Oral anticoagulation with rivaroxaban as thromboprophylaxis in patients recovered from COVID-19 pneumonia inveracruz, mexico

ABSTRACT

Background: Patients affected by COVID-19 are at risk of various venous and arterial thrombotic events, as well as embolic risks, the risk can vary from 17% to 78% according to the different published series. therefore, thromboprophylaxis must be imperative. Aims: To assess the use of rivaroxaban as thromboprophylaxis in recovered COVID-19 patients who are at thrombotic risk Methods: Descriptive and analytical study in patients who presented pneumonia due to COVID-19 in April and May 2020, who received LMWH during their hospital stay and at discharge with rivaroxaban 10 mg/day for 2 months. D-dimer was measured at the beginning of the study and 1 month after discharge. Thrombotic or hemorrhagic episodes are controlled after 1 and 2 months of treatment (June -July 2020). Results: 50 patients, women 40% and men 60%, with a median age of 42.9 years. 64% had mild pneumonia and 36% had severe pneumonia, mean initial D-dimer 556.5 ng/ml, 56% had D-dimer ≥ 500 ng/ ml at the time of hospital admission. Baseline D-dimer values were significantly higher in severe pneumonia. In the follow-up at one and two months, we found that D-dimer values were significantly higher among patients with severe pneumonia and also, in this group of patients, the percentage of patients with D-dimer levels ≥ 500 ng/mL in the first month of follow-up, was significantly higher in the group of patients who were hospitalized for severe pneumonia. During the first month of follow-up, there was a thrombotic event and a hemorrhagic event in the group of patients with severe pneumonia;By the second month of follow-up, there was a hemorrhagic event in the group with mild pneumonia, but this difference in frequencies was not statistically significant. TABLE 1 Variables stratified by type of pneumonia Conclusions: The incidence of thrombotic and hemorrhagic events was low, so the thromboprophylaxis scheme used in patients with recovered pneumonia due to COVID-19 is recommended. Rivaroxaban is safe to use like thromboprophylaxis.