[Learning with COVID-19: what about anticoagulation?]

An Sist Sanit Navar. 2020 Aug 31;43(2):251-254. doi: 10.23938/ASSN.0884.
[Article in Spanish]

Abstract

Infection caused by SARS-CoV-2 (COVID-19) is associated with an increased risk of thromboembolic disease. So-me authors recommend anticoagulation at therapeutic doses for, at least, the most severely ill patients; this practice is not free of risks, which is why only thromboembolic prophylaxis is recommended by other consensuses. In the case of previously anticoagulated patients, changing the oral anticoagulant for a low molecular weight heparin (LMWH) is generally recommended. We present the cases of two patients admitted due to COVID-19, without serious clinical data, in whom anticoagulation (acenocoumarol and rivaroxaban, respectively) was replaced by LMWH at therapeutic doses, both presenting abdominal bleeding. This type of bleeding is an infrequent complication in anticoagulated patients, but the concurrence of two cases in a short period of time in the context of the COVID-19 pandemic leads us to consider that there is not yet any clear evidence on therapeutic anticoagulation in SARS-CoV-2 infection.

Publication types

  • Case Reports

MeSH terms

  • Abdomen
  • Acenocoumarol / adverse effects
  • Acenocoumarol / therapeutic use
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Female
  • Hematoma / chemically induced*
  • Hematoma / diagnosis
  • Heparin, Low-Molecular-Weight / adverse effects
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Rivaroxaban / adverse effects
  • Rivaroxaban / therapeutic use
  • SARS-CoV-2
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / prevention & control*
  • Venous Thromboembolism / virology*

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Rivaroxaban
  • Acenocoumarol