Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine
机构：[1]Hematology and Thrombosis Center, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine, Sorbonne Université, Paris, France[2]Research Group Cancer, Haemostasis and Angiogenesis,” INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Paris, France[3]Research Center on Vascular Disease & Angiology Unit, Department of Biomedical Science, L Sacco Hospital, University of Milan, Milan, Italy[4]Department of Vascular Surgery, St. James’s Hospital/Trinity College Dublin, Dublin, Ireland[5]Department of Vascular Medicine, Flor Ferenc Teaching Hospital, Kistarcsa, Hungary[6]Service de Pathologie Vasculaire, Hôpital ERASME, Université Libre de Bruxelle, Brussels, Belgium[7]Immunology Department, Avicenna (Bu-Ali) Research Institute, Mashhad University of Medical Sciences, Iran[8]Medical Clinic No. 1, University of Medicine and Pharmacy, Cluj- Napoca, Romania[9]Department of Angiology, St. Imre University Teaching Hospital, Budapest, Hungary[10]Department of Obstetrics and Gynecology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia[11]Department of Immunohematology and Transfusion Medicine, & the Thrombosis and Hemostasis Center, Hospital Papa Giovanni XXIII, Bergamo, Italy[12]Department of Pathology, Loyola University Medical Center, Maywood, Illinois, United States[13]Service Anesthésie, Réanimation et Médecine Périopératoire, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de médecine, Sorbonne Université, Paris, France[14]Philippine Society of Vascular Medicine, Manila, Philippine[15]Department of Inrterventional Cardiology, American Heart Institute of Cyprus, Nicosia, Cyprus,[16]Clinic for Hematology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia[17]Medicina Vascular, Sanatorio Allende Córdoba, Ciencias Médicas, Universidad Católica de Córdoba, Argentina[18]University Hospital Center, School of Medicine University of Zagreb, Croatia[19]Cleveland Clinic, Cleveland, Ohio, United States[20]Balassa Janos County Hospital, University Medical School, Szeged, Hungary[21]Department of Cardio-Thoracic-Vascular and Endovascular Surgery, Unit of Lymphatic Surgery, IRCCS S. Martino Hospital, University of Genoa, Italy[22]Department of Preventive Cardiology, Thomayer Teaching Hospital, Prague, Czech Republic[23]Angiology and Blood Coagulation, Department of Specialty, Diagnostic and Experimental Medicine, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy[24]Angiology Unit, Cardiovascular and Thoracic and Medicine Department, Verona University Hospital, Verona, Italy[25]Vascular Unit of 3rd Department of Internal Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece[26]Hellenic Society of Hematology, Athens, Greece[27]Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece[28]Université de Paris, CRESS, INSERM, INRA, URCEco, AP-HP, Hôpital de l’Hôtel Dieu, Paris, France[29]Diabetic Foot Clinic, King’s College Hospital, London, United Kingdom[30]Departement of Surgery, Ministry of Health, Saudi Arabia[31]Department of Cardiovascular Surgery, Faculty of Medicine, Gazi University, Besevler/Ankara, Turkey[32]Internal Medicine Department, Hospital Perea, Mayaguez, Puerto Rico, United States[33]Section of Internal and Cardiovascular Medicine, Department of Medicine, -University of Perugia, Perugia, Italy[34]MedizinischeUniverstiätWien, Universitätsklinik für Innere Medizin II, Klinische Abteilung für Angiologie, Vienna, Austria[35]Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing China[36]The Whitaker Cardiovascular Institute Department of Medicine Boston University School of Medicine, Boston, Massachusetts, United States[37]Vascular Medicine Unit, Internal Medicine Department, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia[38]Department Vascular Medicine, Mulhouse Hospital Center, Mulhouse, France[39]Department of Cardiovascular Surgery, Medical School of Alaaddin Keykubat University, Alanya/Antalya, Turkey[40]Second Department of Medicine, Department of Cardiovascular Medicine, Charles University in Prague, Prague, Czech Republic[41]Department of Vascular Medicine, Concord Repatriation General Hospital, Sydney, Australia[42]Klinik für Angiologie, Zentrum für Innere Medizin II, Ernst von Bergmann