ANTICOAGULANT THERAPY IN COVID-19

Öz

Although many organs are involved in COVID-19, the most common causes of mortality and morbidity are ARDS and thrombosis. Anticoagulant therapy has become as a standard treatment in COVID-19 due to severe thromboinflammation, diffuse intravascular coagulation syndrome and the risk of thrombosis seen as a result. Elevation of D-dimer is the most important marker of COVID-19 coagulopathy. Low molecular weight heparin (LMWH) is the first choice in almost all clinical situations. While the use of warfarin is not recommended, clearer evidence is needed on the effects of direct oral anticoagulants, aspirin and P2Y12 inhibitors. In this review, anticoagulant prophylaxis and treatment indications in COVID-19 patients and the duration of these treatments, as well as the treatment of clinical conditions associated with the disease in the follow-up of these patients will be explained in line with the recommendations of the latest guidelines.

Anahtar Kelimeler

• COVID-19
• D-Dimer
• Low Molecular Weight Heparin
• Anticoagulant Agents

COVID-19’DA ANTİKOAGÜLAN TEDAVİ

Öz

COVID-19’da birçok organın tutulumu olmakla birlikte, en sık mortalite ve morbidite sebebi ARDS ve trombozlardır. Şiddetli tromboinflamasyon, yaygın damar içi pıhtılaşma sendromu ve bunların sonucu olarak görülen tromboz riskinden dolayı, COVID-19’da antikoagülan tedavi, standart tedavi olarak yerini almıştır. D-Dimer yüksekliği, COVID-19 koagülopatisinin en önemli belirtecidir. Düşük molekül ağırlıklı heparin (DMAH) COVID-19’da ilk akla gelen antikoagülan ajandır. Hemen hemen tüm klinik durumlarda ilk seçenektir. Warfarin kullanımı önerilmezken, direkt oral antikoagülanlar, aspirin ve P2Y12 inhibitörlerinin etkileri üzerine daha net kanıtlar gerekmektedir. Bu derlemede, COVID-19 hastalarında antikoagülan profilaksi ve tedavi endikasyonları ile bu tedavilerin süresi yanı sıra, bu hastaların takibinde, hastalık birliktelik gösteren klinik durumların tedavisi de son kılavuzların önerileri doğrultusunda anlatılacaktır.

Anahtar Kelimeler

• COVID-19
• D-Dimer
• Düşük Molekül Ağırlıklı Heparin
• Antikoagülan Ajanlar

Kaynakça

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