İbrahim Halil ÖZDEMİR, Ramazan GÜNDÜZ, Mehmet Burak ÖZEN

Antikoagülan Tedavi ve COVID-19

Giriş ve Amaç: Bu çalışmada, atriyal fibrilasyonun (AF) COVID-19 hastalarında mortaliteye etkisini ve riskli AF hastalarının belirlenmesinde kullanılabilicek risk skorlarını incelemeyi amaçladık. Bunun yanında oral antikoagülan kullanımın tedavideki yerini incelemeyi amaçladık. Gereç ve Yöntemler: COVID-19 tanısı almış hastaların kayıtları retrospektif olarak incelendi. Bu hastalar içinden AF tanısı olan 48 hasta belirlendi. Hastaların yoğun bakım ihtiyacı, mortalitesi, CHA2DS2VASC ve HAS-BLED skorları kaydedildi. CRP ve D-Dimer düzeyleri kaydedildi. Hastaların kullanmış oldukları oral antikoagülan tedaviler kayıt altına alındı. Bulgular: Yoğun bakım ünitesinde takip edilen hastaların CHA2DS2VASC (yoğun bakım: 4,50±1,41, dahiliye servisi: 2,50±1,05, p

Anahtar Kelimeler:

Atriyal fibrilasyon, COVID-19, CHA2DS2VASC, HAS-BLED, antikoagülan tedavi

Anticoagulant treatment and COVID-19

Objective: In this study, we aimed to examine the effect of atrial fibrillation (AF) on mortality in COVID-19 patients and the risk scores that can be used in determining risky AF patients. In addition, we aimed to examine the place of oral anticoagulant use in treatment. Materials and Methods: Records of patients diagnosed with COVID-19 were retrospectively reviewed. Among these patients, 48 patients with a diagnosis of AF were identified. Intensive care need, mortality, CHA2DS2VASC and HAS-BLED scores of the patients were recorded. CRP and D-Dimer levels were recorded. Oral anticoagulant treatments used by the patients were recorded. Results: The CHA2DS2VASC (intensive care: 4,50±1,41, internal medicine service: 2,50±1,05, p

Keywords:

Atrial Fibrillation, COVID-19, CHA2DS2VASC, HAS-BLED, anticoagulant treatment,

PDF

___

Chen, L, Liu, W, Zhang, Q, et al., RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak, Emerging microbes & infections, 2020, 9(1), 313-319.
Zhu, N, Zhang, D, Wang, W, et al., A Novel Coronavirus from Patients with Pneumonia in China, 2019, The New England journal of medicine, 2020, 382(8), 727-733.
Mahase, E, Covid-19: WHO declares pandemic because of "alarming levels" of spread, severity, and inaction, BMJ (Clinical research ed), 2020, 368, m1036.
Wang, D, Hu, B, Hu, C, et al., Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China, JAMA, 323(11), 1061–1069.
Huang, C, Wang, Y, Li, X, et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, 2020, 395(10223), 497-506.
Inciardi, R.M, Adamo, M, Lupi, L, et al., Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy, European heart journal, 2020, 41(19), 1821-1829.
Fumagalli, S, Salani, B, Gabbani, L, Mossello, E, Ungar, A, Covid-19 cases in a no-Covid-19 geriatric acute care setting, A sporadic occurrence? European journal of internal medicine, 2020, 77, 141-142.
Barón-Esquivias, G, Manito, N, López Díaz, J, et al., Update for 2014 on clinical cardiology, geriatric cardiology, and heart failure and transplantation, Revista espanola de cardiologia (English ed), 2015, 68(4), 317-323.
January, C.T, Wann, L.S, Alpert, J.S, et al., American College of Cardiology/American Heart Association Task Force on Practice Guidelines, 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society, Journal of American College of Cardiology, 2014, 64(21), e1-76.
Chen, L.Y, Sotoodehnia, N, Bůžková, P, et al., Atrial fibrillation and the risk of sudden cardiac death: the atherosclerosis risk in communities study and cardiovascular health study, JAMA internal medicine, 2013, 173(1), 29-35.
Chen, N, Zhou, M, Dong, X, et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet, 2020, 395(10223), 507-513.
Tang, N, Li, D, Wang, X, et al., Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia, Journal of Thrombosis Haemostasis, 2020, 18(4), 844-847.
Shanghai Clinical Treatment Expert Group for Corona Virus Disease 2019, Comprehensive treatment and management of corona virus disease 2019: expert consensus statement from Shanghai [J], Chinese Journal of Infectious Diseases, 2020, 38 (00), E016-E016.
Thachil, J, Tang, N, Gando, S, et al., ISTH interim guidance on recognition and management of coagulopathy in COVID-19, Journal of thrombosis and haemostasis : JTH, 2020, 18(5), 1023-1026.
Sünmez, S, Okumuş, G, Kiyan, E, Ece, T, Arseven, O, [A case of heparin induced thrombocytopenia treated with lepirudin infusion: case report], Tuberkuloz ve toraks, 2006, 54(2), 185-188.
Thachil, J, Tang, N, Gando, S, et al., DOACs and "newer" hemophilia therapies in COVID-19: Reply, Journal of thrombosis and haemostasis, 2020, 18(7), 1795-1796.
Testa, S, Paoletti, O, Giorgi-Pierfranceschi, M, Pan, A, Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients, Internal and emergency medicine, 2020, 15(5), 751-753.
Zhang, L, Yan, X, Fan, Q, et al., D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19, Journal of thrombosis and haemostasis : JTH. 2020, 18(6), 1324-1329.
Horby, P, Lim, W.S, Emberson, J.R, et al., Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report, The New England journal of medicine, 2020.