Assessment of the influence of anticoagulant therapy on COVID-19 course and outcome

Abstract

The advent of COVID-19 has given the tasks to healthcare professionals of quickly diagnosing and providing medical care to patients. Currently, an intensive study of the clinical and epidemiological characteristics of the disease is being carried out, and the new ways of its prevention and treatment are being developed. The most common clinical manifestation of a new variant of coronavirus infection is bilateral pneumonia (viral diffuse alveolar damage with microangiopathy); the development of acute respiratory distress syndrome (ARDS) was recorded in 3-4% of patients. Hypercoagulable syndrome with thrombosis and thromboembolism are developing in some organs of patients, other organs and systems are also affected (central nervous system, myocardium, kidneys, liver, gastrointestinal tract, endocrine and immune systems); the development of sepsis and septic shock is possible [1]. The use of anticoagulant therapy with low molecular weight heparins (LMWH) reduces mortality in hospitalized patients with severe form of COVID-19, likely due to its anti-inflammatory and antiviral properties [5]. There is no proven benefit of one LMWH over another. In the suspicion of the development of venous thromboembolic complications, anticoagulant therapy can be started in therapeutic doses before the diagnosis is confirmed: during the period of inpatient treatment, LMWH should be preferred, especially Enoxaparin sodium (Clexane) or UFH, and after discharge from the hospital, it is recommended to switch to direct parenteral anticoagulants, in particular Rivaroksaban NOBEL for a period of at least 3 months [1]. The purpose of this work is to carry out a comparative assessment of the effect of anticoagulants on the clinical and laboratory course and the outcome of coronavirus infection (COVID-19).