Klinikum, Potsdam, Germany[43]Department for Vascular Diseases, Medical Faculty of Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia[44]Board member of the Institute for the Study and Education on Thrombosis and Antithrombotic Therapy, Athens, Greece[45]Angiology Unit, Internal Medicine Department., Città Sant’ Angelo Hospital, AUSL 03, Pescara, Italy[46]Portiuncula University Hospital, Soalta University Health Care Group, National University of Ireland Galway (NUIG), Galway, Ireland[47]Unità di Medicina Vascolare e Autoimmunità, CRIIS-Centro di riferimento interdisciplinare per la Sclerosi Sistemica, Rome, Italy[48]Department of Internal Medicine, Central Hospital of Bolzano, Bolzano, Italy[49]Angiology Unit, Evangelismos General Hospital, Athens, Greece[50]MATMED s.r.o., Private Angiology Facility, Hodonin, Czech Republic[51]Angiologie Centre Cours du Médoc, Médecine Vasculaire Travail, Bordeaux, France[52]UOSD Angiology, San Camillo-Forlanini Hospital, National Health Institute ISS, Rome, Italy[53]Medical Association of Slovenia and SMA, Slovenia Academic Research Centre, Slovenian Medical Academy, Ljubljana, Slovenia[54]Angiology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy[55]Division of Angiology, Department of Internal Medicine 2, Medical University of Vienna, Vienna, Austria[56]Department of InternalMedicine, Angiology and PhysicalMedicine, Medical University of Silesia, Katowice, Poland[57]Specialist Hospital, Bytom, Jan Długosz University in Częstochowa, Częstochowa, Poland[58]Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Stockholm County, Sweden[59]Department of Medicine, Anticoagulation and Clinical Thrombosis Services, Northwell Health at Lenox Hill Hospital, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, The Feinstein Institute for Medical Research, New York, New York, United States[60]Cardiology Department, University Hospital Sart Tilman, Liege, Belgium[61]Center for Clinical Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia[62]Department of InternalMedicine, Angiology and PhysicalMedicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Bytom, Poland[63]Faculty of Medicine, Comenius University, Bratislava, Slovak Republic[64]Department of Angiology, Hypertension and Diabetology,Wroclaw Medical University, Wroclaw, Poland[65]Vascular Medicine University of Chicago, Northshore Cardiovascular Institute, Skokie, Illinois, US Army[66]Medical School of Crete, University of Crete and Heart Sector, Hellenic Healthcare Group, Athens, Greece[67]Department of Noninvasive vascular laboratory, Clinic of Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia[68]Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium[69]Department of Cardiovascular Medicine, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota, United States[70]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Peking University Health Science Center, Capital Medical University, Beijing, China[71]Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital discharge using the IMPROVE-D-dimer score and prolonged post-discharge thromboprophylaxis with rivaroxaban, betrixaban, or LMWH.
第一作者机构：[1]Hematology and Thrombosis Center, Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine, Sorbonne Université, Paris, France[2]Research Group Cancer, Haemostasis and Angiogenesis,” INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Paris, France
通讯机构：[*1]VAS Board, VAS-European Independent Foundation in Angiology/Vascular Medicine (www.vas-int.net). INSERM U938 Bâtiment Kourilsky, 34 rue Crozatier, Hôpital Saint Antoine, Paris, Cedex 75012, France
推荐引用方式(GB/T 7714)：
Grigoris T. Gerotziafas,Mariella Catalano,Mary-Paula Colgan,et al.Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine[J].THROMBOSIS AND HAEMOSTASIS.2020,120(12):1597-1628.doi:10.1055/s-0040-1715798.
APA：
Grigoris T. Gerotziafas,Mariella Catalano,Mary-Paula Colgan,Zsolt Pecsvarady,Jean Claude Wautrecht...&Scientific Reviewer Committee.(2020).Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine.THROMBOSIS AND HAEMOSTASIS,120,(12)
MLA：
Grigoris T. Gerotziafas,et al."Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine".THROMBOSIS AND HAEMOSTASIS 120..12(2020):1597-1628
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