The realities of the anticoagulant therapy using in COVID-19

Background. The SARS-CoV-2 virus invasion lead to COVID-19-associated coagulopathy accompanied with increased incidence of thrombotic complications. Current clinical guidelines give the main approaches to the treatment and prevention of them;however their implementation is not always possible in practice. In fact, there are a lot of violations including with a systemic genesis and associated either with the low understanding of infectious process pathogenesis aspects by clinicians or with their excessive desire to prevent coagulation disturbances. the revealing of real clinical practice conditions in the treatment and prevention of thrombotic complications in patients with coronavirus infection COVID-19. Materials/Methods. We provided an anonymous poll for 223 experts treating patients with chronic and acute vascular diseases. The questionnaire included 18 questions to identify as the experts attitude to this challenge as a whole as well as to their choice of treatment tactics, and anticoagulant drugs, and methods of laboratory monitoring of blood coagulation. Results. Most participants know the increased risk of thrombotic complications in COVID-19 and they are puzzled by it The treatment of COVID-19-associated coagulopathy is considered as the priority goal of anticoagulant therapy in the acute phase of COVID-19 whereas the prevention of venous thromboembolic complications is noted as main goal in convalescences. Low molecular weight heparins have gotten the highest confidence in the administration among anticoagulants. In turn, the most of experts use direct oral anticoagulants in outpatients even despite no confirmation is for DOAC’s effectiveness from randomized trials in this time. Besides it was revealed wide spread of opinions and low count of correct responses about laboratory control of the hemostatic system and anticoagulants. Conclusion. The analysis showed a serious inconsistency between the real anticoagulants administration in patients with COVID-19 and the recommendations of clinical guidelines. This circumstance obviates the need to raise educational level of physicians and surgeons in the field of blood coagulation. © Gemostaz i Reologia LLC, 2021.