Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients

• DOI: 10.1007/s11739-020-02331-1
• Publication Date: 2020-04-15T11:03:08Z
• Authors: Sophie Testa; Oriana Paoletti; Matteo Giorgi-Pie...; Angelo Pan
• Keywords: Critical Care; Heparin; SARS-CoV-2; Pneumonia, Viral; Administration, Oral; Anticoagulants; COVID-19; 3. Good health; Hospitalization; Betacoronavirus; 03 medical and health sciences; 0302 clinical medicine; Emergency Medicine; Internal Medicine; Humans; Drug Interactions; Infusions, Parenteral; IM-Point of view; Coronavirus Infections; Pandemics

The development of COVID-19 syndrome in anticoagulated patients, and especially their admission to intensive-care units with acute severe respiratory (SARS-CoV-2), expose them specific problems related therapy, addition those associated the viral infection. Patients on VKA hospitalized SARS-CoV-2 show high instability PT INR due variability vitamin K metabolism, diet, fasting, co-medications, liver impairment, heart failure. DOAC are exposed under/over treatment caused by significant pharmacological interferences. In consideration characteristics oral anticoagulant drugs, multiple interactions disease possible necessity mechanical ventilation hospitalization units, we suggest replacing therapies (VKA DOAC) parenteral heparin avoid risk over/under treatment.