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Cardiovascular and metabolic science
On-line version ISSN 2954-3835Print version ISSN 2683-2828
Abstract
CHACEK-SASLAVSKY, Samuel; HERNANDEZ-PEREZ, Ana Luisa; MOGUEL, Rafael and GALLARDO-HERNANDEZ, Ana Gabriela. Safe and effective early start of oral anticoagulant therapy in ambulatory patients with COVID-19. Cardiovasc. metab. sci [online]. 2021, vol.32, n.1, pp.9-15. Epub Mar 19, 2024. ISSN 2954-3835. https://doi.org/10.35366/98225.
The current pathophysiological knowledge of COVID-19 patients includes inflammation and micro-thrombus, so hospitalized patients receive low-molecular weight and unfractionated heparin, but not all patients can access these drugs. Our objective is to inform our experience with oral anticoagulants in different doses in ambulatory COVID-19 patients.
Material and methods:
This study presents a retrospective case series of COVID-19 patients, with confirmed PCR diagnosis. According to the disease burden criteria, every patient received supportive treatment plus rivaroxaban or apixaban on different doses and oxygen if needed. The team evaluated the clinical course of the disease, laboratory markers, imaging studies and the presence of complications. The statistical analysis was done with SPSS 21.
Results:
This study included forty-one patients with moderate to severe disease, from a universe of 300 patients with confirmed COVID-19 infection; the patients were allocated into one of three groups based on the severity degree and received intense anticoagulation, usual anticoagulation and usual anticoagulation plus platelet blockade. The median age was 50 years (30-75), 64% male. The D-dimer and ferritin were above normal levels in all patients. The group under intense anticoagulation had higher D-dimmer and ferritin, as well as lower lymphocyte count. This group had a shorter recovery time.
Conclusions:
In COVID-19 patients, the early initiation of oral anticoagulation at home was safe and effective, without the need for hospitalization. We found ferritin as the most important serum marker to define the patient’s stage.
Keywords : COVID-19; oral anticoagulation; outpatient treatment.
