Martina Smolić, Department of Pharmacology and Biochemistry, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia,
Croat Med J. 2022 Jun 22;63(3):287-294. doi: 10.3325/cmj.2022.63.287.
In patients with COVID-19, thromboinflammation is one of the main causes of morbidity and mortality, which makes anticoagulation an integral part of treatment. However, pharmacodynamic and pharmacokinetic properties of direct oral anticoagulants (DOACs) limit the use of this class of anticoagulants in COVID-19 patients due to a significant interference with antiviral agents. DOACs use in COVID-19 hospitalized patients is currently not recommended. Furthermore, patients already on oral anticoagulant drugs should be switched to heparin at hospital admission. Nevertheless, outpatients with a confirmed diagnosis of COVID-19 are recommended to continue prior DOAC therapy. More studies are required to clarify the pathogenesis of COVID-19-induced derangement of the coagulation system in order to recommend an appropriate anticoagulant treatment.
在 COVID-19 患者中，血栓炎症是发病率和死亡率的主要原因之一，这使得抗凝治疗成为治疗的一个组成部分。然而，直接口服抗凝剂（DOAC）的药效学和药代动力学特性由于与抗病毒药物的显著相互作用，限制了此类抗凝剂在 COVID-19 患者中的使用。目前不建议在 COVID-19 住院患者中使用 DOAC。此外，已经服用口服抗凝药物的患者应在入院时转为肝素。然而，对于确诊 COVID-19 的门诊患者，建议继续使用之前的 DOAC 治疗。需要更多的研究来阐明 COVID-19 引起的凝血系统紊乱的发病机制，以便推荐适当的抗凝治疗。
