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Thrombosis centres and AVKs monitoring in COVID-19 pandemic
Vitamin K-Antagonists (VKAs) are the treatment of choice in patients with indications other than atrial fibrillation and venous thromboembolism. Moreover, some patients still assume VKAs refusing to change their therapy when direct oral anticoagulants (DOACs) are properly indicated. The COVID-19 pan...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369471/ https://www.ncbi.nlm.nih.gov/pubmed/32686059 http://dx.doi.org/10.1007/s11739-020-02439-4 |
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author | Barcellona, Doris Marongiu, Francesco |
author_facet | Barcellona, Doris Marongiu, Francesco |
author_sort | Barcellona, Doris |
collection | PubMed |
description | Vitamin K-Antagonists (VKAs) are the treatment of choice in patients with indications other than atrial fibrillation and venous thromboembolism. Moreover, some patients still assume VKAs refusing to change their therapy when direct oral anticoagulants (DOACs) are properly indicated. The COVID-19 pandemic has completely changed our lives, nullifying inter-personal relationships to avoid contagion, making difficult the VKAs monitoring. We describe the re-organization of our thrombosis centre (TC) as an example on how to face the emergency due to the COVID-19 pandemic. In the first phase, to avoid overcrowding at the TC, we planned to increase the interval time between INRs checks and to encourage blood sampling at home, especially for elderly patients. Moreover, precise scheduled blood sampling was also organized while telephone and email counselling were guaranteed by two doctors of the TC. In the second phase, to reduce the number of patients who daily attended our TC a switch from VKAs to DOACs was carried out, if no contraindications were identified. In the third phase, to protect patients, healthcare staff and hospital from COVID-19 widespread, telemedicine was strengthened. We tried to extend self-testing at home by means of portable coagulometers to as more patients as possible. To avoid patients staying or coming back to the TC an ad hoc web platform for sending the therapeutic dose adjustment and the next scheduled appointment was developed. The TC re-organization allowed us to monitor anticoagulated patients respecting personal isolation and security measures to avoid possible COVID-19 contagion. |
format | Online Article Text |
id | pubmed-7369471 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-73694712020-07-20 Thrombosis centres and AVKs monitoring in COVID-19 pandemic Barcellona, Doris Marongiu, Francesco Intern Emerg Med IM-Point of view Vitamin K-Antagonists (VKAs) are the treatment of choice in patients with indications other than atrial fibrillation and venous thromboembolism. Moreover, some patients still assume VKAs refusing to change their therapy when direct oral anticoagulants (DOACs) are properly indicated. The COVID-19 pandemic has completely changed our lives, nullifying inter-personal relationships to avoid contagion, making difficult the VKAs monitoring. We describe the re-organization of our thrombosis centre (TC) as an example on how to face the emergency due to the COVID-19 pandemic. In the first phase, to avoid overcrowding at the TC, we planned to increase the interval time between INRs checks and to encourage blood sampling at home, especially for elderly patients. Moreover, precise scheduled blood sampling was also organized while telephone and email counselling were guaranteed by two doctors of the TC. In the second phase, to reduce the number of patients who daily attended our TC a switch from VKAs to DOACs was carried out, if no contraindications were identified. In the third phase, to protect patients, healthcare staff and hospital from COVID-19 widespread, telemedicine was strengthened. We tried to extend self-testing at home by means of portable coagulometers to as more patients as possible. To avoid patients staying or coming back to the TC an ad hoc web platform for sending the therapeutic dose adjustment and the next scheduled appointment was developed. The TC re-organization allowed us to monitor anticoagulated patients respecting personal isolation and security measures to avoid possible COVID-19 contagion. Springer International Publishing 2020-07-20 2020 /pmc/articles/PMC7369471/ /pubmed/32686059 http://dx.doi.org/10.1007/s11739-020-02439-4 Text en © Società Italiana di Medicina Interna (SIMI) 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | IM-Point of view Barcellona, Doris Marongiu, Francesco Thrombosis centres and AVKs monitoring in COVID-19 pandemic |
title | Thrombosis centres and AVKs monitoring in COVID-19 pandemic |
title_full | Thrombosis centres and AVKs monitoring in COVID-19 pandemic |
title_fullStr | Thrombosis centres and AVKs monitoring in COVID-19 pandemic |
title_full_unstemmed | Thrombosis centres and AVKs monitoring in COVID-19 pandemic |
title_short | Thrombosis centres and AVKs monitoring in COVID-19 pandemic |
title_sort | thrombosis centres and avks monitoring in covid-19 pandemic |
topic | IM-Point of view |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369471/ https://www.ncbi.nlm.nih.gov/pubmed/32686059 http://dx.doi.org/10.1007/s11739-020-02439-4 |
work_keys_str_mv | AT barcellonadoris thrombosiscentresandavksmonitoringincovid19pandemic AT marongiufrancesco thrombosiscentresandavksmonitoringincovid19pandemic |