(15): 706-12. https://doi.org/10.1093/cid/ciaa199.
- Steffel J., Verhamme P., Potpara T.S., Albaladejo P., Antz M., Desteghe L., et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur. Heart J. 2018; 39(16): 1330-93. https://doi.org/10.1093/eurheartj/ehy136.
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