COVID-19-associated coagulopathy: review of current recommendations for diagnosis, treatment and prevention

Лобастов К. В.; Счастливцев И. В.; Порембская О. Я.; Дженина О. В.; Барганджия А. Б.; Цаплин С. Н.

Статья

COVID-19-ассоциированная коагулопатия: обзор современных рекомендаций по диагностике, лечению и профилактике

Лобастов К. В.,

Счастливцев И. В.,

Порембская О. Я.,

Дженина О. В.,

Барганджия А. Б.,

Цаплин С. Н.,

2020

https://doi.org/10.21518/1995-1477-2020-3-4

Коронавирусная инфекция COVID-19 является высококонтагиозным заболеванием, вызванным вирусом SARS-CoV-2. Специфические протромботические изменения системы гемостаза при COVID-19 ассоциируются с повышенной частотой возникновения венозных тромбоэмболических осложнений. Статья представляет собой обзор литературы по диагностике, лечению и профилактике коагулопатии и венозных тромбоэмболических осложнений, ассоциированных с COVID-19. Изучено 11 исследований, оценивающих частоту регистрации венозных тромбоэмболических осложнений, и 11 клинических рекомендаций по коррекции коагулопатии, опубликованных до 22 мая 2020 г. Частота развития венозных тромбоэмболических осложнений оказалась неожиданно высокой: 8–13% в отделении общего профиля и 9–18% в отделении интенсивной терапии на фоне превентивных мероприятий. Профилактические дозы антикоагулянтов, низкомолекулярные гепарины или нефракционированный гепарин показаны всем госпитализированным пациентам. Продленная профилактика после выписки из стационара может быть рекомендована лицам с высоким риском венозных тромбоэмболических осложнений и низким риском кровотечения. Увеличение Д-димера может рассматриваться в качестве показания для инструментального поиска венозных тромбоэмболических осложнений. При подозрении на развитие венозных тромбоэмболических осложнений антикоагулянтная терапия в лечебных дозах может быть начата до подтверждения диагноза: в период стационарного лечения следует отдавать предпочтение низкомолекулярным гепаринам или нефракционированным гепаринам, после выписки из стационара рекомендуется перевод на прямые оральные антикоагулянты на срок не менее 3 мес. Рутинная профилактика венозных тромбоэмболических осложнений у амбулаторных пациентов не рекомендуется.

Цитирование

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1. Version of Record от 2020-06-28

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Об авторах

Лобастов К. В.
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Счастливцев И. В.
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Порембская О. Я.
Северо-Западный государственный медицинский университет им. И.И. Мечникова
Дженина О. В.
Первый флебологический центр
Барганджия А. Б.
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Цаплин С. Н.
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова

Предметная рубрика

COVID-19

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Нospital-replacing technologies:Ambulatory surgery

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journal article

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CC BY

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elpub

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COVID-19-ассоциированная коагулопатия: обзор современных рекомендаций по диагностике, лечению и профилактике

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